Happy Halloween

Sooo, I know I haven't posted in a while, but for a while nothing was really happening, I was just hoping that all the doctors would figure out what was next and they finally did.

I'll start with the exciting news - I'm getting my braces off on Halloween!  YEA!

Here's what happened.  All the doctors finally decided that I had gone as far as braces could legitimately take me.  Dr. F had to move one tooth a bit, and last week it was finally in place.  So, I had a set of molds taken and Dr. F took off two brackets on my bottom, not the most exciting part of the story or the experience.  He then told me to come back Friday (yesterday).

Yesterday he put one of those small bars/bonded retainers on my bottom and asked why I didn't have an appt to take my braces off.  WHAT?  I was supposed to have one????  So I made my appt for next Wednesday.  I cannot wait.

Crissy

Moving along

In the past week or so I have been to see Dr. D, Dr. F and Dr. K a Prostodontist.

Dr. D likes my progress and bone growth.  She thinks I'm ready for the next step, a Prostodontist.  She does think that one or two implants are possible.

My next stop was Dr. F who thinks I'm about done with my braces, OH HAPPY DAY!  He wanted me to see Dr. K the Prostodontist about what he envisions for my teeth.  Depending on what he says I may be done with braces soon.

Yesterday I met with Dr. K. Very nice, mild mannered guy.  He asked a bunch of questions about my history and then reviewed the notes from Dr. F.  He still has some more questions for Dr. F, particularly in regards to a specific tooth that he is worried will move after the braces come off.  Otherwise he thinks Orthodontics has taken me as far as they can.  The rest he thinks he can do with crowns and stuff.  He may want to move a tooth or two, depending on what Dr. F says.  But, he does think the bottom teeth are fine.  Since they've been stuck in position for a while I'm hoping that at least those braces will come off this summer.  But, I don't see Dr. F until August. 

I have bone!

On Friday I saw Dr. D, she did X-Rays and I have bone in both the area where they did on distraction and where the bone graft was.  YEA!!!!  She already has me thinking about next steps.  She doesn't think implants are a good option, so I will need a good prostodontist to work with.

I saw Dr. F yesterday and he's not ready to start moving teeth yet, he wants to see my teeth more solidly set in the bone.  I go back in 6 weeks, which is around the 4 month mark that Dr. D had said was how long bone takes to set.

Surgery #5 Complete

Last week I went in for surgery #5, another bone graft.  Dr. D did this surgery and took bone from my right tibia.

From all accounts the surgery went well.  Dr. D told my father (not a man to be trusted with details) that the work that Dr. S had previously done had made her job easier and that the surgery had gone well. I am hopeful.  I haven't been in too much pain with this surgery, which is nice.

Here are my post-op war stories -
I wake up in recovery and I have a nurse who is an idiot and doesn't even know it.  She goes to take my warmer away, except I'm still cold.  When I warmed up she took away the warmer but left me under a stifling number of blankets, including the plastic one that connects with the warmer.  Then I get a neighbor who "can't breathe" apparently he had a chest tube and it hurt to breathe, but he was actually breathing.  For anyone who has come out of surgery - you don't really care, you just want them to shut up.  Of course there was some mix up with the PSA so it took a little longer then necessary to get working and shut him up.  Finally the nurse comes to check on me and I asked what I had to do to get away from the guy, she laughed.  I wasn't actually trying to make a joke...

3 hours goes by and I'm still in recovery.  The nurse assures me she's working on my release to post-op ambulatory, but times goes by slowly (I was in front of a clock, it goes very slowly) and now I'm starting to develop pain.  I tell the nurse this.  I know that if I get medication that I have to stay here for a while, my thinking was that if I'm going to be stuck here another hour, give me drugs, if I'm ready to go then send me on my way.  She says that as long as my pain is below a 2 I should just wait.  Who the heck said anything about the pain scale?  I decided I should take my chances and get away from her before she killed me.

In post-op ambulatory the nurses were much better, I even had a student nurse who was a complete sweetheart.  They even gave me drugs!  Then I finally got to leave and go to my parents house.

Recovery has been ok, my leg is not as sore as I expected, but I do find it's often hard to get comfortable, particularly at night when I'm trying to sleep (emphasis on the trying).  But otherwise I'm progressing ok.

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!

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?

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.

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.

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.

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?

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.

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.

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 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'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.

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!