Bracket

The last time I saw Dr. F he noticed that one of my brackets was loose on my tooth.  But because of the surgery he was not able to fix it.  It happens to be the tooth next to my gap (not the middle tooth).  Well the bracket has separated from the tooth.  You wouldn't notice unless you were actually checking the tooth.  I just hope the tooth doesn't move backwards - both literally and figuratively.

A Christmas Miracle

I might be being overly dramatic, but I did have a good visit to Dr. S this week.

He said he likes the development of the bone, YEA! 

He doesn't want to touch anything in my mouth for a while, but he wants to see me in early February and then he'll take a better look at the work he needs to do on the soft tissue, basically not all of the closure closed up right, it's better then after the last surgery, but needs more work.

Also, he's still not sure about my middle tooth next to the bone graft.  I may still lose that since he's thinking it might be part of the reason for the problems in the area. 

Did I mention the bone was developing?

The Orthodontist

I hope you haven't waited too long for this...

So on Monday Dr. F put my teeth back in.  They had a tough time getting the wire back in.  My teeth narrowed in a bit since I didn't have a wire in for a month.  Dr. F put in a new wire that would help pull my teeth back out again.  I hope it works or I'm going to end up with 2 really skinny implants when this is all over.

But he told me to be careful eating since I'm not totally healed up.  I did enquire about my overdue dental cleaning, that will have to wait at least 2 months.  He did laugh at my question, which I did preface with, "I know I can't do it for a while," which was a little annoying.

I think we have some bone!

I saw Dr. S today and the bone graft is looking good.  YEA!

I do need a little work on the soft tissue, which I had figured out already.  But that will just involve some Novocain in the office.   That will be some time after Christmas.

He took out some of the loose stitches, which was nice since they area annoying, but it hurt A LOT.  I felt like he was just poking me with sharp objects.  But now I can feel the roof of my mouth much better.

Also, I can eat regular food again.  I had pot roast for dinner!

I also saw Dr. F,  but you'll have to read about that later in the week.

The good, bad and the slow to post

I saw Dr. S last week, sorry it's taken so long to post.  I keep forgetting when I'm actually at the computer to post about it.  But I'm here now!

So the good news is that I have not lost any bone.  Yea!

The bad news is that he didn't seem to like how part of my gums closed up.  And I still have a small hole into my sinuses.

We're now at the "wait and see" stage.  Oh, I thought I was already at that stage.

I am still on a "very soft" diet, which isn't so great.

I also still have a little bit of pain at times, either that or I'm addicted to tylenol and advil.

1st Doctors Visit

I had my first Doctor's visit today.  I saw an associate of Dr. S.  He didn't do too much, did make me properly brush my teeth though.  Said that things were healing appropriately.  Moved me up to mushy foods - pasta, mashed potatoes, eggs...  Originally I thought I would be much more up on my feet at this point, but I'm not.  It didn't sound like they wanted me to return to work next week like I had originally planned, so I wont be.

I see Dr. S next Monday, I suspect I will learn a lot more then.

I also saw Dr. F, who basically did nothing.  The surgeon doesn't want to have my teeth put in for another 2 weeks until the swelling goes down more.  Dr. F decided not to bother putting the wire back in until then as it's not needed.

It seems like they're taking things very conservatively at this point, which is ok.  I'm not sure if after the bone loss last time they're feeling more conservative or if there were any issues with the surgery where they are feeling a need to be more conservative.  

I will say that today I have had a bit more pain then I have had in the past few days and I'm taking the same amount and types of pain killers.

Oh, and laughing hurts, no more funny sitcoms for a few more days.

Coming along

So I'm coming along, the swelling is down to a point where I don't look grotesque (or did my sister say I looked grotesque?  Ahhh, sisters!)  Well, I don't look that bad, but am still pretty swollen.  I also have some bruising on my neck and throat, but it's light and hard to see.  My mouth still hurts too, but I'm taking mostly just Advil and the Percocet at night to help me sleep.

This morning I woke up with a gross taste in my mouth and it seemed very mucusie mixed in with a bit of dried blood.  There also seemed to be bits of something in there.  I'm hoping it's just some particles from my smoothie last night, but I'll find out more today when I see the surgeon.  But after losing the bone last time I'm a bit nervous about anything that doesn't seem 100% right.

What day is it?

Since my surgery I have been a bit oblivious to my surroundings.  At times I'm awake and aware of things, and at other times my brain is mush.

My pain has been subsiding, but my swelling is up.  My head looks like a lopsided watermelon, my lower left side is swollen and my upper right is swollen.

On my lower right I noticed today that Dr. S removed the bracket on a tooth.  I don't mind seeing it go since it was the bracket that was leaving my gums irritated, though I'm sure Dr. F will be putting it back on.

I did have some nausea last night, which was cured when I threw up after taking the anti-nausea medicine. I'm not sure that's how that is supposed to work...

Surgery #4

Disclaimer - I'm writing this slightly delirious after surgery.

Last Friday I saw Dr. S and here is what he said he was doing during this surgery.  He was going to mix Bone Morphogenic proteins with a bit of bone from my jaw and something else.  He was going to open up the gums more to allow more blood flow and healing.  He showed me some pictures of another case with a similar problem and the mouth looked great at the end.  He did think he was going to have to take my one middle tooth out and asked permission.

Monday I saw Dr. F and he took out my wire and teeth, which felt really weird.

Tuesday:  Surgery was supposed to take 2 hours, it took over 3.  The anesthesiologist was able to get me intubated through the nose using the camera.  Though Dr. S had to move my tongue, which might explain why my tongue hurt after the surgery.  He did not take out my middle tooth, he said it had enough bone around it.  My throat hurts and it hurts to talk.  My jaw hurts from where he took the bone.  My parents are driving me nuts.  My face is very swollen.

