Thursday, July 31, 2003
Only Five More Cranks!
I had my appointment today with Dr. Weston and the others at the NYU Orthodontics Department. Dr. Weston, Dr. Karlis and Dr. Hahn examined me, then three other dentists came to take a look as well. Apparently the expansion has been good on my left side, but more troublesome on the right. There was some controversy between them all over whether to continue with the expansion or not. As Dr. Weston explained, some of them feel that after the device comes off, the bone and jaw will revert somewhat back to its original position, while others feel that my having had the surgery will mean that the movement back will be minimal or nonexistent. Dr. Hahn seems to be the most conservative, while others advised a more aggressive schedule of cranks. The final verdict is that I am to continue with one crank a day for five more days, with the final twist on Monday night. I am happy and comfortable with this schedule. I am expecting that once I stop cranking, the swellling and numbness will really begin to go away. Dr. Weston took an X-ray of my upper jaw/palate, and he showed me where the bone was cut and has now separated. Over the next several months, new bone will grow into the space and will hopefully solidify that way and hold for all time. I was there today for about 90 minutes, and Dr. Weston was very nice to me and answered all of my questions (I had a lot of them) and addressed my concerns. I am going to have to wear this expander for at least two more months, perhaps three.
Gap Toothed Smile, Crooked Teeth
Now that I have been expanding my upper jaw, my smile looks horrifyingly awful. There is a large gap between my two front teeth, and the right front tooth is crooked and sticking out. Everything looks terrible. They need to make me look worse before they can make me look better. I know this is only temporary, but it still makes me a little uncomfortable. I just have to remember that I will be very happy 18 months from now.
Clear Vs. Metal Brackets on Top
On my way out, one of Dr. Weston's colleagues, a tall, good-looking dentist who has been wearing braces for a year, came over to say hello to me. This guy has clear braces on top and metal ones on the bottom. I had planned on getting the clear ones on top, but this dentist suggested that it might be better for me to just get the metal ones. He says he's constantly being asked questions about his braces. ("Do you have something on your teeth? Is that Invisalign? etc.) and he finds this annoying. I probably would too. If he had metal braces, he said, people would know what they are and not bother him so much. This gives me something to think about over the next couple of months.
Renegade Tooth on Lower Level
I have one molar on the lower right side that sticks out a great deal, and one of the dentists today suggested that this be corrected now. So there was talk today among the doctors of attaching a bracket to the renegade tooth, and rigging something to the expander device, then attaching both with a rubber band to bring that tooth back into line. This would be carried out after the expansion itself, but while the expander is still in my mouth.
The Check for $3,000
Before I began today, I was presented at the receptionists with my contract for treatment. The total cost is $4,000. I had three payment options, but by paying all in one lump payment I received a 25% discount, so I paid $3,000 today and got the whole thing over with. I knew this was coming, and I had the check ready. It is very expensive, and money has been and will be tight for me for the rest of the year, but I am glad to have saved $1,000. If I choose the clear brackets on top, that will cost an additional $250.
Drugs Schedule
I have been taking fewer pain meds, and I have been sleeping better. I will no longer enter my pill taking schedule.
July 30, 11:15 pm. 14TH CRANK
I had my appointment today with Dr. Weston and the others at the NYU Orthodontics Department. Dr. Weston, Dr. Karlis and Dr. Hahn examined me, then three other dentists came to take a look as well. Apparently the expansion has been good on my left side, but more troublesome on the right. There was some controversy between them all over whether to continue with the expansion or not. As Dr. Weston explained, some of them feel that after the device comes off, the bone and jaw will revert somewhat back to its original position, while others feel that my having had the surgery will mean that the movement back will be minimal or nonexistent. Dr. Hahn seems to be the most conservative, while others advised a more aggressive schedule of cranks. The final verdict is that I am to continue with one crank a day for five more days, with the final twist on Monday night. I am happy and comfortable with this schedule. I am expecting that once I stop cranking, the swellling and numbness will really begin to go away. Dr. Weston took an X-ray of my upper jaw/palate, and he showed me where the bone was cut and has now separated. Over the next several months, new bone will grow into the space and will hopefully solidify that way and hold for all time. I was there today for about 90 minutes, and Dr. Weston was very nice to me and answered all of my questions (I had a lot of them) and addressed my concerns. I am going to have to wear this expander for at least two more months, perhaps three.
