EP 342: The MARPE Experience – Bodywork, Diet, and the Mind-Body Connection in Orthodontics

They've done studies that like the human body can only withstand X amount of pain, but during childbirth it's X amount of pain. And I'm like, did they do the initial study on men? Because clearly women can sustain more pain. That's what the standard is like in health. Even like more men are diagnosed with sleep apnea, but women still have the symptoms of sleep apnea, but we just don't have as many apneic events. But we're not getting that like quite quality deep sleep the same way.

Hi and welcome to episode 342 of the Untethered Podcast. Today we have my dear friend and colleague Jeanne Nelson joining us. Jeannie is the owner of Breathe, Eat, Sleep Talk and she is an ASTRO certified speech language Pathologist, born and raised in sunny Arizona, and communication has truly been in her blood from the start. She was inspired by her grandma, who is also a speech therapist, and by early experiences watching her aunt use sign language with her cousin with down syndrome, Jeannie learned that communication is about so much more than words, it's about connection. Professionally, she is a lifelong learner with degrees from Arizona State University and Northern Arizona University, and she's earned the prestigious Asha ACE Award for her dedication to continuing education. Through her private practice, she works with everyone from babies taking their first bites to adults navigating TMJ dysfunction and sleep apnea. And JEIE brings a truly holistic approach to care, blending her expertise in myofunctional therapy, feeding therapy, speech sound disorders, and even craniosacral fascial therapy to help release restrictions and support optimal oral function. And as if that wasn't enough, she is also a certified birth doula who supports hypno babies and hypnobirthing clients, weaving compassion and whole body wellness into everything she does. So please help me welcome Jeannie to the show. Let's jump in. Welcome to the Untethered Podcast. I am your host, Holly Balkan.

I'm a certified myofunctional therapist, feeding specialist, podcaster, business owner and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to bring you the most up to date information in the orofacial myofunctional therapy, airway, tethered oral tissue and pediatric feeding therapy space. If you're new here, I challenge you to keep an open mind and join my mission to spread this message far and wide. If you've been around since June 2019, thanks for being a loyal listener. As we jump into today's episode, remember to listen with correct oral rest part posture Tongue up, lips closed, teeth apart.

Breathe through your nose. Let's get started. Jeannie, welcome to the podcast.

Hi.

I am excited to have you on here because I feel like we talk, like, all day long on social media, so it's fun to actually record together.

I agree. I have so much. So much that we could talk about, for sure.

Yes. And I know we do, like, you know, we have very similar backgrounds and the work that we do and everything, and I love that. But I also really love the fact that we're going to be going through our Murphy journeys simultaneously. And I think that was, like, really funny that we kind of figured that out. You're like, wait, you're going into Murphy? I'm going into Murphy. And I was like, wait, when are you doing it? So tell us, when are you getting your Murphy installed into your mouth?

So I'm also feeling so happy that I have someone to go through it with, because it's kind of a terrifying procedure, especially because of all the things that we know. But my date is August 12th. 12th. That I'm getting mine installed. So.

Yeah. And I'm August 11th. So we were like. We are literally, like, within 24 hours of each other. And I know we were talking a little bit before we hit record, so it'll be a little bit different, too, which I think will be really cool. We'll have to, like, come back and do another episode once we're, like, further along in our journeys or maybe after, like, we get the markies out of our mouth. I don't know. But, you know, I know that, like, I have this piezo thing where, like, Dr. Koval is going to basically split my suture for me when, you know, they're putting them up in and everything. So I'm not going to, like, split on my own, which is the opposite of what you're doing. You're doing the procedure which most people do, where they do the suture splits on its own. Right.

Yes. Well, so. And I'm curious, and maybe you go into this, but talk to me about how she does that. Does she put you under for that? Is it just like.

