What it's like to be wired shut

I thought I'd share a bit about what it's like to have your mouth wired shut. This is one of the main reasons that I wanted to write this blog. One of the first things I did when I found out that I was going to have to be wired shut eventually was look up what to expect. It turns out that the majority of people who are writing about their experiences are doing it as a recommendation from their orthodontist to correct bite problems. Now, don't get me wrong - some folks have really bad issues that need correcting.  Some don't even seem like much of a choice, their bites were so off to begin with it made more sense to have the surgery than not. But that wasn't my experience. I was already in rough shape, and the outcome of my surgery was a hope to get things aligned - no promises of a better facial structure, more attractive profile, etc. 

When Dr M told me that I was going to be wired shut, I didn't really think twice. I just wanted to fix my mouth. By this point I had been healing for about a month, and my whole lower jaw was really swinging over to the left side. Teeth weren't lining up, my face was crooked....I mean anything to fix that was ok with me. I had been thinking since the beginning of this experience that I should be wired shut anyhow..I mean my mandible was fractured at both contact points to my skull. How could it heal properly while just hanging there by muscles? I have since learned that this is a very viable treatment option when one side at least is not displaced. So I did some research to see what it might be like. Here are some things folks said: 

- You will be hungry

- You will "eat" from a syringe 

- You might feel claustrophobic 

- You may not be able to breathe well/get winded easily

- You will be able to talk 

- It will hurt to yawn. 

Here's what I found to be my experience. 

- I was hungry 

- I had to eat through a syringe 

- I never felt claustrophobic

- I was able to breathe just fine, but there were some instances where I had to breathe through my mouth (if I over exerted myself) and had to open my lips wide to get the air to pass quickly through my teeth. 

- I was able to talk. But, since the fractures were right near my TMJ joint, it was very tiring to do. 

- I found myself clenching my teeth a lot. This was a reflexive thing, to keep them from chattering or bumping together. 

- Yawning is hell! It's wiser to have a nap than let yourself get tired enough to yawn. 

One thing that I didn't expect was how much my jaw would spasm and jerk all over the place. Completely uncontrollably, and it is very painful. It would also cause my teeth to bash together, which was even worse. This wasn't really to do with being wired shut, but is something that happens to most people with broken jaws. Taking muscle relaxers really helped with this, just over the counter Robax, though my Dr prescribed me Valium to help with that as well. 

Now lets get to the most awful part of being wired shut. THE HUNGER!! This was the theme of my life. I cried over the hunger. I whined. I bitched and moaned. I even almost screamed the wires open one day. This is no joke. You just cannot ever feel satisfied on liquids alone. You can fill your belly with enough that your stomach isn't growling, but you will never feel full. When I started this experience, I was probably around 150 lbs, and 6 feet tall. This is a totally normal BMI, but I didn't get wired shut until a month after the accident, so by then I'd been on a no-chew diet for as long. I'm sure I had lost 5 lbs since August 12, if not more. So this was just the next step in my starvation diet I guess. By the end of the wiring, I was down to 135 lbs and I don't think I had much more to lose. 

Well, eating from the syringe was awful. Just awful. I felt like that was just humiliating...like adding insult to injury. I can (and will) write an entire post about it. 

I'd say this: if you know you will get wired shut, FATTEN UP. I don't know if it will help, but I would hope so. And be patient with yourself. Constant hunger is painful and you will be hangry the whole time. It's ok. You're allowed to be. 

From undisplaced to displaced condyles (aka surgery #2)

In my last post I explained the treatment plan for my broken jaw, and after the initial surgery I was sent home with arch bars on my teeth and a no-chew diet to allow my condyles to heal hopefully in the right positions.  I went about 2 weeks like that, until I went to visit the oral surgeon again. My jaw had begun to heal to the left side - toward the side that was the most broken.  The plan to remedy that was to put elastics on the arch bars, from the top right to the bottom left, which would pull the lower jaw over to the right side.  He booked me in for that a few days later. 

When I went in to get the elastics on a few days later, we got a bit of a surprise. Dr M (my oral surgeon) put the elastics on to pull my jaw to centre and the pain was completely unbearable. My request for stronger painkillers than what I already have prompted him to question things.  Before sending me on my way with the torture devices (aka elastics) he sent me for another panoramic x-ray.  This came back with the awful news that my right condyle had displaced sometime in the past couple of weeks, which explains the migration of my jaw to the left.  Elastics was not going to be enough. Another surgery was in the cards.

A few days later, I went back to his office for the next surgery. This was about a month after the original surgery, which happened 3 days after the accident. The plan was to knock me out and manipulate my jaw toward centre, hopefully righting the displaced condyles (or at least one of them) to the proper position and wiring me shut for a few weeks. 

