Oral Maxillofacial Surgery

How Did My Face Measure Up?

My oral maxillofacial surgeon is Dr. Leonard Kaban at Massachusetts General Hospital. Before meeting up with him, some of his colleagues did a bunch of pictures, measurements, x-rays, and scans.

<--- What adjectives do you like to hear when people look at your face? I got "moderately convex." That's ok. At least my face isn't severely concave.

In my profile x-rays (below), you'll see in the first one that my profile is relaxed and my (endearing) overjet is hanging over my lower teeth like a prominent dental awning. In the second film, they asked me to jut my lower jaw as far forward as I possible could. (Then they told me to "try harder.") Notice the diameter of my trachea indicated by the red crossbar. My airway is significantly closed off by my recessed jaw and opens when I move it forward. I've even learned to do this now. When I take a deep breath, I move my jaw forward and I can breathe easier.

What is the Medical Term for F#@ed Up?
As one of the fellows measured my facial landmarks with odd tools and dental floss, he mumbled distances and comments to an assistant who took notes. "Mr. Shull presents with hypothelorism and diastema," he stated indifferently.

"Just so you know," I interjected, "I know what those words mean and I'll try not to be offended. (A little medical humor on my part). But, I was surprised by the first. Hypothelorism is abnormally close-set eyes and diastema is a gap between the two front teeth.

Knowing I'm a speech pathologist, he added "Oh, you must've learned those terms in your Craniofacial Abnormalities class." Wow. Really? Ok. Then I really was offended... a little.

The Plan(s)
During my follow-up with Dr. Kaban, he presented three options. The first step in each required getting braces (done) and the extraction of some impacted wisdom teeth. The goal of the braces is to move my teeth so my bite will align post-surgery. He also wants to open my narrow upper arch and move my upper teeth as far forward as possible to reduce the distance my jaw will have to be displaced. In essence, increasing my overjet. To which I replied, "I'll look like a rake!" Yeah, I got nothing. I suppose it's good to have surgeons without senses of humor.

Once my teeth have been sufficiently moved forward, they will break my lower jaw (and probably upper jaw) and move them forward and set them in place with titanium screws. 

I Sleep like a Log – Being Sawed by a Rusty Chainsaw.

I have snored my whole life. I'm not talking, "Zzzzzzz." It vibrates the keys sitting on my dresser. I can be heard through walls and I'm told through ceilings. My snoring is a source of anxiety and embarrassment.

I keep people up at night. When I was little I went skiing with a friend's family. A group of us boys shared a room with bunk beds. By the end of the weekend, they were plotting revenge – what should they do to me in my sleep? (Bowl of cold water? shaving cream?) Anyone who sleeps near me spends their night rolling over, huffing, fluffing pillows, and grunting. They feign coughing or loudly clearing their throat hoping to wake me long enough for them to fall asleep. But I don't wake up. If I do, its for about .001 seconds. Frustration builds until they cannot take it anymore. Eventually, they yell, push, or punch me awake. It's jarring to wake up to someone yelling at you. To me it seems like it comes out of nowhere. By now I've experienced it enough (and listened to people recount every detail of how miserable they were) that I have come to expect it. I suppose its only fair for me to have to endure their stories. They had to spend a sleepless night listening to me.

Sharing a room with someone has become stressful. I might fall asleep with a friend, but I will probably wake up to someone who wants to smother me with a Pillow Pet™. I make people miserable while I'm unconscious – the ultimate passive aggressive.

I really didn't think anything could be done. But I was given an ultimatum. So, I finally went and talked to my doctor. He referred me for a Sleep Study.

This blog will document the extreme process to stop my snoring.