I'm on clear liquids for 3 days, then liquids for another 3 days.

Not much going on...

I haven't written lately, because there just isn't much going on.  I'm just waiting for the next surgery in November.  I did go away to England and Scotland for 2 weeks, the food wasn't great, but I was able to eat it and that made me very happy!

This week I did go to see Dr. S, but there wasn't much to report from that.  He told me to keep doing what I'm doing.  That this sometimes happens with adults and he was confident the bone stimulating proteins would help.  I did keep some of the bone, so that's good.

One other good thing is that my primary care physician has opted not to have me come into the office for a pre-surgical clearance, he feels that I'm in good health and he can clear me without seeing me.  I think since he did one back in July too helped.  So I have one less thing to do before the surgery.

Another procedure...

I went to see Dr. S yesterday.  He cleaned out the wound more, which does not hurt but feels really weird.  He said he needs to open up the wound again and put in the BMP/Bone stimulating proteins.  But this will involve going under general anesthesia so I will have it in the hospital.  He said that the recovery wont be nearly as long, just a few days.  Sounds great!  But he did say I could eat pretty much anything I wanted, he didn't recommend candy apples and other really hard foods though.

I also saw Dr. F, he put in the last tooth I was missing, which is good.  I do not see him again until the day before the procedure/surgery.  He said that this delay will delay the braces a bit but otherwise things were going well with my teeth.

good news and more bad news

Yesterday I saw one of Dr. S's colleagues.  The good news is that he said I'm fine to take my trip in September.

The bad news is that it's because it will be a while before Dr. S will be able to put in the bone stimulating proteins.  Apparently, I need to heal up before he can put thim in and this doctor indicated it would be a few months.  But what was even more interesting was that he indicated that Dr. S might need to put more bone in.  I'm not sure if this doctor was seeing more bone loss then Dr. S had initially seen, or if Dr. S was giving me the better scenario hoping that he would be able to just use the bone stimulating proteins.  Either way, time will tell how much bone I lose and how to deal with it.

I had thought the bone stimulating proteins would go in sooner, but the more I think about it Dr. S didn't give much of an indication of when they would go in.  It was Dr. F who seemed to indicate that they would use them soon.

The most frustrating part is knowing that all this will delay the whole process.  I'm not sure if it will delay the braces much since the bone is more for the implants then for the the braces.  But this would certainly delay getting the implants.

Overnight in the hospital

I've been meaning to write about my night in the hospital for a few days now because it sucked.  I hate to be so negative, but anyone who has spent a night in the hospital knows what I'm talking about.

I fall asleep around 10pm and then around 11pm my Mom decides to go home, but wakes me up in the process.  I was up for a while after that, in part because the hallway light was shining on my face.

It was like that all night, I would fall asleep and anywhere between 40 minutes and an hour and a half something would wake me up.  One time it was the IV machine beeping, then it was my roommate moaning in pain, then they want to take your blood pressure.  In the true irony of it all, the longest stretch of peacefulness I experienced was when i was awake and writing emails on my iPhone because something had woken me up and I couldn't get back to sleep.

Ugh, not good news

I went to see Dr. F today and he seemed happy with the progress I was making and put in one of my fake teeth.  My mouth does look better, but the tooth is kinda annoying.

He also explained how the bone stimulating proteins would be put in.  There is a bit of an upside down valley in my gums where the bone is supposed to be.  The bone stimulating proteins would be put in there and then that valley will fill in.  But the bad news is that Dr. F told me to make sure I can fly after they put it in.  Ok, he didn't say I couldn't fly.  But since I'm going away in the middle of September if there is a restriction I could have an issue.

I did call Dr. S's office and am waiting a call back.

Back to the surgeon

I saw Dr. S again this week and got some good news.  My wound around the bone graft is healing now, similar to how a scab heals over a cut.

I no longer have to rise with peroxide and water, instead I have to use one of those liquid syringe things and clean out the wound with that.  I think it's a bit better, but I'm not sure how much better that is.

The orthodontist

I saw Dr. F this week for the first time since the surgery.  It was obvious that he hadn't spoken to Dr. S yet.  He did try to call him while I was there, but wasn't able to talk to him.  He said he would talk to him that night.

I filled him in on the bone situation and he noticed the missing tooth himself.

He changed my wire in the top, another thick wire which left my teeth quite sore.  So just as the pain was fading so I didn't constantly need to take advil, the new wire changed all that.

Dr. F did not put in my fake tooth and is working on another tooth to put in place of the tooth that was taken out.  I'm hoping for next week when I go, but I doubt it.

Otherwise, he sent me on my way reminding me to keep the open wound in my mouth clean.

2nd Doctor's visit

I went to see Dr. S today.  I was a little worried about this visit because I got the impression when I saw the covering surgeon last week that things weren't quite right with the healing.  I didn't think it was anything major, but something just wasn't right.

I waited a while to see Dr. S and when they brought me back they put me in a different room then I had ever been in before, this one was obviously one they used for in-office surgeries.  The chair was much more sophisticated, the room was much larger, there was an IV stand.  Then I found the draws labeled for "IV meds," and "emergency meds."  That didn't make me feel more confident.

After waiting a little more Dr. S finally came in and said that the covering Doctor said that I had some bone exposed.  He asked if I noticed.  I said it just looked like a funny hole to me, though I will say that I do sometimes notice a bit of mucus or blood on my front teeth that I think is coming from my sinus area.  Though at the time I wasn't sure if that was what he was referring to.  He looked in my mouth, but couldn't see much.  He cleaned out the wound area and then irrigated.