This time I was a lot more aware and lucid, so it was almost like going for the first time.  I wasn't nervous - by this point I had resigned myself to the fact that I had suffered a really bad accident and a lot damage to my mouth, face and teeth. What I wasn't expecting is the pain of the anesthesia! When he injected it into my hand, it burned like my hand was on fire and I really was just wishing to be knocked out as soon as possible to make it stop. It must have been less than a minute, but the pain was so intense it truly felt like 15 minutes. Not pleasant. 

When I woke up, as promised, I had 2 wires holding my mouth shut, and a series of elastics covering all my teeth in whatever pattern Dr M had deemed necessary. 

Here's what that looks like:

Treatment Plan (or lack thereof)

Well after I left the hospital and went home to wait for surgery, it was a giant fog. I have to say that I don't remember a whole lot from that time, other than being in a LOT of pain and that my parents took my son to their place for the weekend so that I could rest and not worry about scaring him. Bless their hearts.

I went home on the Wednesday, probably sometime around noon, and crawled into bed with a heavy dose of narcotics. Still with my front lower teeth flopped out, still with my lower canine hanging on by a thread in my mouth. I know that somehow I made it to Friday like this, because that's when I went in for my surgery - the oral surgeon put my face back together.  Essentially this involved pushing the block of bone holding my upper front teeth forward, pushing the block of bone holding my lower front teeth back together, and re-inserting the lower canine that had been avulsed.  Since it had been loosely attached and remained inside my mouth all this time, it had a good chance of being viable.

Here are before and after photos from the procedure:

The interesting part about these photos is that the wires and arch bars are attached and holding my bone/teeth where it's supposed to be, but did nothing to address the broken condyles.  According to the x-rays, only the left side was displaced, and the right side, while a complete break, was not displaced.  The general treatment plan for this type of condylar fracture pattern is to leave well enough alone, hoping that the undisplaced side would help to maintain the position of my mandible and allow the whole thing to heal on it's own.

As you can see, I wasn't even wired shut. A diet of soft food only - strictly NO chewing - would help to keep the pressure off the breaks and allow them to heal.

The other thing that I notice when looking at these photos is how straight my bottom teeth are, and the top don't look too bad either, with the exception that I am missing the cap from the lateral incisor. Embarrassing, yes, but only a temporary situation.  Since the wires that hold the arch bars in place are  wrapped around individual teeth (and mine were crowded to begin with) they don't do great things to your teeth orthodontically.  Now that I'm 11 weeks out from this day, I can see how much my teeth have moved, and not in a good way. You will see in later posts.

From this point on, I am in for weekly visits with the oral surgeon to monitor my progress, jaw placement and tooth status. The main things he was watching for are that my jaw is healing in the correct position and that none of my teeth (particularly the one that he had to replace) are dying.

My Dental, and otherwise, Trauma

It was just a regular Tuesday when it happened, not much different from any other day. My husband Mike and I were both at work, and did the occasional mid-day discussion about what to have for dinner, what plans were for after work, that type of thing. I had just started going to a gym near work that I was really enjoying - a real gym with some great trainers and exercises based on free weights and body weight. Pretty no frills, which means pretty intense. I was loving it! I was signed up for a class that night and I was feeling a bit tired that day, and even considered skipping it.  Instead, we planned to pick up our son and meet at Boston Pizza for their 50th anniversary celebration, after which I'd hit the gym. I sort of figured that the extra calories would help propel me through the class despite my tiredness.

We went for dinner, and my hubby and little guy went home for bath and bed - I went to the gym for my class. All was going pretty well, I was doing well in the class and felt happy that I had gone instead of blowing it off to lounge on the couch. We were doing some leg exercises - lunges, stepping up onto boxes, and it was time to go outside to the parking lot to do suicide sprints.  Essentially, you sprint a short distance between 2 points - a short distance the first time, run back to the start, a little further the next time, back, and a little further a third time and back to the start line. This time we were to sprint to the first line, lunge walk backward to the start, then sprint to the next line and lunge walk forward to the start line.  I made it through sprint #1, lunged backward to the start line, and turned around to sprint again. I took off pretty fast, feeling surprised at how ahead of everyone else I was. I was almost to the end of sprint #2 when my legs just turned to jelly. I remember taking 2-3 shaky steps, knowing I was going to fall but not being able to do anything about it.

I fell pretty much directly forward, propelling my head toward the ground. I extended both arms to break my fall and held my head back in an attempt to avoid it crashing into the ground. For my efforts I was rewarded with a broken right wrist, a fractured left arm and smashed my chin into the asphalt. My chin split wide open and I knew right away that something was very wrong inside my mouth. My teeth felt really damaged, and I was spitting out blood and bits of teeth everywhere.