No, it's. She. Even as I was just recording with her. Yeah. Like, yesterday or two days ago. I don't even know what day it is anymore. Maybe it was yesterday. Oh, my gosh. And so I asked her literally, like, 500 questions, which was really helpful to do on a podcast because I'm like, everybody actually has questions, and then I have questions. So let's cover all the bases. So I don't you know what? I didn't ask her, like, what the tool is that she uses, but she even says she's like, it's not a surgical procedure. Like, yes, it's procedure. It's in office. I think it's more of a, like, local anesthetic. Like, I'm not under general anesthesia or anything. I think it's just. They numb the area and. And that's that, so. But what she did show me is that based on the imagery that they. They take, they actually create a physical, like, printed guide that goes into my palette. So. And it shows them the exact line based on the imaging they took of, like, where they cut down the suture line. So that's how they know, like, where to split the palette. So I was like, okay, that's cool, because it's not like they're going in blind and just, like, you know, going down where they think the center of your palate is, because that would be probably really not a successful approach. Yeah, and then. Yeah, and then they put the Marpi in the. You know, the mini screws and everything go in. I think I'm gonna have. I think it's six mini screws in my palate. Is yours the same?

I believe mine's six. Yep. Yes.

Yeah. And then. And then. Yeah. I mean, we. So I think the big. One of the big differences, too, that I'm coming to learn from talking with others is because I'm having this piezo treatment that done when my Marpi goes in, I can't use a water pick for the first week because there's some, like, tissue healing that has to happen. I can't. I don't start turning the appliance right away. I actually don't turn it until I think a week later. So I basically have to let my mouth, like, heal for a week before I physically start cranking things. And then another thing that's a bit different is she was saying that because I had, like, the nasal surgery and they fixed my septum, plus I had the rhinoplasty, like, I really don't want my nose to change, which obviously, like, the base of it might widen a little bit. But she said because of how the other facial bones shift and the skin kind of, you know, moves and everything, she's like, my nose should not look any wider because I only need, like, 5 millimeters of growth where most people need more. So she was like, if you needed more, that would be different. But because I've done other expansion in the past, I only need 5 millimeters. She's like, it's not a ton. And she said, I guess that when with their. With the appliance that she uses, you only get, like, 0.1 millimeter every time you turn it, whereas most are 0.2 or 0.25. So she said hers is, like, slower than, I think, some other MAR B appliances. And she's like, with me, she's like, we are gonna, like, keep super close eye on it, and if we need to slow anything down even more, like, we can do that so that it doesn't, like, disrupt my nose.

I'm like, okay, that's amazing. And so this is something you and I have talked about a little bit. My nose is actually something that has not been addressed yet. And we've talked about this because my nose is actually one of my biggest problems right now and has been my whole life, and it's never been addressed. I know I have a severe deviated septum. I know there's lots of turbinance. My nose is a little asymmetrical. And then I just. I notice things just because I'm in the MYO space and because I'm me and looking in the mirror all the time. So I'm critical of that. But I'm in some ways hoping that it does kind of change my nose and the symmetry of my face. So that's, like, different goal, I guess, that we have.

Yeah. Do you know how many millimeters you need of expansion or how much they're going for?

So I think he's going for, like, as much as possible. So my intramolar width is currently 27, so it's really narrow.

So. And so, like, he may be going for, like, what, 35 or, you know. Yeah.

So, like, I think. I think as much as it allows. So I know he's going to be closely monitoring it, too, but I think he's kind of going for as much as he can. Is that. Are you going for 35 too, or what is your end goal?

