Re: Consult with Dr West in Seattle! YEAH!

[Guest guest]

Hi Fran,

Thanks so much for the update. Wow, sounds like you will have a lot of

stuff done! I'll bet it'll change your life, though. I also have the

receded jaw/chin bump that you described. It'd be interesting to share

pictures sometime if you want to, as I hardly ever see people with my

type of problem.

I'm meeting with Dr. West for the first time in May, and I'm both

really excited and somewhat nervous. I am so hopeful that he will tell

me my appearance can be improved, as he did you.

Yeah, it's expensive. I'm paying all the orthodontia out of pocket,

and I'll end up paying most of the surgery ($8,000 with maybe $2,500

reimbursed by insurance) myself. It's a lot. But I'm hoping it will

help me feel better about myself, and if it does, it will be so worth it.

I too look forward to your next post!

Luna

[Guest guest]

Hi Diane,

Did you see my post on the answers to questions? I hope it will

help you with some of your plans for the early phase of the

recovery. That is soooooooooo cool about surgery being that close

for you! I am sure you are getting excited for that!! I would be!

Dr West gave me two options for the surgery. One with the upper jaw

included with the lower jaw, and one without the upper jaw. I was

kind of in overwhelm on the day of the consult. If I do just the

lower jaw, the volume will be less in my mouth. He said they would

lower the jaw as much as they can lower the upper jaw. So, without

the upper being done, the lower will basically just be pulled

forward, to the right and rotated to the right. No downward

extension. I didn't know what to decide, though when asked, he said

that if I want more volume, doing both would more approximate that.

I have since decided to to both the upper and lower. It makes no

sense to just make the jaw a little better, when adding the upper

gives me a chance to really have a more normal funcioning mouth. I

want the best result I can have from this surgery and with ONE

recovery!!

I will call my OD (Dr Chad Smart in Tacoma, WA), Monday and set up

an appointment with him, and my dentist (Dr in Fircrest,

WA) about the crowns post recovery. Since the plan has changed

somewhat about the full mouth rehab, I want to make sure what his

plans are and approximate expense related to that. I should know

more in the next couple of weeks I would think. I am hoping to get

my braces on as soon as they can be scheduled after I talk with both

doctors. I already know that the OD will take payments, and am

hoping my dentist will do the same so I don't have a huge lump sum

bill for it. I hope he will be me a discount on my portion of it

too. I will let you know.

And way to go about a possible time frame! Keep me posted!

Hugs,

Fran

> Fran,

>

>

>

> This is wonderful news! I'm glad Dr. West was able to give you the

answers

> you were wanting.

>

>

>

> When I saw him, I too was impressed with the time he took with me.

It sounds

> like he really spent a lot of time with you. I'm sure this was very

> comforting for you. I can imagine how excited you felt when you

left

> thinking there is hope!! I can see why he is so highly regarded in

the

> Northwest.

>

>

>

> Three to four years can be a long time, but can also go by very

quickly.

> Take it one step at a time and you'll reach the top! When are you

getting

> your braces on?

>

>

>

> When I went to the orthodontist last week he said I would be ready

for

> surgery in three to seven months!

>

>

>

> Please keep in touch and let me know how things are progressing. I

look

> forward to seeing the answers to your questions.

>

>

>

> Best wishes,

>

>

>

> Diane

>

>

>

> _____

>

> From: orthognathicsurgerysupport

> [mailto:orthognathicsurgerysupport ] On Behalf Of

> franesmith2000

> Sent: Saturday, April 16, 2005 12:27 PM

> To: orthognathicsurgerysupport

> Subject: Consult with Dr West in

Seattle!

> YEAH!

>

>

>

>

> Hi everyone,

> As promised, here is a report of my consult. I will post the

> answers to the questions people from this board asked as well, but

> will do that in a separate post. It will be shorter that way, and

> more specific to your questions.

>

> No problem at all regarding asking about the consult! I am so

> excited to tell you!

>

> First, the consult was great. He took like 2 hours or more with me

> about this! He is totally nice, which I had already heard. He

> answered all my questions, and I had them typed up! lol I even had

> other peoples questions from the orthognathic board. lol He

answered

> them all.

>

> First, my problem is that I have limited space between my jaws. I

> have a really deep bite and a small overbite. My arches are flat

and

> my teeth small. My jaw is receded, but have a button on the end of

> my chin, so my profile is normal looking. My teeth are straight

and

> even. Even though my jaw is " z " shaped, the body is amazing and

> likes to be symmetrical. It has compensated with extra fat on one

> side, so that in looking at me straight on, you don't know that I

> am " Z " shaped at all. When I tip my head back, THEN you can see it

> clearly. I never knew I had this problem until Dr Rashi mentioned

> that I had a jaw problem. No one ever said that to me before. Then

> my dentist mentioned it to me. He took over from my old dentist,

and

> the new one had this type of surgery himself, so he was really in

> tune with it.

>

> I cannot fit a bite of food in my mouth with my teeth closed. I

have

> no room at all, even for a relaxed tongue. To clench my teeth, I

> have to pull my tongue back into my throat, and glue it to the

roof

> of my mouth about 1/3 of the way back from my upper teeth, due to

> the shape of my palate. I pocket food into my cheeks and feed very

> small pieces of food into the back molars to chew and swallow. I

> choke really often (my throat is constricted a bit too, from

thyroid

> cancer surgery 15 years ago this month). I have callouses on the

> inside of my cheeks from eating this way! lol

>

> Okay, enough background. I have been to three orthodontists after

> speaking with my dentist. They all said the same thing and

> recommended the same orthognathic surgeon. Dr West in Seattle. He

> was amazing.