Gap Toothed Smile, Crooked Teeth
Now that I have been expanding my upper jaw, my smile looks horrifyingly awful. There is a large gap between my two front teeth, and the right front tooth is crooked and sticking out. Everything looks terrible. They need to make me look worse before they can make me look better. I know this is only temporary, but it still makes me a little uncomfortable. I just have to remember that I will be very happy 18 months from now.
Clear Vs. Metal Brackets on Top
On my way out, one of Dr. Weston's colleagues, a tall, good-looking dentist who has been wearing braces for a year, came over to say hello to me. This guy has clear braces on top and metal ones on the bottom. I had planned on getting the clear ones on top, but this dentist suggested that it might be better for me to just get the metal ones. He says he's constantly being asked questions about his braces. ("Do you have something on your teeth? Is that Invisalign? etc.) and he finds this annoying. I probably would too. If he had metal braces, he said, people would know what they are and not bother him so much. This gives me something to think about over the next couple of months.
Renegade Tooth on Lower Level
I have one molar on the lower right side that sticks out a great deal, and one of the dentists today suggested that this be corrected now. So there was talk today among the doctors of attaching a bracket to the renegade tooth, and rigging something to the expander device, then attaching both with a rubber band to bring that tooth back into line. This would be carried out after the expansion itself, but while the expander is still in my mouth.
The Check for $3,000
Before I began today, I was presented at the receptionists with my contract for treatment. The total cost is $4,000. I had three payment options, but by paying all in one lump payment I received a 25% discount, so I paid $3,000 today and got the whole thing over with. I knew this was coming, and I had the check ready. It is very expensive, and money has been and will be tight for me for the rest of the year, but I am glad to have saved $1,000. If I choose the clear brackets on top, that will cost an additional $250.
Drugs Schedule
I have been taking fewer pain meds, and I have been sleeping better. I will no longer enter my pill taking schedule.
July 30, 11:15 pm. 14TH CRANK
Tuesday, July 29, 2003
Monday, July 28
3:45 am, 1 vicodin
10:15, 2 aleve
3:15 pm, 1 vicodin
7:30, 2 advil
11, 1 vicodin
11:30 pm, 12th CRANK
3:45 am, 1 vicodin
10:15, 2 aleve
3:15 pm, 1 vicodin
7:30, 2 advil
11, 1 vicodin
11:30 pm, 12th CRANK
Monday, July 28, 2003
Strange Crack Last Night
Last night about an hour after I went to bed (and and hour after my nightly crank on the device), something in the roof of my mouth cracked. It was sudden, it was painful, and it was alarming. It felt like something broke or snapped. It woke me up too. I was glad that I had an appointment this morning with Dr. Karlis. When I got there, she took me and Edgar (another one of their victims) up to orthodontics. Both she and Dr. Hahn examined me, I told them about the crack, they said it was expected and told me to keep cranking on the device once a day. The swelling is down somewhat on the left side of my face, and I have some feeling back in the skin on the left side of my nose. The numbness persists in the other places. I go back on Thursday to see Drs. Weston, Karlis and Hahn.
Sunday, July 27
5 am, 1 vicodin
10:15, 1 vicodin
3:45 pm, 1 vicodon
7:45, 2 advil
10:30, 1 vicodin
July 27, 10:45 pm: 11TH CRANK
Last night about an hour after I went to bed (and and hour after my nightly crank on the device), something in the roof of my mouth cracked. It was sudden, it was painful, and it was alarming. It felt like something broke or snapped. It woke me up too. I was glad that I had an appointment this morning with Dr. Karlis. When I got there, she took me and Edgar (another one of their victims) up to orthodontics. Both she and Dr. Hahn examined me, I told them about the crack, they said it was expected and told me to keep cranking on the device once a day. The swelling is down somewhat on the left side of my face, and I have some feeling back in the skin on the left side of my nose. The numbness persists in the other places. I go back on Thursday to see Drs. Weston, Karlis and Hahn.
