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Clinical Notes: Maritza. F, Massage therapist,  Lakewood, NJ, Age 26, 5'5'' 173 lbs:  Goal 130 pounds, Mildly active, willing to commit 6 months passionately to OJW.  Email address: maritzaf77@aol.com  (Expected weight loss 50 pounds)

October 16, 2003:
    Examination of teeth, gums, all soft tissues, extent of movement of jaws, and TMJ (Temporo-Mandibular Joint) reveals that Maritza is in good health. Her medical dental history indicated that she had no medical or dental problems related to treatment using OJW. A routine panoramic X-ray was taken, which further showed that her teeth and TM joint were normal. Her occlusion was tested with articulating paper in order to test for/locate any possible traumatic occlusion. None was noted. (The Temporo-Mandibular Joint (TMJ)) is a "ball and socket" joint. The "ball" is the top part of your lower jaw and is called the "condyle". You can feel them by putting your fingers just in front of your ears when opening and closing your mouth. Maritza was told that in OJW the jaws are wired together but the teeth of the upper and lower jaw touch just barely, thus allowing about 1.0 mm of lower jaw movement in ever direction. Consequently, no pressure is placed on the TM joint. She signed the informed consent for jaw wiring . She came alone. and was provide a review of the entire procedure and  was advised of the dangers she might encounter and how to avoid them. the informed consent and the FAQ's were reviewed and she signed the OJW Telephone memo indicating that she was aware of all aspects of the OJW treatment method for the control of compulsive overeating. "Begg" brackets were bonded on upper teeth 4,5,6 and 11, 12, 13 and lower teeth 29,28,27 and 22,21, and 20. (the canines and first and second premolars Both the teeth and the brackets were micro etched and the teeth were then also acid etched. All of the teeth to which brackets were bonded had normal enamel. The brackets were "double bonded", in that a second layer of adhesive was place on the flanges of the bracket. All excessive and unsightly adhesives was removed and the space between the teeth was checked for unimpeded passage of dental floss. Maritza was shown the wiring method and practiced on the intraoral wiring training device under Dr. Ted's supervision with precautionary advisements. Finally, she was asked to put her teeth gently together and the wiring was done with "dead soft" .014 inch diameter stainless steel round wire.  Maritza observed the wiring technique and then cut out the wire as a practice procedure which she did with ease in about 5 seconds. She was then wired closed on the right and left sides. She agreed to follow the recommended protocol: After 5 weeks snip off the wires, exercise for 5 days and return to the office for evaluation, cleaning and rewiring.  She said her jaws were very comfortable and that the jaw wires permitted her a slight bit of jaw movement. She was given instructions and practice regarding how and when to remove the wire. She was given instructions on how to exercise her jaws  during the 5 days she would be released from the wires and advised re the possibility of the joint becoming more limited in motion over time (two fingers of opening rather than 3 fingers).  She was counseled to adhere to a 1350 calorie  low/no salt liquid diet.  She was advised to always carry her wire-cutter with her. Lacking a wire cutter a simple fork could accomplish the emergency removal of the wire. She was provided with instruments to assist in the removal and replacement of the wires.  
Ps. She indicated that she intended to return for follow up visits and was advised to weigh herself each day.  She was instructed to keep a graph of her weight loss 18"wide (each day) by 9" high (weight) and make an entry every day/week.

How do you figure out how many calories YOU need  each day?

Calculate BMR: Adult female: 655 + (4.3 x weight in lbs.) + (4.7 x height in inches) - (4.7 x age in years) =   655  + 4.3 X 173 + 4.7 X 65 - 26 = 1678.4 = BMR This accounts for about 60 to 70 percent of calories burned in a day and includes the energy required to keep the heart beating, the lungs breathing, the eyelids blinking and the body temperature stabilized.

Now to your BMR, add the calories you burn each day, for example: Walking at a moderate pace for one hour = 300 calories now the total is 1978.4 calories  Now add  to 1987.4   The "thermic effect of food**"

**(This is the amount of energy your body uses to digest the food you eat -- it takes energy to break food down to its basic elements in order to be used by the body. To calculate the number of calories you expend in this process, multiply the total number of calories you eat in a day by 0.10, or 10 percent. If you need some help determining how many calories you eat in a day:

So if you eat about 2000 calories/day 10% of that is 200 calories and added to 1987.4 = 2187.4 Conclusion: You need 2187.4 calories each day

Now if you adhere to 1350 calories of liquid diet you are eating  2187.4 - 1350 calories  less calories than your body needs (837.4 calories)  to lose one pound of true fat will take you (3500 divided by 837.4) and that equals 4.1 days (in 7 days you will lose 1.7 pounds)

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