The Good:  The palate and the floor of my nose are "communicating" and healing up fine.
My leg is doing well.  He seemed happy that I was walking without a limp, still a little sore and taking it easy with stairs.

The Bad:  I still have an open wound from the bone graft and have lost some bone.  He didn't seem too concerned at this point.  He said it may need to be cleaned out another 1 or 2 times and then he'll put in some bone stimulating proteins (in the office, not a surgery) and take it from there.

My mom's biggest worry - I wont be able to go to Las Vegas next Friday.  It crossed my mind, but my mind was running a bit at the time so I didn't ask.  I didn't get the impression that it would, unless you puts in the bone stimulating proteins next week.  But I'll ask next week when I go, it's not like I can do anything about it now anyway.

My leg still hurts

The other day my sister and my Mom dragged me to the outlets.  It sounded like it wasn't going to be an extended day of outlet shopping like we sometimes do so I didn't think too much of it.  But as usual, we were there for hours.  The problem is that while I can walk fine on my leg, it was still sore.  I woke up in the middle of the night when my pain killers wore off and my leg was hurting worse then it had in about a week.  I am feeling better now after taking a day to rest my leg.

Aside from the outlet thing, I thought my leg would be feeling pretty much normal by now, but it's not there yet.  I can walk fine, sometimes it feels sore, other times it feels pretty close to normal.  Stairs are an issue.  I can go up without much problem, I think that is more of an issue of the muscles being weak from not being used.  I have not been able to walk down normally though, my knee hurts when I bend that much.

My first visit to the doctor

My surgeon is on vacation this week so I saw a different one and I didn't really care for him much.  I felt like I got berated for blowing my nose, which apparently i'm not allowed to do, even though my doctor said I could do it very very softly. 

He irrigated my mouth and cleaned out the wound which felt weird.  

He said I could eat some more foods.  But I can't bite into anything with my front teeth, but can eat stuff that needs just a little chewing in the back of my mouth.  I'm not sure how much more food that is, but I'm sure I'll come up with some new ideas.

I have to say my gums look really weird though.  Before I just had a gap in my gums up to the roof of my mouth.  Now it looks kinda like a hook or an O with a hole on the edge.  It looks like the gums behind my tooth line need to grow forward and that the hook needs to grow to connect to the other side of my gums, which it doesn't really do.  It's weird, I thought the gums would look much more complete.

I think I sprung a leak

Over the last day or two I've noticed that when I blow my nose I can taste it.  I think that somehow my nose and mouth are still connected and there is a hole somewhere.  This goes back to when I thought liquids where still sneaking into my nose.  I thought I was crazy then, but maybe not.  I think I have a leak somewhere in there.  I go to the doctor tomorrow so hopefully I'll get some answers.

I was a Guinea Pig

I found for this surgery I ended up as a bit of a guinea pig, which I didn't feel like last time.

Dr. S's resident decided he wanted to refresh his memory of how to do IV's.  The nurse let him do it.  The IV went in ok, but after the surgery it was killing me, way more then anything else did.  It had to be moved to my other arm and even after it came out my arm hurt when the blood pressure cuff would check my blood pressure. Hmmm, maybe he should practice on someone with better veins.

Then after the surgery in recovery my nurse was in training, she wasn't too bad at her job, but she certainly didn't seem ready to care for 2 patients at a time.  The good news is that the nurse helping her was very good.

I think much more guinea pig stuff would have pushed me over the edge.

I'm a sensitive little thing!

Yesterday and today I've noticed the roof of my mouth has gotten more sensitive, and it feels quite strange.  Yesterday I started to notice that when I would drink it would sometimes feel like liquid would go up my nose, yet it doesn't.  I've occasionally gotten the same sensation today but I've also found at time that the roof of my mouth is getting sore so when I touch it, it sometimes hurts.  I guess the numbness is wearing off, I guess that's both good and bad.

Fascinating Recovery

When I woke up from surgery I was fascinated by what was going on around me.  The first things I did was check the clock and check to see if I lost a tooth.  But then I found everything going on around me to be really interesting.  The girl to my right had a double mastectomy and had another wound, she was going home that day. Though interestingly she didn't have anyone there waiting for her, she had some friends meeting her later on - WOW!

A little while later a new patient came in to my left and she had also had a mastectomy.  Wow, apparently I need to get on top of my breast self checks!

When I woke up I asked for my parents, I knew that since I was staying overnight they would allow them in for a visit, unlike last time when I had to pull myself together.  The nurse said I had to wait until I left recovery, but I told her I was staying overnight and she said I could see them soon.  It did take a while to see them though since they had to change my IV first.  When my parents had left they told them it would be about an hour until I got my room, it ended up taking closer to 2 hours between getting some drugs (I wasn't in pain so I didn't take medication until after my parents left,) and getting all of my paperwork together.

There was a nurse who had been working recovery for about 3 months and she was my nurse.  But after 3 months she was having issues with managing 2 patients.  I heard a fair amount of conversation about her and the nurse mentoring her kept having to remind her to do things and keep on top of things and stuff.  I'm afraid poor old Sally doesn't have a career in recovery.  I hope I don't get to find out from experience though.  But who knows the nurse mentoring lives in my town so I could run into her somewhere.

My surgery and stuff

Tuesday was the surgery and it went well according to the doctors.  One of my teeth did have to come out though, one next to my gap, but not the middle tooth.  The tooth had no bone so the bone graft wouldn't have set there.  I'm not terribly surprised though.  As I recall, and mom confirmed this. The tooth didn't grow in itself.  A hole had to be cut into my gums and a bracket from the braces attached to pull the tooth down.  Owell, it was an ugly tooth anyway.