Sunday, July 27
5 am, 1 vicodin
10:15, 1 vicodin
3:45 pm, 1 vicodon
7:45, 2 advil
10:30, 1 vicodin
July 27, 10:45 pm: 11TH CRANK
Saturday, July 26, 2003
Saturday, July 26
6:45 am, 1 vicodin
10:15, 2 aleve
4:15 pm, 1 advil
6:15, 1 vicodin
10:15, 1 vicodin
July 26, 10:15 pm, 10th CRANK
6:45 am, 1 vicodin
10:15, 2 aleve
4:15 pm, 1 advil
6:15, 1 vicodin
10:15, 1 vicodin
July 26, 10:15 pm, 10th CRANK
Friday, July 25, 2003
One Week After Surgery
The surgery was one week ago. Today at work, many of my co-workers said that I look much better. I can still tell (and feel) that I am swollen. The numbness persists, though by the end of the day I was starting to feel a little better on the left side. On my way home from work tonight I found a great place that makes a "he-man" protein shake. It was terrific, and I'll be getting one every day. I hope my liver can handle all the pain pills I've been taking. I tried to lay off the vicodin for most of the day, hoping that avoiding it would help the swelling go down. I feel much better when medicated with it, though. I cranked the device in the afternoon at work, and felt a few crackles when I did. I finished the penicillin a half hour ago.
Wednesday, July 23
4:45 am, 1 vicodin
8:45, penicillin
9, 1 vicodin
11:45, 2 aleve (now spelled correctly)
1:30 pm, 1 vicodin
1:30, penicillin
6:30, 1 vicodin, vitamin
8:15, penicillin
10, 2 fiber
10, 1 advil
12:00, 1 vicodin
12:15, penicillin
Thursday, July 24
4 am, 1 vicodin
8:30, 1 advil
8:30, penicillin
11, 1 vicodin
2 pm, 2 advil
2, penicillin
3:30, 1 vicodin
7:30, penicillin
7:30, 1 vitamin, 1 fiber
8, 1 advil
9:15, 1 advil
11:30, 1 aleve
Friday, July 25
4 am, 1 advil
4, penicillin
9:15, 2 aleve
11, penicillin
1:45 pm, 1 advil
3:45, 1 vicodin
6:30, penicillin, 2 fiber
11:30, multivitamin, 1 fiber
12:00, 1 vicodin
12:30, penicillin (last one)
July 25, 4 pm: NINTH CRANK
The surgery was one week ago. Today at work, many of my co-workers said that I look much better. I can still tell (and feel) that I am swollen. The numbness persists, though by the end of the day I was starting to feel a little better on the left side. On my way home from work tonight I found a great place that makes a "he-man" protein shake. It was terrific, and I'll be getting one every day. I hope my liver can handle all the pain pills I've been taking. I tried to lay off the vicodin for most of the day, hoping that avoiding it would help the swelling go down. I feel much better when medicated with it, though. I cranked the device in the afternoon at work, and felt a few crackles when I did. I finished the penicillin a half hour ago.