You know, I don't even remember what my intermodal or with this, but she basically was like, based on what I'm seeing, like, you. She's like, you don't need more than 5 millimeters. So. So. And she was like, it could be five to seven, but, like, I think we're going for five. So I think I am, like, less than the average patient that comes in. But again, it's like, people. I was standing with an SLP colleague who's not, like, in the MYO space. We do, like, Pilates together the other day. And she's like, so why are you doing more expansion? Like, is it like, what is your goal? And I told her, I was like, my goals are one. Ever since the nose surgery, I've had this post, post nasal drip that has not left. And it's worse when I'm in recycled air. Like that is a big trigger for it. So if I'm sitting in a car, I'm on an airplane, like it just starts going and my husband is like, you're making that smorgy sound. Like, why are you doing that? I'm like, because there's literally stuff falling out of the back of my nose into my throat right now. Like I have to swallow it. Like it's like a, like a. I'm constantly like, it's like disgusting. I sound like a pig. So my part of me is like, I don't. And I don't know what it is. I don't know if something in like the nasal surgery, like something sitting somewhere different, something got triggered. I don't know, like what. Maybe it's just stimulating something to produce extra. I don't know. So it's, it's so strange. If I use clear the nasal spray, then I feel like it does help it a bit, but it feels like more of a band aid than a long term, you know, solution. And so one of my, in my head and I'm like, I've totally made this up. This is not something that like has been promised to me, of course, but I'm like, in my head I'm like, if I get that 5 more millimeters millimeters expansion, it's going to change some things in the nasopharynx. And hopefully whatever is triggering that to happen leads to it stopping. Like my goal is like for that to stop now. I take, you know, I'm like, I know there's no magic wand. We don't know if that'll actually happen, but I'm really hopeful that it will. And then secondly, I've. There's three things. So that's one. The second one is I've been waking up with a scalloped tongue quite a bit over the past like year or so. And I'm like, I feel like I have enough room for my tongue in my palate. Like I don't have that overflow when I suction my tongue because of like the DNA vivos and everything. But for whatever reason, I just feel like things are not sitting where they're supposed to be. And part of that is my Maxilla on the upper left side is turned inwards a little bit. And so what that I think is doing is causing one is causing asymmetry. So I'd love for those asymmetries, like, to be addressed and fixed. And she says that will absolutely. Like, that is the plan. And then the third thing is. Well, and it's directly related to that, but I started to wake up, and I had a couple times where I woke up and I could not open my jaw. And I felt, like, pain and discomfort in the left, like, temporomandibular joint area. Really more the muscles than the joint itself. And it's crazy, because if you watch me talk, everyone's like, oh, your jaw deviates to the left. What we realized is it's not. And I realized this when I was doing the DNA vivos with Manny, who was doing the pt, doing all the body work with me. We realized it's not my mandible that's off. It's my mandible is actually centered. It's deviating because of what's happening with my maxilla. So it's compensatory and, like, secondary to what's happening with the maxilla. And the vivos just was not strong enough to open the suture and actually, like, get. Get us what we needed to do to unlock the maxilla, because we tried, like, through bodywork, plus the appliance, all the things. So that is a big goal for me, is to, like, unlock the maxilla. Obviously, we'll be able to separate the two sides of the palette, and then when everything, like, heals, like, have it heal in the right place. Have it, you know, basically. So fix all those issues. Yeah. So I don't know. For me, that's. That's the big thing. I do feel like it's so crazy to watch me talk because, like, the asymmetries that happen are totally a result of this, like, maxillary bone on the left side. And it's wild. Yeah.

It's so interesting. Well, and I think one big thing with all of this and, like, along with what you're saying, like, I can so relate to the reasoning for it because it's similar, but, like, slightly different. But I think a lot of people say that to you, like, why. Why are you doing that again, to yourself? Like, and my orthodontist, so this might differ from yours too, he's actually doing braces on me at the same time. And I have hesitations about that because I've actually had braces three other times in my life. So I'm not looking forward to it. I think you and I are also exactly the same age, So I turned 40 in, like, a week. No less than a week. It's August 4th, so really soon. So soon.

Happy early birthday.

Thanks. But. But being, like, almost 40 and thinking about going back into braces is, like, not fun, and I'm definitely dreading it. However, I'm trusting this orthodontist because of his knowledge and, like, how he does things. And his reasoning for doing that at the same time is to help with aesthetics and then also to just kind of do two things at the same time. So it's not. So it is providing all the growth that I can get. So, like, not just teeth tilting, like, but also getting, you know, the. The bone to grow, too.

So.