There was one complication during the surgery though, with anesthesia.  When they put the tube in my nose it hit my pharyngeal flap and got stuck.  The doctor couldn't see the tube and called in the ENT to scope me.  He saw some trauma to the pharyngeal flap, but not damage.  They had to intubate me through the mouth and I have a sore throat from it.

Some wacky observations:
I remember being moved from one table to a stretcher after surgery
I was in very little pain for the first few hours after surgery
I'm not in nearly as much pain as last time and that makes a big difference
I'm not very swollen in the face, though that has gotten worse over time.

Well I have lots more to say, but I'm tired so it will have to wait until later.

I can now touch the roof of my mouth

On Friday I went to Dr. F and had the palate expander taken out.  I cannot tell you how happy that made me!  The roof of my mouth was so soft and tender, it felt so good to be able to touch it again.

Taking the palate expander out wasn't an easy feat for Dr. F, though it seemed to go fairly smoothly.  It did hurt me though, not so much the teeth that held the palate expander, but Dr. F kept leaning on my front tooth that always hurts and really hurt after having the wire taken out.  I actually had to complain about it, and I usually don't complain unless something really hurts.

Dr. F gave me the option of having my fake tooth put back in, but I would have to come back on Monday afternoon to have it taken out again.  I decided to save myself the trouble of going back on Monday and go without the tooth, I didn't have any real plans this weekend anyway where I would have felt funny without the tooth.  I did ask if it would be back in by the time I went away in September and Dr. F sounded sure it would be.  I do have to wait until Dr. S gives the ok for that though.

After taking out the palate expander Dr. F put new bracket rings on the teeth that were holding the palate expander.  One of those rings feels a little off, I'm not sure if it's the way it sits on the tooth that it feels funny or if it's just hitting my teeth differently making it feel like it's off.

Since Friday my teeth have been quite sore on the top, especially my two front teeth.  When they take the wire out my teeth always feel a little sore and loose, like the teeth are just sorda floating within in the bone and aren't really solid in the bone.  It makes me wonder how different the damon braces system is to the old way and if part of it has to do with them keeping your teeth from setting into the bones, making them easier and quicker to move.

On another note, last weekend the chain that was moving my tooth on the bottom right fell off and I ate it.  I only noticed when I was eating and the tooth felt funny, I looked and the chain was gone.  Grrrr.  Of course it was a Saturday afternoon and the office was closed.  By Sunday morning the tooth had moved back totally.  Grrrr.  Dr. F did not replace the chain on the last visit.

Surgery is Tuesday!

Pre-Operative Stuffs

On Tuesday I went to Dr. S for my pre-op visit.  He outlined my surgery in too much goory detail and we discussed drugs.

Here is how the bone graft works - he doesn't actually put bone in my gap, he puts bone where the teeth should go and bone promoting protein in the gap.  At least that was how I understood it.  He'll cut the skin the the hole and then stitch it back together to make a base for the sinuses and a roof to the mough.  Then he went into the bone graft part and I only got so far as him cutting open my gums in the front of my mouth and lifting them up.  I'm guessing then he puts in the bone, but I had heard enough.  He'll take a piece of bone from my left tibia and then my leg will hurt and I'll be hobbling around for a week to 2 weeks. 

Dangers - biggest concern is infection and banging my leg and breaking it before it heals.  ACK!

Recuperation - I have an overnight reservation at the hospital.  I'm wondering if I can get an email confirmation of it so I can add it to my tripit app on my iphone.  Then I'll be on clears for the first and second day and after that soft foods until I see him again 8 days after surgery. 

Wednesday I went for some pre-op stuff at the hospital, the usual stuff - blood work, a million questions on your medical history and pre-surgical instructions.  The Physician's Assistant I had this time was a million times better then last time, she didn't even screw up my paperwork! 

Another painful experience

Last week I was back at Dr. F's office and left feeling slightly irritated...

Apparently my wire on the top shifted a bit and had to be moved back.  Also, he did fix the wire that was attached to the palate expander, I think I left him wondering how I did that.  Also, one of the girls put a shorter chain on the lower right tooth that they've been trying to rotate.  It has hurt a fair bit since then so I think the tooth might have actually moved.  Looking at it though sometime I think it did move, other times I don't think so. 

We also had a conversation about my surgery on the 27th, he's not sure how Dr. S wants to handle it.  Then he started to almost think out loud to me about how they usually wait 5-6 months from the time the palate expander finishes expanding - that would acutally be Aug 17.  This is the first I've heard the wait time this way.  I was originally told by Dr. F 4-6 months and the same by Dr. S, no one added in the rest about after the palate expander finishes expanding.  This irritated me quite a bit since it was 3 weeks before my surgery and he decides to bring it up then.  At this point I'm pretty much committed mentally to July 27th.  But once or twice Dr. S has made comments about Dr. F being conservative, which fits well with my perception of him.  But at this point I'm sticking with the July 27th date.  My theory is that if the surgeon thinks this is enough time then it probably is.  If it was an orthodontic issue then I would defer to the orthodontist. 

Two other things that I have thought of/ noticed since that visit.  The numbness in my gums has gone away on the right side of my mouth.  I'm still dumb a bit on the left side, but being as the tooth on the left side of the cleft hurts I know that the area there isn't still numb.  The other thing I thought is that when Dr. F gets me ready for the surgery he's probably going to take the wire out of my braces and it probably wont go back in for a few weeks.  My fake tooth is held in with the wires.  3 weeks after the surgery I'm going away with the family for a few days, I can deal with a gap for that trip.  However, in the middle of September I'm going away on a 2 week tour and I do not want to have a gap there.  I feel funny meeting new people and having to explain the lack of tooth, but even worse is that every picture from that trip will have me missing a tooth and that will drive me crazy for the rest of my life.