Brian the trainer (who is also the gym owner) called 911 immediately and we waited for the ambulance to arrive. At this point I was holding my mouth and bleeding EVERYWHERE. In the middle of a parking lot. Not my finest moment. I managed to walk myself over to the curb and got the trainer to call my husband to tell him to meet us at the hospital and find a sitter for our 3 year old.  At this point, folks from the gym and the offices next to us came out, wanting to assess the damage to my face and offer me ice - but there was no way I was going to let them look inside and see all the broken teeth, teeth that had come out of their sockets and freak me out even more by the looks on their faces (I knew it was bad enough to probably be scary looking). So of course, everyone starts telling me that it's not that bad (they couldn't see!) and they can fix teeth. Who are "they"? I wanted to punch them all...directly in the teeth.

THE ER

Once I arrived at the ER, I was put right into an isolation room. I was so grateful - my injuries were pretty bad and something folks would be tempted to stare at, which I certainly didn't need. The trainer stayed with me until my husband got there, and I won't forget his kindness and sincerity while he hung out with me. Once my husband got there, Brian left and I allowed myself to freak out a little more.

The ER doc (Dr S, who was fantastic) went right to assessing my injuries, splinting my arm and suturing up my chin. I got 5 stitches under my chin, which I was assured was a "legit" amount - no pansy 2-3 stitches which I feel is mostly for show. I would later find out that Mike was pretty sure my chin had gone right through the skin, that's how deep of a cut it was. The Dr wouldn't even consider my requests to glue it up...which I asked for to avoid the anesthesia! Apparently the glue wouldn't have held up with how deep my laceration was. The good news is that the scar is under my chin, and won't be too noticeable at all.

Dr S then went on to explain that my teeth were very badly damaged, and of course, hospitals do nothing for that so he got me the name of a dentist and was prepared to send me on my merry way....this despite what was glaringly obvious: my dental injuries. To quickly name what even I knew was going on:
- My lower left canine (33) was completely avulsed, hanging on by just a thread
- My lower front teeth (41-43, at least) were sticking out into my lip, at an alarming angle to where they should be
- My lower bicuspids (35 and 45) were broken almost right off
- My upper front teeth (11,12,21,22) were tipped inward
and, most alarming
- My face was swelling incredibly, I couldn't move my jaw and my jaw was in incredible amounts of pain.

My husband kept mentioning this to Dr S, but he kept telling me that it was a matter of physics.  The force with which I hit the ground had been absorbed by my body - first my arms, then my chin and finally, my teeth. The amount of damage that had been done to those parts was massive (particularly my teeth) and it would be "terrible luck" if my jaw were broken too. Well, around midnight as he was preparing to release me, Mike reminded him again of how much pain my jaw was in, prompting him to send me for some head x-rays for a look.

Taking those x-rays was, in a word, torture. I had to take a frontal image, one left side and one right side image, and I literally had to lie down on my gurney in between because I was dangerously close to passing out, vomiting or both from the pain. Not a good sign.  Dr S discovered at least 3 breaks....and I was admitted for the night.  A cat scan showed much of the same....extensive damage to my jaw.

Here are some cell phone photos that my husband took of me while in the ER.  WARNING - if you aren't into blood and gore, don't look!!

Here is an image of the type of fracture I sustained - this is not my exact fracture pattern. Obviously there was some upper jaw damage, and this does not illustrate all the damage to my individual teeth either. But it really helps to show the major breaks: 

The following morning the consulting oral surgeon paid me a visit, and let me tell you - seeing someone who had the promise of being able to help me was like seeing a mirage in the desert.  He informed me that he was going to need to do some surgery, but that it would take time to get an available OR to deal with a non-life-threatening situation, and I was to go home and wait. This time, with some real good drugs.

About Me.

I am 33 years old, a fit and healthy mom of a 3 year old boy and happily married to the man of my dreams.  I like to cook, run, work out, read and crochet. I work in Supply Chain Management, which means I have a pretty sedentary job, but I try to stay active and eat well most of the time. 

Before my accident I had always longed for braces, but didn't get them as a kid. I had moderate crowding of my teeth, and just before my wedding in 2010 I had my 6 top front teeth capped to make them straighter, whiter and fake the 'perfect teeth' look. I was quite happy with the results and it really helped me feel much better about my smile. I didn't really give my teeth another thought until my accident on August 12, 2014. All that changed....real fast. 

Welcome!

Hi Everyone, welcome to my personal blog about an unexpected jaw trauma that resulted in a severely fractured jaw, major dental damage and my journey through to recovery.  I hope that this is helpful - I found in my searching that there aren't a lot of blogs out there dealing with this kind of jaw trauma, and I hope that someone might find my experiences and first-hand knowledge helpful.

This is my first blog, and I welcome your feedback. I will also answer your questions as best I can, this is a pretty unique situation and any help I can provide, I will.

Please also accept my apologies for this blog being written out of order. I'm trying to catch up on almost 3 months of experience, while simultaneously writing posts of current experiences so that I'm capturing them at the time and not always looking backward trying to remember things. So you might see "current" information before the back story. Really....so sorry for the confusion.