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.

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.

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.

You have glue in your hair.

I started out my morning with a trip to the dentist to get my cap put back on, it took about 15 minutes with no drama.

In the afternoon I went to Dr. F for my braces. I started with a bit of good news... My bill was readjusted, the price didn't change but my payment options did and I didn't have to leave as much of a down payment. I could have paid the whole thing off and saved 5%, but then I wouldn't have much savings and that was a risk I wasn't willing to take.

Dr. F came and looked at my teeth and played with some brackets. Then a sweet girl came and prepped my teeth. They clamped my mouth open with some strange contraption, it made me wonder? Is this how Hannibal Lecter feels? Then she did the prep work, all I really know is that she sandblasted my teeth. Then Dr. F placed all the little brackets. The brackets didn't feel so comfortable, not that I thought they would. Once Dr. F was done the girl who was prepping my teeth picked the glue out of my hair. After having my mouth clamped open I must admit I had already lost some of my dignity, what's a little glue in the hair? I rinsed out and had the wire put in and things started feeling less comfortable. I wasn't in pain but there was definitely pressure on my teeth. I ended up only having one rubber band. My nephew had wondered what color rubber bands I would get, but Dr. F took away that concern. He used the "clear" braces in the front and the one rubber band was metal colored to match the brace it was on. Based on what the girl said, I either didn't get rubber bands because I spent a lot of money and am getting 5 star treatment (knowing the price tag that might be right), or it's because I'll actually brush my teeth and floss and generally take care of my teeth.

One dental observation. One of the teeth on my bottom right (I think a molar) had grown in sideways, it was never a problem, but I think, based on the placement of the brace, that Dr. F is going to rotate the tooth.

In the next few days I'll post some pictures of my teeth, as requested by my friend Kelley. I just don't have time tonight.

Orthodontist #3

In the middle of March I met with Dr. F. He's a bit older then the others, and knew my old orthodontist and plastic surgeon. This felt good. He started with a very basic history and I liked his style. Then he hit me with the $650 consultation fee. I figured I wasn't really in a position to walk out and I liked him so far so I went with it and had the whole history done. Besides the $650 would go towards my total price from my braces - I was trying to think positive because I knew the braces were going to be expensive. During the history he seemed to do things a little differently and in a good way. I left poorer, but felt like I might have met, the one...

Three weeks later Mom and I met with Dr. F. He presented 3 options. I'll go in reverse order... Don't do anything except have LF make a better crown for the two teeth and go on with life and be done. He didn't say it, but I will, it wouldn't last forever. Option 2 had me using braces to round out my mouth and make other adjustments. Get a bone graft to secure the teeth in that area and call it a day. This was pretty much I was expected and was similar to what Dr. G had suggested. But plan 1 was still to come. This plan would start with a palate expander, braces, then bone graft. What this would do is open up my smile more, widen the base of my nostrils and allow for a more extensive bone graft. All of this would allow the opportunity for me to also have surgery to further repair my cleft lip and the partially collapsed nostril. The price tag was just about $9000. for the braces. Dr. F explained that the palate expander and bone graft would be processed through health insurance which would probably have some sort of co-payment/deductible issues. He also explained that NY State has a law that requires health insurance plans to pay for an implant for a congenitally missing too, which I have, or rather don't have.

I walked out feeling more then a little overwhelmed. I didn't walk in thinking that I needed perfect teeth, nor did I ever consider having my nose and my lip re-repaired. But the ability to do so, if I chose to, made me lean toward the most extensive plan. Mom seemed to agree too, though she never said so. I did a little research on this infamous palate expander and found this account of the experience, and it really didn't seem that bad.

Orthodontist #2

At the end of January I met with Dr. K, Orthodontist #2. He immediately seemed very nice, caring and interested in my case. I got the appointment really fast with Dr K the downside was that he hadn't spoken to LF or Dr. S so I had to explain all the different issues, probably not the most effective way to do this. I liked him and his office manager seemed well versed in getting insurance companies to pay for things. Additionally, he was only charging $5000 for the braces. I must admit that I was weary that the price was so low compared to Dr. G, but his office seemed a little more modest so I hoped it just had to do with lower overhead

A few days later I got a call from LF, she had spoken to Dr. S and they decided that Dr. K wasn't up to doing the job. She found another Orthodontist for me to go to, Dr. F. I started to wonder if this was every going to happen.

Orthodontist #1

In December I met with Dr. G, the first orthodontist I would meet with. On the first visit he took x-rays, photos and molds. He seemed to be a nice guy with a nice office, and he explained to me about a new braces system, Damon, that had come out since I had braces years ago. I don't remember the specifics of it, but they are supposed to be better, faster, and less painful.

In the beginning of January I went for the consultation with my mom. I called a few days before the appointment to make sure that he was ready. At the appointment he seemed confident he could do the job and seemed to know orthodontics. He however had not consulted with LF, who I knew wanted to speak to him, I have been and continue to be in close contact with LF. Dr. G did not know where my teeth were. Granted, the two teeth covered by the cap can be a bit deceiving, but there are two teeth side by side, he thought that one was in front of the other. He also started talking about a periodontist, which had never been mentioned and said I could need jaw surgery, also never mentioned. He just didn't seem to be working with this team that was being created, he seemed like he was operating on his own. When I left he said he would get in touch with LF, which he should have done BEFORE I came. I wasn't impressed and neither was my mother. I should mention that his cost would be $7,500., which I thought was a lot for a guy who I wasn't impressed with.

I consulted with LF, told her that I didn't feel comfortable using Dr. G. She decided to talk with him about the case, if for no other reason then to get a gauge on what his thought process was. She didn't seem overly impressed with him either. She did some asking around and it was recommended that I see Dr. K.