I think I broke something and my tongue is paying the price

At some point today I noticed something felt different about my palate expander.  Towards the front of my mouth there was more metal, like something was out of place.  There is a piece on it that does move around a little bit so I initially thought it was that.  But it wasn't moving and it was hurting my tongue when I would talk.

Giving it some thought I remembered that Dr. F had used some wire to tie it off and hold it in place, I wondered if it was the wire from that.  Which left the question of how that happened and what to do with it.  But I couldn't see inside my mouth to even look.

I went to my parents house for dinner and Mom looked but didn't see anything, though she's not known for her vision.  So I went to the neighbors house since the husband is a dentist.  He looked and from what he said the wire used to tie off the palate expander had shifted.  He seems mildly concerned that it could brake off and I could swallow it, but otherwise thought I would be ok until Wednesday when Dr. F is back in the office and I have my appointment.

Is nothing easy?

When novacaine goes bad.

A few weeks ago I went to LF to get 2 small cavities filled.  I'm not a fan of the drill, but it's always been more of a nusance then anything else.  But this time I was having an anxiety attack.  My heart rate went up, my hands started shaking and that drill was driving me crazy!  I felt so silly about it that I didn't even say anything.  I hate the drill, but not this much, or so I thought.  I managed to survive the encounter and the cavities were filled.

Later on that night I was thinking and realized I had the same reaction last time, at the time I thought I was just a little emotional since I was starting this whole process with my teeth, but I certainly didn't feel that way this time.  I checked Google - apparently there has been a recent change in novacaine and the newer stuff now has epinephrine in it and I'm not the only one to have had a reaction like this.  The "new" novacaine lasts longer, which is good if you can tolerate the epinephrine.  If not then it seems you have the choice of valium or different novacaine.  I spoke to LF and she's going to give me different novacaine next time.

Sorry it took so long to post this, but nothing is really new with my teeth at the moment - they're all still there but not doing much at the moment.  I do see Dr. F this week and my surgery is in 3 and a half weeks.

A cleaning and good news

Last week I went for a dental cleaning. LF was excited to see me and my mouth. She's always so positive and happy - she thought everything looked good to her. But she did find 2 cavities starting so I'll be seeing her again next week.

Yesterday I went for an adjustment with Dr. F, he didn't do much other then change the chain on teeth on the lower right. The tooth that is sideways doesn't seem to be moving, but what do I know? But I did get good news. Dr. F will take the palate expander out before my surgery and it probably wont have to go back in - oh happy day!!!!

I got a tooth!

I've been late putting out this post, but on Monday I got a tooth to fill in my gap, YEA!

I was in the chair for about an hour, but it was worth it. The way the tooth is attached is that it is on the wire for the braces. As such, Dr. F put in a really think wire - think steel rod. Then Dr. F used some thin wire to tie it in too. I have to say it seems really sturdy in there. But the girl had a lot of trouble putting the wire in, it was a miscommunication between Dr. F and her - she was trying to feed the wire to my back teeth, but the wire only had to go to the tooth one in from the back. Also of note, Dr. F made the tooth a touch shorter then the ones next to it, so that it wouldn't be taking any pressure from biting on it.

I was in quite a bit of pain when Dr. F was putting the tooth on the wire. It's next to my middle tooth that hurts, so a new thick wire combined with all that movement from tying on the tooth, it was bad. It was the kind of pain that your eye want to cry, the pain doesn't make you cry, but it's so close to the tear ducts that you can't control it. I didn't actually cry, but I felt close to it. But in the next chair was a young girl who I think was crying and in quite a bit of pain. I must admit that I figured me crying wouldn't help her and I had to be tough and that gave me a little extra incentive to keep the tears in my eyes.

But I have to say, the tooth looks great! The picture was a self portrait with my iphone so it's not the best, but I think it gets the point across. I'm a smily happy go lucky kind of person, I now find myself, when I'm smiling, to be totally conscious of the fact that I now have a teeth (and hence not flashing my toothless smile) and it feels much better, I'm less shy about it. It's a good thing.

No new tooth, but I got a wire

Yesterday I went to Dr. F, I had hoped to get a new tooth, but ended up with a new wire instead. Although Dr. F did pick a color for the tooth that will be made to fill in my gap, hopefully he can add that when I return in 4 weeks. I did warn him that if I didn't get the tooth my mother was going to be calling him, she is quite eager for my tooth thinking that it will improve my speech. I do not believe it will have any meaningful impact on my speech.

But he did do a couple things during this visit.

He added a rubbery chain to the tooth on my lower right that is sideways, it would seem he's finally trying to rotate that tooth.

He also added a wire to my top row of teeth, while doing that the cap on one of my teeth fell off and had to be recemented. But my teeth really hurt today, I'm taking some good drugs and they still hurt. Also, it appears this morning that the wire has already moved to the left. I'll have to try to go tomorrow to take care of that.

Another milestone

On Wednesday night when I was brushing my teeth for bed I tugged a bit on my last and final stitch that was still in my mouth and it hurt, a lot.

On Thursday in the morning it hurt so much that I had someone from work take a look at it, I was actually on the verge of tears at one point because it hurt so much.

Thursday afternoon before dinner I noticed it finally fell out!!!!! Yea! It only took 6 weeks and 2 days, but who's counting?

So what's the deal with the bone graft?

I went to Dr. S today primarily to discuss when I would have my bone graft surgery. He said that Dr. F was being very conservative and I had to wait 4 months since the date of my last surgery. February 23 + 4 months = July (I'm guessing that Dr. S is going on vacation in early July so no late June or early July). I scheduled for July 27, but nothing is that easy since that is cutting it close to some vacations I have planned. I'll get back to that in a minute...

