x-ray pics

It's very strange to see yourself in x-ray, but I think it's facinating! I'm amazed that all this hardware is hidden underneath my skin. I'll try to explain if you're interested.

These x-rays were taken at my Saturday doctor's appointment after I was released from the hospital. The first photo is a frontal x-ray and you're seeing my teeth in the middle. The top boarder of the photo is at the middle of my eye sockets. The upside-down T things and the L things above my upper teeth (beside my nose) are holding my upper jaw back together with my skull. What you are seeing are are the flat titanium plates that look kind of like tiny connected metal washers with holes for the screws to hold them in place. On the lower you can see the 2 upsidedown L plates plus some screws at the back of the jaw. Dr. Wolford developd the specific procedures that he uses. In order to avoid a major nerve bundle that runs along and through the bottom jaw bone, they acutally cut down the middle of the bone to avoid the nerves and slide the bones around. We've seen it all explained to us with advanced skeletal models, and I still can't really explain it. If you look you can see darker rectangles along the bottom jaw line. Those are cuts in the jaw where there is now space (that I can feel with my fingers!) which will evenutally fill in with new bone. On the top jaw they used and amazing filler as necessary in places that's made from coral, and my own bone will actually grow into the coral and it will become bone. The top jaw (which is continuous with your skull) is as thin as an egg shell! It is for this reason that I have to be careful not to chew with any force for several months. Matt and I got to see the titanium plates upclose when we were planning the surgery, and it's amazing to see them on x-ray.
This second picture is a side view x-ray. You'll first notice my impressively large brain (ha, ha). You can see less of the hardware. I'm struck by how far up it is toward my nose and eyes. If you look closely you can see my swollen lips and nose splint. The screws you're seeing behind the teeth are actually those on both sides of my jaw, not in my mouth, as it would appear.

Musings for my SLP friends who deal with swallowing: It's interesting to clearly see my epiglottis and pyriform sinuses. Without being able to move the subject around a little bit, I'm not sure I see the vocal cords. Without seeing a previous x-ray, I don't know if I'm seeing some swelling of the posterior pharyngeal wall. I sure felt like I wasn't getting good epiglottic inversion right after surgery, swallowing water and then feeling like there was vallecular retention. I had difficulty initiating a repeat swallow and then would cough as I aspirated the retention that finally spilled out of the valleculae after the swallow and into my airway. Smaller sips helped but a head turn did not. I couldn't really try a chin tuck because I had severe difficulty with anterior to posterior bolus propulsion. By the time I came home I could swallow a thin creamy soup but thicker stuff hung in my throat. Now I'm much better as swelling has reduced. I'm like my own case study! It's been very interesting for me. In the morning before I moved from recovery to my own room Dr. Wolford came by for rounds and said that my job for the day was to try to start eating puree foods. I was still taking tiny sips of water by syringe to avoid coughing/aspirating as much as possible. I was fortunate to have a nice strong cough so I wasn't too worried about aspirating the water. I would have been interesting to see my swallow on videoflouroscopy. I had been diagnosing what was going on with my swallow all night in recovery (since I was thristy and not sleeping) and I told Dr. Wolford in appropriate technical terms what I thought was happening with my swallow and why I was concerned that I was not ready to be swallowing/aspirating puree. I think he was surprised to hear the technical (and perhaps accurate) description of my symptoms and after a mildly stunned pause, he just reassured me that things were going to be okay. I wasn't showing off knowledge, just being upfront with my symptoms and why I might not be able to follow his instructions. I'm a very good patient and always try to do what the doctor tells me! He clearly understood this. Once I got to my room the nurse told me that my job for the day was to learn to drink liquids. Now this I could handle! It all amuses me to look back at it.