A clipping

Appologies for my lack of posts.  I've been to see Dr. F and Dr. D, but it was right before and after taking a vacation and then with the chaos.  But here I am.

When I saw Dr. F I complained that my teeth were moving (and they hurt a lot) - he told me that was good.  It seems my teeth were moving into place, imagine that.  The pain has subsided and I'm able to eat again!

Dr. D was a more interesting visit.  On January 20th she is going to clip out the distraction device.  Small in the office procedure.  She is going to leave the part of the device that is under the gums, under the gums. 

Then in late February, early March she is going to do another bone graft in the area that was not covered by the distraction.  At that time she will remove the part of the device that is under the gums.  She said she would probably take bone from him hip - I can't wait. 

When she had initially mentioned doing the bone graft I had thought it would be a smaller procedure, but when you start talking about taking from my hip I know it's not a small procedure. 

I turned in my screw driver

Today I turned in my screwdriver, meaning I'm done moving my distractor!  It's always nice to hit a milestone.  They didn't end up moving the distractor as much as I thought they would, but it's pretty darn close and now I have so much more bone.

I don't have to see Dr. D for another 3 weeks and Dr. F for 6 weeks.  I nice break since I've been seeing them once or twice a week since the surgery.  Dr. D said she'll do another x-ray in 8 weeks to check my progress.  Until then, I feel like Madam Pomfrey in Harry Potter and trying to grow some bone - it's tough work!

Bones...

On my last trip to Dr. D she said that the teeth are moving fine and that although the gap in my gums has not cleared up, she said that wouldn't happen until I stop moving the teeth/bone.

Another one of the doctors from the practice was also in the room, he showed me 2 x-rays of my mouth, one from that day the other from a week ago - you could see the difference in where the teeth were.

While the two doctors were talking Dr. D mentioned that she was only going to move my teeth 2 teeth lengths, leaving the gap for the 3rd tooth.  The other doctor commented that the way the bone was positioned she probably couldn't go much further anyway.  The bone that is moving is more tapered at the gum line, so up in the gums it should meet up with the other bone first, never giving the bone at the bottom a chance to meet next to the other tooth.  I hope that made sense.

Then she said I would need a bone graft in that gap.  Ick!  I'm not sure if only going the length of 2 teeth (instead of 3) is because of the bone or because of the adjustment to slowing down the movement.  Either way, yuck, I don't want another bone graft.

One plus side is that I had a very small hole in the roof of my mouth and that seems to have been pushed closed with the movement of the bone and teeth, yea!

I don't like this Dr.'s Appt!

Monday I went to see Dr. D and it didn't go that great.  My gum separated from one of my back molars, leaving a gap and allowing fluid to come out.

Now I'm on an antibiotic, which my body doesn't like.

Dr. D also decided to stop moving the bone for 2 days and then on Thursday she wants me to start turning the screw again, but only twice a day instead of 3 times a day.  I'll see her again on Friday.

Ugh, this is very annoying and frustrating!  But on the up side my mouth seems to be doing much better now.

Here is a photo of my mouth.  In the front you can see a large bar, that is the screw.  When my mouth is closed other then looking a bit swollen in that area you can't see the screw.  When I open my mouth obviously it's a different story.  On the left you can see my two fake teeth and then a gap.  On the right of the first gap are the 2 teeth that are being moved.  To the right of those teeth you can (hopefully) see another gap, that is how much my teeth moved in 4 days.  Above that gap you can also see some metal, that is part of the device that was put in my mouth during the surgery.  There are actually two of those ladder like pieces.  One is on the right side of where the gap is the other is on the piece of bone that is moving.

Yesterday I saw Dr. D and let me just say that she is marvelous, I really do love her.

She started by rewiring the work that Dr. F had done.  On my upper left there are 4 teeth in the back, then the 3 toothless gap and then the right middle tooth.  The 2 left back teeth are staying where they are, the other 2 left teeth are the ones that will be moving into the gap with the bone.  She tied the 2 teeth that are moving together and then tied them to my bracket so they are guided by the wire as they move.

Yesterday Dr. D started to move the 2 teeth.  She turned the screw once (.3m), then my sister turned it once and later in the night I turned it once.  I can already feel the difference in the gap between my teeth in the back.  But when the teeth move I don't have any pain, I barely feel anything actually, just an extremely mild strange sensation.