I asked Dr. S what the recovery was like after the bone graft - he said for 2 weeks I'll be on really soft food, ugh, I'm sick of soft food already! He said he was going to take the bone from my tibia (shin just below my knee) and that I would be a little sore 7-10 days and wont be jogging for a little while. But he said that if he had to take from my hip then the recover is a lot slower, possibly a couple months to get fully back up and running. He seemed to play that down, but the fact that he mentioned it indicates that it's a possibility. I also looked online, though it's hard to tell what type of bone grafts people are reporting about. Sounds like I'll be fairly sore for at least 2 weeks and the roof of my mouth will be easily irritated and tender for 2 weeks. And I saw that there might be an issue with flying (the whole pressurized cabin thing.)

After talking to Mom, who seemed a little concerned about the time frame and confused as to why I couldn't do it earlier I decided to call Dr. S's office. He said 2-3 weeks to fly, so I'm good, but I'm on the border with that time frame and that stressed me a bit. I asked if there was any possibility of getting the surgery the week before and was told that they are waiting for more surgical space and she'll see next week if they get more room. If they do she'll call me and give me a spot the week before. I would feel much more comfortable with that. While the trip to Las Vegas with my family is pretty relaxing I feel like 3 weeks will be cutting it close, 4 weeks I feel MUCH better with.

The other thing I asked about was my front tooth that I've been having trouble with - it's been sore for a couple years now and finally had a root canal in the fall. It's very close to the cleft but Dr. S thinks there is enough bone. However, he wont know for sure until he cuts open my mouth. Ackk!

I also have a vacation that I'm planning for mid September with Contiki. I think I'm fine with mid to late July and the recovery. Unless, they take the bone from my hip, my solution is to carefully research the reasons I can cancel my tour with travel insurance companies.

Building confidence

Since I've been back to work I have been feeling much better about my poor speech. Maybe my speech has gotten a little better, but I doubt much. Last week was a little rough being my first days back and then taking a training class - the whole being around strangers in a large group thing. Then over the weekend I had to speak with the executive staff at work and that went well (or at least I didn't hear anything bad.) Then this week I was away for training. I went to Washington DC, and other then a down moment when I first got to DC, I did well. And my down moment was probably more related to my being in a strange place and trying to find food with little success. But the first day in class I told the class that I had had surgery and that if they couldn't understand me to just ask me to repeat myself. I was a little quieter then I might normally be (possibly a good thing), but when I only had a few problems with I did speak and everyone was very nice and respectful. I'm running out of new and intimidating situations to be stressed about.

Felling a little better

I went to the Oral Surgeon on Monday afternoon. He said everything looked good and that I don't need to come up for follow up. However, he said to keep my appt that's in 2 weeks so we can work out a date for the bone graft. He did think that late June or early July was quite possible for that surgery.
He asked if I would be interested in a fake tooth with some sort of device that would cover up my hole and prevent fluid from going up my nose. I said yes, and he called Dr. F. He didn't speak to him, but plans to. I was so happy I nearly cried, I felt very cared for by Dr. S. He also anticipates that Dr. F will allow my palate to close up a bit before the surgery and said that my teeth are slanted out a bit, which I hear is common with the Surgically Assisted Rapid Palate Expander.

I asked where he gets the skin from for the palate and he said there is always plenty of skin in the cleft (remember it's two separate pieces of palate that are covered. He cuts that skin strategically so that there is enough for my base of my sinuses/nose and enough for the roof of my mouth. That's kinda what I thought, but now I know for sure.

A gross story, but it's almost funny 2 days later

You have been warned... But I think it's an interesting story if you want to know what it's like to have a palate expander.

I used to go to a place at a local mall that does messages on message tables. I went once after my surgery and with the trouble swallowing and laying on my stomach it was hard to keep the saliva in my mouth for 10 minutes, but I was able to do it. I hadn't been there since the surgery since my face was swollen and stuff and this week I thought I would give it a try, big mistake.

So I go and ask for a 10 minute message. A few minutes in the saliva in my mouth in building up and eventually I end up drooling through the hole in the table. Opps. But I feel a little better. Eventually I try to lift my head a bit to slurp up the saliva and swallow it. Another big mistake. It seemed to have pushed the saliva into my sinuses (not hard to do with the hole in the roof of my mouth.) So now it just dripped out of my nose uncontrollably. It was gross and I totally couldn't stop it. Think of a couple minutes of saliva dripping out of your nose...

I wont be going back there anytime soon, and I wont be getting a message while laying on my stomach either. I wonder if I can do one of those funky chairs?

Full expanded and need a tooth

On Wednesday I went to Dr. F and was done expanding! He put something in the expander so it wouldn't move anymore, took some pictures and an x-ray. He told me I come back in 4 weeks and he'll make me a fake tooth for the gap.

Here's where things kinda went sour and the reason I didn't post this for so long. I asked Dr. F what we were going to do about my not being able to talk. Well, he said I was talking fine and left it at that. I'm not sure if he can do anything, maybe Dr. S made up the thing about the retainer type of thing. But I felt like I was blown off. My speech is fine if you're a 10 year old. But I'm 33 years old and speak to government officials at work. I'm in a position at work where I can't afford misunderstandings. In most cases I can be understood, but it's not uncommon that I have to repeat myself or rephrase things so that people can understand me. I'm quite frustrated with this and am not sure how I'll deal with it for another 3 to 5 months. On top of having issues at work, it doesn't make me want to go out and meet people or go to social events. It's one thing to have speech problems with friends and family, it's another thing when you're with people you don't know. It makes a new social setting even more stressful. I start work again tomorrow, it should be interesting...