Wednesday, July 23
4:45 am, 1 vicodin
8:45, penicillin
9, 1 vicodin
11:45, 2 aleve (now spelled correctly)
1:30 pm, 1 vicodin
1:30, penicillin
6:30, 1 vicodin, vitamin
8:15, penicillin
10, 2 fiber
10, 1 advil
12:00, 1 vicodin
12:15, penicillin
Thursday, July 24
4 am, 1 vicodin
8:30, 1 advil
8:30, penicillin
11, 1 vicodin
2 pm, 2 advil
2, penicillin
3:30, 1 vicodin
7:30, penicillin
7:30, 1 vitamin, 1 fiber
8, 1 advil
9:15, 1 advil
11:30, 1 aleve
Friday, July 25
4 am, 1 advil
4, penicillin
9:15, 2 aleve
11, penicillin
1:45 pm, 1 advil
3:45, 1 vicodin
6:30, penicillin, 2 fiber
11:30, multivitamin, 1 fiber
12:00, 1 vicodin
12:30, penicillin (last one)
July 25, 4 pm: NINTH CRANK
Thursday, July 24, 2003
Reducing Cranks on the Device to Once a Day
I met with Dr. Weston this morning. The numbness in my face continues to be my greatest cause for concern and discomfort, but before I could get too far into my whining and complaining to Dr. Weston about this, he explained to me what's behind the numbness. He also knew exactly where the numbness was and what it felt like. I was quite impressed, and was also reassured that what I am going through is normal. The nerves on either side of my nose have been aggravated by the swelling, and rather than fire off pain signals 24/7, they have simply shut down. Dr. Weston examined my upper teeth and said he was very pleased with the progression of the separation. I was worried about one tooth in particular, the middle one between the bands on the right, which seems to be lagging behind the others, but this is apparently not a cause for alarm. He says it will catch up with the others, and if it doesn't it will pop into line in no time once the braces are applied this fall. He showed me that while I do have more space than when we started, we still have a ways to go with the separation. And he will probably expand a bit further than what is actually needed, as the bone will tend to move back once the device comes off. When Dr. Hahn came to talk to me, he seemed surprised that I am numb. He wants me to come back in a week for a panoramic X-ray, and he wants me to cut back on the cranking from twice a day to once a day. Dr. Weston says this easier schedule will give the roots of my teeth more time to move and will prevent them from "tipping" out. The bad news is that this whole thing will last longer. Hopefully, the slower schedule will make the swelling/numbness go down. I so much want the numbness to go away.
Schedule of Cranks
Dr. Hahn asked that I keep track of when and how much I crank the expander device. It was turned during surgery on July 18 by Dr. Karlis. Since then I have been keeping written records, which I am transposing from my notebook here:
Monday, July 21, 9 am, 2 cranks (with Dr. Karlis)
Monday, July 21, 11:30 pm, 1 crank
Tuesday, July 22, 8:15 am, 1 crank
Tuesday, July 22, midnight: 1 crank
Wednesday, July 23, 11 am: 1 crank (with Dr. Karlis)
Wednesday, July 23, midnight: 1 crank
Thursday, July 24, 11 am: 1 crank
Now that I will be cranking just once a day, I will move toward doing it before bed, as that is the easiest time of the day for me to do it.
The Drugs
Since the surgery I have been taking a lot of pain medication and other pills. Penicillin was prescribed to prevent infection. I also got hydrocordone/acetominophen (also known as Vicodin). I got the super strength pills with 7.5 milligrams of hydrocordone and 750 milligrams of acetominophen. It's basicallly Tylenol on steroids with a narcoic kicker. For pain I've also been taking Advil (ibuprofen) and Alleve (naproxen sodium). in addition, I've been taking my men's multivitamin and also fiber pills (to prevent constipation from the antibiotic and the narcotic). Since I have been writing everything down, I might as well type in the schedule here:
Friday, July 18
Don't remember exactly/didn't write down. I know I started the penicillin.