>

> I did have, from one of my consults with the OD's, a set of molds

> and panoramic x-rays for Dr West.

>

> The first thing he said to me, after introductions and all, was

that

> he thought I needed a functional rhinoplasty. I think so too, but

I

> have never had any doctor tell me this. My right septum is so bad

> about midpoint, that the right side is completely blocked. When my

> left side swells from a cold or whatever, I am a total mouth

> breather! Dr West will repair the base of the septum with the

> maxilla repair (the base is separated when the upper jaw is broken

> and sawn), but he said I would need the rhinoplasty after the jaw

> surgery to correct the upper septal blockage. And he said my

> deviation is so obvious (from the inside only, the outside looks

> fairly straight), that is should be covered by insurance. I didn't

> even ask him about this. Amazing! He was going to recommend it for

> me.

>

> He is recommending that I have both upper and lower jaw work. For

> the upper, he will saw the maxilla lengthwise, then segment it - I

> am not entirely sure what this part means, but I think it means he

> will also break it in two places vertically to contour it - lower

it

> and move it out toward the tip of my nose. He will use bone graft

> from my hip to fill in the spaces, screw it and plate it with

> titanium. He will fix the base of my nasal septum with this part

of

> the procedure. He said bringing this forward and down will improve

> significantly the NL fold area. He also said it would balance my

> face. What I have hated all my life, thinking my cheeks were too

> full, is not the case. The cheeks are fine, it is the upper jaw

that

> is receded and flattened (I think this is what he was referring to

> anyway). By adjusting them, it will balance and give symmetry to

my

> face. I am thrilled with this part of it!!! I have always hated my

> chipmonk cheeks. And it was never them from the start!! I am

amazed!

>

> The lower will be broken past the vertical part of the jaw, and

> split anterior to posterior (kind of a slice), moved forward, down

(

> the same amount as is moved downward on the upper maxilla), to the

> right and rotated to the right. It will also be held with titanium

> and then banded for recovery and healing. It will add length to

the

> lower part of my face and allow my tongue to fit, my lips to fit

> normally without scrunching (the upper anyway), and hopefully I

will

> be able to chew in a more normal fashion. He is hopeful that it

will

> free up my tongue enough to help me with the frequent choking.

>

> I will start braces, which I will be in for about 18 months to 2

> years. Then the surgery, followed by more braces. When they are

> stabile, they will crown all of my front and front molar teeth. He

> thinks we can avoid having to crown all of my back molars, by

having

> the OD move the teeth up from the root. This will add length to

them

> so they will be able to support the new jaw positions. The fronts

> are already too short, and cannot be moved that much to make up

the

> difference, so they will just space them a little, lightly abrade

> them and add the crowns. Because all of the visable ones will be

> done, my dentist says I can go really white. I will never need

> bleaching again! YEAH!!

>

> Of course, this is a lot to do, and a long process and longer

> recovery. I am looking at 3-4 years total. The surgery and most of

> the crown expense will be handled by insurance. Unfortunately, the

> orthodontia will not be covered. It is excluded for adults with

our

> policy, even for medically necessary reasons. So that is $5500 out

> of pocket, and the $1000 for the co pay on surgery, and the copay

> for crowns. It is going to be spendy. But the OD will take

payments

> on the braces, and I am going to try to work out a deal with my

> dentist who will be doing the near full mouth rehab and crown

work,

> as I will be one of his first cases with this. We will see.

>

> I have decided to do it. I think, long term, that it will be very

> beneficial, and even life saving. I will let you know how it

> progresses. And keep me posted as to your situations too!

> Hugs,

> Fran

>

>

>

>

>

>

>

> _____

>

>

[Guest guest]

Hi Luna,

I am sure your consult will go fine. Dr West seems to have a good

eye for the asthetic result as well as the functional result. I am

sure it is a well educated and studied eye! And he is so nice, you

feel free to ask him questions that you REALLY have! I mean about

how you feel about the way it looks or the way you look when you

eat, which kind of surprised me. I have been to a lot of

specialists. There have been very few who are open and emotionally

available to you. He is definately on that short list of available

specialists. He comes out to the waiting room to get you even!

lol When was the last time a specialist did that? lol

You are going to do fine. And the time until your consult date will

pass quickly too. I remember looking down the road for weeks and

wondering and worrying. But it seems short now! lol I don't know

why that happens, but it will pass for you too. I am relieved just

to have a definate plan and am ready to get started. I will keep

you posted and watch for your posts about your upcoming date too!

Hugs,

Fran

>

> Hi Fran,

>

> Thanks so much for the update. Wow, sounds like you will have a

lot of

> stuff done! I'll bet it'll change your life, though. I also have

the

> receded jaw/chin bump that you described. It'd be interesting to

share

> pictures sometime if you want to, as I hardly ever see people with

my

> type of problem.

>

> I'm meeting with Dr. West for the first time in May, and I'm both

> really excited and somewhat nervous. I am so hopeful that he will

tell

> me my appearance can be improved, as he did you.

>

> Yeah, it's expensive. I'm paying all the orthodontia out of pocket,

> and I'll end up paying most of the surgery ($8,000 with maybe

$2,500

> reimbursed by insurance) myself. It's a lot. But I'm hoping it will

> help me feel better about myself, and if it does, it will be so

worth it.

>

> I too look forward to your next post!

>

> Luna