If I had known about this I don't know if I would have chosen this route. It's not just about my problems with speech, and at the end I'll probably be happy with everything and all this discomfort and frustration will be forgotten. But the palate expander is quite inconvenient, I have trouble swallowing, eating, taking medication, brushing my teeth. If I knew then what I know now I would have asked a lot more questions and maybe made a different decision. There's a lot of things that weren't in the brochure I got.

Also, I was supposed to get my dental cleaning this coming week, that will have to be put off for 6-8 weeks to avoid getting an infection in my cleft.

Update, including gross stuff

Sorry I've been so quiet lately, I've been meaning to post, but just haven't gotten myself together to do it. I've been healing well and progressing well so all of that is good. I'm not in any real pain. Occasionally, I feel a little sore in the cheeks after expanding, but that's more of an uncomfortable feeling then a pain feeling and it only lasts a little while. I have encountered two problems though... If you don't like gross stuff, don't read past here.

If you look back to months ago where I posted photos of my mouth you can see a light line in the roof of my mouth. That is where my cleft palate was pulled together, closing the hole that was in the roof of my mouth. Think of it as the roof palate being made of two pieces that were pushed together, the crease could always allow liquids to pass through, but it was so tightly fit that it rarely happened. Well what the palate expander is doing is pushing those two pieces of palate apart. Now all those liquids can EASILY (especially if my head isn't upright) pass through to my nose. Food hasn't been a problem though. The good news is that my eating is going better, I'm not back to steaks yet but I'm eating nearly as much food as I was in the past at a meal. It's still softer foods, but it's getting easier to find foods to eat on a menu and I'm not stuck eating the same foods for every meal.

The other problem is with my speech. I'm losing a lot of air through my nose and sound very nasally. I'm having trouble enunciating some sounds, it's very frustrating. To make it even worse I have a tendency to talk fast, which makes me even harder to understand.

Dr. S had mentioned there was the possibility of a retainer type of thing that could be made to help, and I think I need that, A LOT. But it looks like Dr. F will have to make it and I suspect when he makes this it will include a tooth (where the large gap has formed.) I'll ask about that next week when I go to Dr. F for my last expansion on March 17.

Days 4, 5, and 6

So Days 4, 5, and 6 of surgery were not good days. All the liquid medications were really bothering my stomach and making me throw-up. Not a particularly nice thing to do after having surgery on your mouth. I was prescribed an anti-nausea medication which was only partly helpful but cost me $60, ouch! I ended up switching my penicillin to a pill and stopped taking the Tylenol with codeine.

On Saturday I went to Dr. F (my Friday appointment was canceled due to snow) and apparently the palate expander wasn't tightening quite right, he said it was loose. I was subsequently rotated 4 times at that appointment causing pain to 1 tooth and a bit of dizziness. But otherwise Dr. F said things were looking good and I wasn't too swollen.

Days 1 and 2 - Post-Op

I'm finally back to report on days 1 and 2 post surgery. They were relatively quiet days, I would take medication every 4-6 hours (I took a total of 5 on top of any medication I was already taking) and was in and out of sleep most of the time. I missed some good parts of the olympics in these in and out of sleep fazes. There was a fair amount of pain, but nothing crazy as long as I was taking pain killers (Tylenol with codeine). The pain was primarily in the area just below my cheek bones, but also a bit in my temples.

Eating was difficult since my mouth didn't open much. Primarily I just had broth, jello and maybe an egg. Eating was slow and I wasn't terribly hungry. I stuck with mostly apple juice to drink.

I slept on my parents recliner/couch, it allowed me to keep my head up without fighting pillows. This was a particular issue since the night before surgery I tried to sleep kinda upright so I wouldn't get too congested and had a terrible time sleeping and had a little bit of a stiff neck in the morning.

On Wednesday I had to use my key to open the expander once. Being the only one who knew how to use the expander I had to do it myself. I got the key in the hole pretty quickly and did it. It didn't hurt much, though I did feel some pressure in my head.

The mean post-op nurse

Well from the subject you might have guessed that I had the surgery, and if you didn't guess - well I did. On Tuesday morning I went in at 6am and had the surgically assisted rapid palate expander surgery and it sucked. The morning went ok, got to the hospital ok and did all my processing fine. The doctor was a little late, something about a tractor trailer slowing him down. The nurse anesthetist was a girl I went to High School with.

After surgery I woke up and my whole entire head hurt! I asked for my mommy (it's times like these when we revert to childhood) and was told I couldn't see her until I left post-op but I don't remember what I had to do. But she gave me meds and I went back to sleep. Then I woke up again looking for mommy again and was again told I couldn't see her. She was tough, I was pathetic. Finally the pain killers were making me ill and I was actually sitting up when the Dr. S came by who berated the nurse for not having ice on my face. After that I pulled myself together so that I could leave post op and see my Mom and Dad. Probably 2 hours had passed. Then in the get ready to leave area I was still in quite a bit of pain and constantly in and out of sleep. It's all a bit of a blur but once I decided I was ready to go I got a last bit of medicine and then mom helped me get ready to go. I think it was close to 2pm by the time we left. I did get a bit of a chuckle when I was riding through the hospital in the wheel chair with ice packs on my face and people would almost walk into me.

I'm writing this on Friday and am doing ok all things considered. I'll write some more about the experience in the next few days but wanted to give a bit of an update about the surgery and the mean post-op nurse.

Ready to expand

I went on Wednesday and had the palate expander put in my mouth. I'm not a fan. I spent the first couple minutes trying to figure out how to swallow and in the end needed a tip from the girl in the office. slurp. I've gotten much better at swallowing though it still something that I sometimes have to pay attention to.