But I get that question a lot where people are like, why are you doing that to yourself? Like, your. Your smile looks fine, your teeth look straight. And it's like orthodontics is so much more than just straight teeth. And I think being in this space, we also know super well that, like, this is also so much more than just the muscle, because. Because of habits that we've had in our whole life. So up until we were 40, all the things that we did for so long before we got into the myo space, before we understood how the. How the bones focus on the muscles and how all of that works. So. Yeah. How the bone. How the muscles influence the bone and how they shape. I actually, I also had expansion as a child. I don't know if you had that.

I did expansion and braces and then permanent retainers. Yep. All the things.

Yeah. Did you have headgear, though? That's. That's the one.

I. I did not have headgear, no. So there was no retraction or anything or protrusion. You know, like, I didn't have either, or. I just had the rapid paddle expander followed by braces, went into upper and lower permanent retainers that were supposed to fall off by the time I was 20. They didn't. I had them taken out at 30, and everything started to shift. And then I learned through my o why that was happening.

Right. Yes. Yeah. So, yeah, it's the same. I had. I had an expander, actually pretty young for back in the day, but when I was seven was when I started my whole orthodontics journey. So I had expansion and braces just on the first front. On the top front, four teeth, and then had to have it again in middle school and then again in college. So here I am 20 years later getting it again. So.

Gotta love it. Gotta love it.

Yes.

Yeah, I. So I'm not going to have braces, but I am going to have. And it's, it's kind of like Invisalign, but they actually do their. They print their own. So she uses Invisalign, but she also has something where she can print her own clear aligners. And so for her Murphy cases, she uses her, like, own clear aligners. And so I was asking her about this when we recorded because I was like, well, tell me the timeline again. So I do your braces before I talk about that. Do your braces go on, like, right away or do you like, get the marpy first and then the braces go on like, at a certain point.

So to my understanding, they're going on at the same time. Oh, wow.

That's a whole lot of fun.

It's a lot of fun. I'm definitely, like, hoping that this goes as quickly as possible. Do you have an estimate for was? Because I don't have an exact timeline either. And I think because, because of my profession, because of how much I talk to this orthodontist, we're, we're doing it like together kind of as a case study, you know, like, like, what, what can we do to like, help balance your teeth and your jaw and like, to make things more optimal? But yeah, so I'm not sure.

I mean, I've seen other people go into murpy and braces and they still have the murpy in their mouth when the braces go in. I just, I don't know at what point, like they got the braces if it was right away, if it was later on. So that's why I was curious. But so my timeline looks like this. So I get the Marpi August 11th. And then I think what she said was like, you know, we turn it for however long we turn it. I know it was maybe, was it six to eight weeks maybe, that we're turning it. It's like once a day unless we slow it down for whatever reason because of my nose. And then, then she was saying that at that point, when I'm done turning it, what they do is they take off the arms that are like connected to the teeth, but they leave the center of the appliance in. Because she said it takes probably, I think was like upwards of 8ish months. And I'm totally misquoting the timeframe was maybe 8 to 10 months for the, like, the growth that you had to fully Fuse, heal all the things, right. So they'll leave that in for another eight to 10 months. But as soon as the arms come off, they move me into the clear aligners. And then what she does from the gaps that have been created in the teeth is she moves everything forward tooth by tooth with the aligners. So she will move like my central, you know, upper central incisors, like closer together than the next teeth and the next teeth and the next teeth, which I think is really cool because when I did DNA vivos, I went into Invisalign afterwards and in order and I didn't have to, it was more for cosmetic reasons. And what ended up happening was I did lose some of my expansion in closing the gaps because the gas just the way that I guess the Invisalign did it, it kind of retracted me a little bit. Maybe not all the way, but like enough that I, I could feel that I lost tongue space. And whether that was just tooth tipping that then got, you know, was kind of tipped out and got pulled back or whatever it may have been, I don't know. Do I feel like my, my palette is more expanded from the DNA vivos and that I got like real skeletal expansion? I do. And my, you know, my imaging suggested suggests that as well. I don't think my current ortho feels like that is possible with that appliance. So, you know, like, she's not like saying that outright, but that's kind of like read between the lines, really feels like it's more of a tooth tipping appliance. So, you know, did I get the same kind of expansion that I think I'm going to get with this?