Saturday, July 19
10 am, 2 alleve
11 am, penicillin
12:45 pm, 1 vicodin
5 pm, penicillin
5:30 pm, 1 vicodin
9 pm, 1 advil
11:15 pm, penicillin
11:15 pm, 1 vicodin
Sunday, July 20
4:15 am, 2 alleve
7:15 am, penicillin
7:15 am, 1 advil
10:30 am, 2 alleve
11:45 am, 1 vicodin
1:30 pm, penicillin
5:15 pm, 1 advil
6:30 pm, penicillin
6:30 pm, 1 alleve
8:25 pm, 1 vicodin
midnight, penicillin
midnight, 2 advil
Monday, July 21
5:15 am, 1 alleve
7:15 am, penicillin
7:45 am, 1 vicodin
12:30 pm, penicillin
12:30 pm, vicodin
12:30 pm, 1 vitamin, 2 fiber
5:15 pm, 2 advil
6:15 pm, penicillin
6:30 pm, vicodin
8:15 pm, 2 alleve
8:30 pm, 2 fiber
11:30 pm, penicillin
11:30 pm, 1 vicodin
Tuesday, July 22
4:20 am, 1 vicodin
7:45 am, penicillin
8:30 am, 1 vicodin
12:30 pm, 1 alleve
1:45 pm, 1 vicodin
1:45 pm, penicillin
4:30 pm, 2 advil
7:45 pm, penicillin
7:45 pm, 1 vicodin
7:45 pm, 1 vitamin, 1 fiber
11:30 pm, penicillin
11:30 pm, 1 vicodin
I met with Dr. Weston this morning. The numbness in my face continues to be my greatest cause for concern and discomfort, but before I could get too far into my whining and complaining to Dr. Weston about this, he explained to me what's behind the numbness. He also knew exactly where the numbness was and what it felt like. I was quite impressed, and was also reassured that what I am going through is normal. The nerves on either side of my nose have been aggravated by the swelling, and rather than fire off pain signals 24/7, they have simply shut down. Dr. Weston examined my upper teeth and said he was very pleased with the progression of the separation. I was worried about one tooth in particular, the middle one between the bands on the right, which seems to be lagging behind the others, but this is apparently not a cause for alarm. He says it will catch up with the others, and if it doesn't it will pop into line in no time once the braces are applied this fall. He showed me that while I do have more space than when we started, we still have a ways to go with the separation. And he will probably expand a bit further than what is actually needed, as the bone will tend to move back once the device comes off. When Dr. Hahn came to talk to me, he seemed surprised that I am numb. He wants me to come back in a week for a panoramic X-ray, and he wants me to cut back on the cranking from twice a day to once a day. Dr. Weston says this easier schedule will give the roots of my teeth more time to move and will prevent them from "tipping" out. The bad news is that this whole thing will last longer. Hopefully, the slower schedule will make the swelling/numbness go down. I so much want the numbness to go away.
Schedule of Cranks
Dr. Hahn asked that I keep track of when and how much I crank the expander device. It was turned during surgery on July 18 by Dr. Karlis. Since then I have been keeping written records, which I am transposing from my notebook here:
Monday, July 21, 9 am, 2 cranks (with Dr. Karlis)
Monday, July 21, 11:30 pm, 1 crank
Tuesday, July 22, 8:15 am, 1 crank
Tuesday, July 22, midnight: 1 crank
Wednesday, July 23, 11 am: 1 crank (with Dr. Karlis)
Wednesday, July 23, midnight: 1 crank
Thursday, July 24, 11 am: 1 crank
Now that I will be cranking just once a day, I will move toward doing it before bed, as that is the easiest time of the day for me to do it.
The Drugs
Since the surgery I have been taking a lot of pain medication and other pills. Penicillin was prescribed to prevent infection. I also got hydrocordone/acetominophen (also known as Vicodin). I got the super strength pills with 7.5 milligrams of hydrocordone and 750 milligrams of acetominophen. It's basicallly Tylenol on steroids with a narcoic kicker. For pain I've also been taking Advil (ibuprofen) and Alleve (naproxen sodium). in addition, I've been taking my men's multivitamin and also fiber pills (to prevent constipation from the antibiotic and the narcotic). Since I have been writing everything down, I might as well type in the schedule here:
Friday, July 18
Don't remember exactly/didn't write down. I know I started the penicillin.