She also took some weird high tech x-ray and showed me what she was doing.  I'll admit, there was nothing earth shattering in this but the x-ray was very fancy and a little over my head.

Oh, and she did say the surgery went well.

I have to go back on Monday.

I'll work on a picture or two so you can see what's going on.

First Trip to the Orthodontist

Wednesday I went to see Dr. F for the first time since the surgery.  He seemed happy with how things looked.  He also put 2 of my 3 teeth back in my mouth.  I'm sure my sister will be very happy (she was concerned after my surgery).

One of the two teeth that is being moved with the bone has moved backward in my mouth a bit.  This happened over time since my tooth was pulled back in June.  Dr. F didn't bother putting the tooth on the wire, I'm assuming since it has a different bracket on it and I was having surgery 2 weeks later.  I'm not sure why he didn't try to move the tooth sooner, but he didn't.  So now it was wired to the screw in my mouth to pull it back in to place.  I think it might have been easier doing it sooner then later.  But what do I know?

Surgery #4

This is just a quick post since I'm getting really tired, but since I haven't posted since the surgery I thought i should come up with something.

Surgery was Thursday and from what I remember, Dr. D said it went well.  I also saw Dr. S - he said he saw the photos and it looked good.

Now I'm just eating mushy food and waiting to see Dr. D on either Thursday or Friday and start moving this bone.

The pain isn't too bad, and the swelling is starting to go down.  But I have a screw sticking out of my mouth, that's a little weird.  It also makes swallowing a little awkward.  Lets just say that I'm working on my drooling problem.

I don't like that answer...

I saw Dr. F a week ago, nothing really new.  BUT, I did ask if Dr. D would be able to take my fake teeth and wire out - I have a wedding the weekend before surgery and Dr. F is away that week.  Dr. F said he would have to discuss that with Dr. D, he's not sure she knows how these braces work. 
BOOOOO!

I'm still around and still waiting

I haven't posted in a while because there is either nothing going on or what is going on is frustrating. 

The short story is that the Infectious Disease doctor cleared me for surgery, without seeing me.  That's fine with me, less running around.  And from everything that I have heard (from medical personel) the medication I had taken was the appropriate action and nothing more was needed. 

My surgery is now scheduled for Sept 22, a much longer wait then I wanted, but between my schedule and Dr. D's schedule this was the earliest I could get in - darn summer vacations! 

So, I'm just waiting...

I'm confused

On Friday I FINALLY got a call regarding my clearance by the Infectious Disease doctor.  He sent a letter to Dr. S clearing me for surgery.  Except, I never saw him, he only saw my test results.  Basically, Dr. S requested my cases be reviewed with all the information that was available to the Infectious Disease doctor and the doctor decided I was fine.  Sounds like my surgery got postponed for nothing. 

Don't get me wrong, I don't mind the delay if it's for the right reasons.  But I'm left wondering if Dr. S will be fine with this approval or if he'll push for more.  I know he wanted me tested again after I was on medication, which I haven't been, thought the Infectious Disease doctor would do that. 

I guess I'll find out on Tuesday, if someone actually calls me then. 

I didn't have surgery...

I'm not sure if I mentioned it, but my Mother got an infection after having her hip replaced, MRSA.  It's not a pleasant infection!  I've spent a lot of time around her -  helping her, keeping her company.  Not surprisingly I tested positive for carrying MRSA. 

My surgeon decided to postpone my surgery until an infectious disease doctor could review my case.  When I spoke to my primary care physician he told me that Dr. S was concerned that maybe I had been carrying it when I had my previous surgeries and that was part of the reason that my bone grafts were not a sucess.  But my primary care pysician also said that I had been cultured during the surgeries and didn't show MRSA then.  But, Dr. S wanted to have my case reviewed.  I'm told that my case was reviewed and I was cleared for surgery by infectious disease.   But of course this is a holiday weekend so I wont get an update until at least Tuesday when Dr. S can take a look at the note sent over to him. 

It worked out well though, my Mom was pretty sick earlier this week and I wasn't totally comfortable with having the surgery.  But I'll feel better about it in another week or so, she is doing much better.