Talking has been another issue. I took off of work on Thursday but went in on Friday. I'm pretty self conscious about my speech, though it is steadily improving. Thursday I had to call tech support for my Tivo, then Cable, then Tivo again. I did manage to be understood.

I figure when I finally get this thing out I'll have finally mastered it.

I was taught how to expand it, but will not start expanding until after surgery on Tuesday. A couple teeth are a little sore from either the expander or from the bite being a little off. That will all change as I expand, I think and hope.

But a greater challenge has been that on and off all week I've had a cold threatening me. Earlier in the week I was just tired and a touch of sinus congesting, then I was feeling ok and the sinus congestion didn't seem as bad. I'll never know if I was actually getting better or just wishful thinking. Saturday I woke up with my ear bothering me from congestion. I've continued to baby myself hoping that this will all clear up. I'm feeling better today then yesterday but am quite concerned. On top of all of it I might be starving to death. The first 2 days I was having some real issues with eating, and although doing better I am still having issues which have left me eating less then I should be. Yesterday I really started to feel the affects of starvation. I seriously wonder how the people on Survivor survive with so little food. I've had headaches, fatigue, dizzy spells. I've been doing better at eating today.

Here's hoping I feel better tomorrow and the Doctor says I can continue with the surgery this week.

A fitting of sorts

This week I was back to Dr. F. He he fitted me for my palate expander. He took out the spacer and fitted my two (one in from the back) molars with rings and took a mold of my upper teeth. It would seem those rings will be attached to the palate expander. Then in an evil twist of fate he put new spacers in. My teeth have been a little tender, though not too bad, but now one of the spacers digs into my gums whenever I bite into it. I suppose that wont seem so bad when I get the palate expander in... That's just a week and a half away.

So exactly how much blood do they think I'll lose

The other day I got a nifty letter in the mail from Dr. S's office, it has all this info about my appts leading up to the surgery. It also recommends that I take an iron supplement for a month before the surgery. This could very well be a standard procedure since women do tend to have low iron counts, or it could mean I'm going to lose a lot of blood. Losing a lot of blood sounds much more dramatic, though hopefully it isn't true.

I did call my primary care physician regarding the iron because I have hemochromotosis, I absorb too much iron, but my iron levels are on the lower end right now. My doctor said it wouldn't hurt and so I'll be adding some iron to my diet soon.

Wide Open Spaces...

Ok, Dr. F added some spacers in on the top. It wasn't an easy process, it seems I have some very stubborn teeth, they take after me. The little plastic ones wouldn't go in on the right side of my mouth and I got jabbed a couple times on the roof of my mouth with the several attempts. Dr. F ended up putting in a different type of spacer in the right side.

Up next?

First week of February I am getting fitted for bands, I think. I overheard Dr. F talking to the secretary he didn't actually say it to me. Then the Wednesday before my surgery I go for the palate expander, I can't wait! They really do need to make a sarcasm font.

Did I mention that my surgery was approved by my health insurance? It was and I now know I made the right decision regarding that, I'm thankful that something is working out and not stressing me out.

I can't take the drama in my head

Years ago I took the Landmark Forum, part of Landmark Education. The short story is that it's a life improvement class, though that makes it sound really cheesy, it is much more then that. One of the lessons in it is about how your brain and mind are always thinking and talking to you. Too bad they don't tell you how to shut it up. They just tell you that it's stuff your mind makes up.

Well my mind wont stop talking and creating all this drama. I mentioned in my last post that I am considering staying at my parents house right after my surgery, and I'm 99% sure I'll do that, I just don't think I'll be able to handle icing my face that first day. I'm thinking this might end up being a good opportunity to listen to podcasts and cheesy movies I know every line to (but I wont mention any names). Today my Dad mentioned me staying for a couple days, WHAT, put the breaks on, who said a couple days? I was hoping to get out within 24 hours!

I'll have to admit that I personally don't enjoy spending large amounts of time with my parents simply because when they are together they fight non-stop. I can't deal with it... But also there is the whole, I'm sick I want my bed, and my couch and my stuff... I've been completely out of my house for 2 and a half years (mostly out for another 3 years before that.) It's my childhood home, but not my home. I love my little apartment, it's warm and fuzzy and has my stuff in it. That's where I want to be when I'm sick, even when I'm moaning I want my Mommy.

In the end I know I'll figure it out as I go and at some point I'll simply demand to go home, my Dad will comply and my Mom will probably yell at me. But in the meantime why can't I stop the fight in my head about how long I have to stay?

Stuff they don't put in the brochure

First, my wire on the bottom of my braces shifted last weekend so I was back at Dr. F's this week to have it moved back, it seems to be staying place now.

More importantly I was at Dr. S (Oral Surgeon) on Wednesday. The good news - my surgery is approved! The bad news, the stuff they don't say at the first consultation... I'm scheduled for late February. Dr. S went through his whole thing on how he cuts into my gums on the outside side of the teeth at the root line and cuts into the bones to break them - I'm almost adjusting to the concept of this though it's one of those things I think I would rather not know. After the surgery I'll apparently be very swollen and will have to ice my face all day and night and overnight. I'll be in pain for about 3 days, but I'll have pain killers for at night. I'll have to sleep upright the first night. The swelling will last 2-3 weeks and there may be some bruising. I'll start on a liquid diet the first day and then add foods over that next week, but mostly soup, and ice cream types of stuff. Ugh, this was not in the brochure!

I always knew I would be miserable, but this is sounding way worse then I thought. I'm actually considering going to either my parents house or my sisters house that first day and night. But I did place an order with mom for her homemade soup, I'm going to add an order of her apple sauce too. I'll make my own pea soup before hand.