Saturday, July 19
10 am, 2 alleve
11 am, penicillin
12:45 pm, 1 vicodin
5 pm, penicillin
5:30 pm, 1 vicodin
9 pm, 1 advil
11:15 pm, penicillin
11:15 pm, 1 vicodin
Sunday, July 20
4:15 am, 2 alleve
7:15 am, penicillin
7:15 am, 1 advil
10:30 am, 2 alleve
11:45 am, 1 vicodin
1:30 pm, penicillin
5:15 pm, 1 advil
6:30 pm, penicillin
6:30 pm, 1 alleve
8:25 pm, 1 vicodin
midnight, penicillin
midnight, 2 advil
Monday, July 21
5:15 am, 1 alleve
7:15 am, penicillin
7:45 am, 1 vicodin
12:30 pm, penicillin
12:30 pm, vicodin
12:30 pm, 1 vitamin, 2 fiber
5:15 pm, 2 advil
6:15 pm, penicillin
6:30 pm, vicodin
8:15 pm, 2 alleve
8:30 pm, 2 fiber
11:30 pm, penicillin
11:30 pm, 1 vicodin
Tuesday, July 22
4:20 am, 1 vicodin
7:45 am, penicillin
8:30 am, 1 vicodin
12:30 pm, 1 alleve
1:45 pm, 1 vicodin
1:45 pm, penicillin
4:30 pm, 2 advil
7:45 pm, penicillin
7:45 pm, 1 vicodin
7:45 pm, 1 vitamin, 1 fiber
11:30 pm, penicillin
11:30 pm, 1 vicodin
Wednesday, July 23, 2003
More Pain, More Agony
I have been completely miserable for the past two days. Last night, the pain was so bad that I was on the verge of tears. I met with Dr. Karlis this morning. I complained about all of my aches and pains, including the soreness, the numbness, pain at the root of my upper left teeth, my sore throat (caused from the anesthesia tube), and my general state of agony. She assured me that everything was OK, that the surgery had been successful and that the numbness and pain will go away. She had me crank the key (I hadn't done it that morning yet), so we know I have the hang of it. Every time I crank the thing, the pain and numbness increase a great deal. She said I could take a day off from the cranking or reduce it to once a day, but frankly I would prefer to get this over with so I will be continuing twice a day. She encouraged me to focus on my diet and to get lots of protein.
Return to Work Today
After meeting with Dr. Karlis, I went in to the office. It was good to be back at work, and I was quite busy this afternoon. I did not do too bad on the phone. I usually tell the caller or callee that I have had jaw surgery, so they understand why I might sound strange. Many of my co-workers noticed the swelling immediately, and they were curious as to how I was doing and how I was feeling. I told Don that it hurts me to laugh, so he posted a "No Laughing Zone" sign in my work area. Tomorrow morning I see Dr. Weston, and I will head in to work afterward. I will, as usual, have my list of questions for him. Topic A will be how much longer I have to keep turning this damn key!
I have been completely miserable for the past two days. Last night, the pain was so bad that I was on the verge of tears. I met with Dr. Karlis this morning. I complained about all of my aches and pains, including the soreness, the numbness, pain at the root of my upper left teeth, my sore throat (caused from the anesthesia tube), and my general state of agony. She assured me that everything was OK, that the surgery had been successful and that the numbness and pain will go away. She had me crank the key (I hadn't done it that morning yet), so we know I have the hang of it. Every time I crank the thing, the pain and numbness increase a great deal. She said I could take a day off from the cranking or reduce it to once a day, but frankly I would prefer to get this over with so I will be continuing twice a day. She encouraged me to focus on my diet and to get lots of protein.
Return to Work Today
After meeting with Dr. Karlis, I went in to the office. It was good to be back at work, and I was quite busy this afternoon. I did not do too bad on the phone. I usually tell the caller or callee that I have had jaw surgery, so they understand why I might sound strange. Many of my co-workers noticed the swelling immediately, and they were curious as to how I was doing and how I was feeling. I told Don that it hurts me to laugh, so he posted a "No Laughing Zone" sign in my work area. Tomorrow morning I see Dr. Weston, and I will head in to work afterward. I will, as usual, have my list of questions for him. Topic A will be how much longer I have to keep turning this damn key!
Monday, July 21, 2003
More Pain This Evening
Well I was fine until about dinner time. Apparently turning the key is going to increase the pain, swelling and numbness. Dr. Karlis opened it up two cranks this morning, and I was fine all day until late this afternoon, when things started to bother me more. I went for a walk, and fixed myself dinner: yankee bean soup and mashed potatoes and gravy from the diner, plus applesauce and cottage cheese. Yum. I'm about to begin my oral hygeine ritual: brushing, flossing, rinsing, and warm salt water. And of course the dreaded crank on the key. Yikes!