There is no tooth fairy

On Monday I had an "exciting" day, I had my middle tooth pulled.

The day started with a trip to Dr. F's office, I needed to have the wire taken out of my braces.  That went quickly and without incident.  He told me that after my tooth was pulled that I could come back and have the fake teeth put back in to cover the span of now 3 teeth.

On the way to Dr. D's office I had a slice of pizza, which was a better idea before I had the wire taken out of my braces.  My teeth always feel tender after the wire comes out. 

At Dr. D's I was quickly set up for the extraction, some topical numbing cream, novicain (with epinephrine, opps - that doesn't agree with me).  Then a yank, and the tooth was out.  Dr. D did introduce me to one of the other doctors in the office while discussing if she should put in a little bone.  They decided not to.  2 or 3 stitches later my mouth was stuffed with guaze. 

After that we discussed the surgery.  She showed me where she would put in the distractor, and told me that the bone needs to move 20 cm, which at less then 1 cm per day will take about 3 weeks.  But, she will not start to move the distractor for 1 week.  After the distractor is in place the bone will need to set for about 4 months before they will take out the distractor.  If for some reason they need to take it out earlier she said that Dr. F has some tricks up his sleeve for keeping everything in place.  She explained that I will be on a soft food diet since she is concerned about me healing; but, she didn't say how long - ugh, I'm sick of soft food!

After that I left the office (guaze still in my mouth) and went to Dr. F's.  I didn't know how long I had to keep the gauze in my mouth so I still had it in my mouth 30 minutes later when I arrived at Dr. F's.  This became a problem because it meant I never had a chance to take any pain killers and the novicain wore off by the time I was done with Dr. F - NOT GOOD!  This wasn't quick, but it seemed relatively easy for Dr. F to put my wire back in, along with the 3 fake teeth thing.  Let me tell you, these teeth looked better then my real teeth ever did!  After that he showed me a model of my head, which was cool, explained what Dr. D is going to do.  Which was slightly different from what she said she was going to do.  I think they are still discussing exactly how they are going to do the distraction.  It's really cool and nifty and way over my head, so as long as they figure out what they're doing and are all on the same page, I'm good with that.  Then Dr. F took some pictures, I have no doubt I looked completely miserable in these pictures - I just wanted drugs or to cry by then. 

Luckily I carry Advil with me, I got in the car and the first thing I did was take Advil, then I noticed I was still bleeding a little.  But I needed some dinner (soup) and to get my prescription filled for pain killers.  I was never so glad to get home and relax. 

In other news...  My mother had surgery a month or so ago and got MRSA and is in the hospital on IV antibiotics for that.  This leaves the possibility that I have MRSA and on Wednesday went to my primary care physician to get tested.  I should get the results from that test back late this week or early next week.  If it's positive then I'll have to go on antibiotics immediately in preparation for the surgery.

Oh, and as for the subject - I did get to keep my tooth, but I was affraid to put my tooth under the pillow for the tooth fairy.  How freaky would it be if she actually showed up?

I seem to have fallen behind

Sorry, I had some chaos a few weeks ago (mom had her hip replaced), then I went on vacation.  Came home to mom having an infection.  ugh!

But anway, before my trip I did go see Dr. F.  He did a mold of my mouth.  When I have my middle tooth removed he will not be able to put a 3rd tooth on my wire so he will make a retainer like device.  Depending on how Dr. D closes up my mouth from the extraction Dr. F may be able to give me the retainer on the same day. 

He also adjusted the wire on the bottom and I'm really starting to see the tooth Dr. F is rotating move.  That makes me happy, it hurts when I bite on harder foods. 

A broken tooth and a new wire

Last week I was imbibing some jelly beans in honor of Easter and broke the bracket of one of my fake teeth, but don't tell the orthodontist.  I went in that Monday afternoon and had it fixed.  We did discuss my middle tooth being taken out, which is going to be a little tricky with timing since Dr. F will be out of the office the week before the week that I go away on my cruise. 

I eventually got to speak to Dr. D this week.  She hadn't had a chance to update herself on my file since she was away.  But she said that with my surgery date there was enough time after my cruise for me to get the tooth out then, instead of before the cruise.

Yesterday I went back to Dr. F for my regular appointment.  He didn't seem to remember our conversation from last week.  But I have an appt for the week before I leave on my trip to get molds done.  He also decided to try and move my bottom right tooth again, this is the 3rd attempt.  I figure it must be working because it hurts.  I took a picture of how he set this up.

A new surgeon and a new procedure

On Monday I did meet with Dr. F.  We did discuss the option of a bone graft and distraction.  While he didn't say it in so many words, he did seem to think another bone graft would not work.

Today I met with a new surgeon from Dr. S's office, Dr. D.  She is wonderful!  My sister would even let her do surgery on her.  I walked out feeling even more convinced that distraction was the right way to go.  She would also like to have Dr. F move my middle tooth a bit before it has to come out, allowing it to pull some bone with it.

Then I can go on a cruise and enjoy myself before they put the distraction device in.

From there it will take a few weeks to move my teeth and the device will stay in my mouth for a few months while the bone behind it grows.  After that they'll see how things develop in regards to what exactly they will do.  But the bottom line is that a few months later I should be able to get implants put in.

A bunch of crappy choices

I saw Dr. S yesterday to discuss my next steps.  I was given 3 choices.
1.  Not really do anything, but have a prosthetic put in place for the missing teeth.  I didn't have 3 surgeries so I could get a prosthetic to put in my mouth.  That plan is out.

2. Have another bone graft, they'll take out my middle tooth during this surgery.  Then hope to have enough bone to do 2 implants and bridge the 3rd tooth in.

3.  Have Dental Distraction.  What the heck is that?  Well they put in an appliance and move 2 of my teeth, which will bring the bone and tissue with it.  You can read a bit more about this type of procedure here: http://www.bilodeauorthodontics.com/case6.pdf Pictures are included of the device.  I need to go meet with another surgeon in the office who specializes in this area.

When I spoke to Dr. F last time I got the impression he wasn't too kean on the Distraction.  But looking at my other options, it seems like it has the most hope.  I already had 2 bone grafts that didn't get the job done.  I should say the last bone graft did work, it just didn't fill in the complete area that needed bone.  But if I had all these issues with the first 2 grafts, I question if a 3rd graft will be the answer.

I wonder what's ahead of me

I got a call on Friday from Dr. S's office, he wants to see me.  My appointment isn't until later this month, but has left me wondering what Dr. S and Dr. F have decided should be the next step....

Minor adjustments

Monday I went to see Dr. F.  All he did was make a minor adjustment to my bottom braces, the pain is starting to subside now. 

He did also discuss with me what Dr. S had proposed about moving my tooth, some sort of displacement procedure thing.  He made it sound a lot more complicated then Dr. S did.  Something about an incision and putting in a small metal thing.  Umm, ok.  But, Dr. F is not convinced this is the best course of action (not sure what he thinks should be done).  Dr. F thinks the bigger problem is a lack of blood vessels in the area of the cleft, which is causing all my problems.

Moving my newly cleaned teeth

I saw my surgeon last week and went for a cleaning this week, just to round out the excitement, I have the orthodontist next week.

Dr. S's next plan is to move one of my teeth.  It is the tooth next to the gap in my mouth, he wants to move it forward to help close up the gums.  By moving it (using the braces), the gums  (which haven't closed up right with my last 2 surgeries) should close up better.  I can't wait, I love moving teeth!

The other thing he said is that it looks like I will lose my front tooth, he said the bone just isn't there and he thinks it's part of the reason that the gums aren't closing up right.  It doesn't sound like something they're doing for a little while.  My dentist, LF, also agreed that the tooth didn't have good bone structure and it's not in good shape internally anyway.  But LF is as always, excited about my progress.  She however was not too excited that I have been using perodex since my surgery, it's been staining my teeth and I will agree they were looking pretty gross.

Ouch!

After my last appointment with Dr. F my braces were torturing me.  The way he attached my rogue tooth to the wires were really cutting into my gums quite badly.  I had 3 teeth constantly covered in wax.  So back I went to see Dr. F.  I gave it a few days so that my tooth could move back into place, which I figured would make it easier to put on the wire.  After a bit of wire clipping and tugging, the tooth was reattached to my wire and I was not in pain!  Oh, happy day!