Well I was fine until about dinner time. Apparently turning the key is going to increase the pain, swelling and numbness. Dr. Karlis opened it up two cranks this morning, and I was fine all day until late this afternoon, when things started to bother me more. I went for a walk, and fixed myself dinner: yankee bean soup and mashed potatoes and gravy from the diner, plus applesauce and cottage cheese. Yum. I'm about to begin my oral hygeine ritual: brushing, flossing, rinsing, and warm salt water. And of course the dreaded crank on the key. Yikes!
The Numbness Is Going to Go Away
I met with Dr. Karils first thing this morning. I brought with me the key to the device and my list of questions. Topic A was the numbness. Dr. Karlis said that it will go away. She explained that there are nerves on either side of my nose that have been aggravated, and that the swelling has exacerbated this. The nerves were not cut. As the swelling goes down, I will begin to feel pins and needles and eventually things will go back to normal. She did say, however, that some people have had the numbness for as long as six months. I hope I am not one of those people. I also asked Dr. Karlis about problems with the anesthesia, and she said that I did in fact have trouble coming out of it. She said I was very agitated. She took two X-rays, a panoramic mouth shot and one of my two front teeth. She showed me both, and explained to me that the roots of both of my front teeth separated nicely and there are no complications there.
Turning the Key
This morning with Dr. Karlis was the first time that I cranked the key to the device in my mouth. I was nervous as to how this would go, but it was fine. I turned it once, and Dr. Karlis turned it once more. I am to turn it once in the morning and once at night. Each crank creates an additional 0.25 millimiters of space. When the device is cranked, it just feels tighter. Each time the gap between my two front teeth will widen. It's currently about half to three quarters of a millimeter.
Dr. Karlis also got me some more of the wax from the orthodontics department. I use the wax to cover the brackets where they meet my cheeks, to eliminate the irritation. On the elevator out I bumped into Dr. Varnai and one of Dr. Weston's associates, who were curious about the surgery and wished me well. Dr. Weston sent me a friendly email last night to check up on me and to reassure me that the swelling will be going away. I see him again on Thursday morning.
I met with Dr. Karils first thing this morning. I brought with me the key to the device and my list of questions. Topic A was the numbness. Dr. Karlis said that it will go away. She explained that there are nerves on either side of my nose that have been aggravated, and that the swelling has exacerbated this. The nerves were not cut. As the swelling goes down, I will begin to feel pins and needles and eventually things will go back to normal. She did say, however, that some people have had the numbness for as long as six months. I hope I am not one of those people. I also asked Dr. Karlis about problems with the anesthesia, and she said that I did in fact have trouble coming out of it. She said I was very agitated. She took two X-rays, a panoramic mouth shot and one of my two front teeth. She showed me both, and explained to me that the roots of both of my front teeth separated nicely and there are no complications there.
Turning the Key
This morning with Dr. Karlis was the first time that I cranked the key to the device in my mouth. I was nervous as to how this would go, but it was fine. I turned it once, and Dr. Karlis turned it once more. I am to turn it once in the morning and once at night. Each crank creates an additional 0.25 millimiters of space. When the device is cranked, it just feels tighter. Each time the gap between my two front teeth will widen. It's currently about half to three quarters of a millimeter.
Dr. Karlis also got me some more of the wax from the orthodontics department. I use the wax to cover the brackets where they meet my cheeks, to eliminate the irritation. On the elevator out I bumped into Dr. Varnai and one of Dr. Weston's associates, who were curious about the surgery and wished me well. Dr. Weston sent me a friendly email last night to check up on me and to reassure me that the swelling will be going away. I see him again on Thursday morning.
Sunday, July 20, 2003
Two Days After Surgery
It's now two days after my surgery. Today the swelling has subsided somewhat, and I while I look pretty bad I no longer look alarmingly terrible. I managed to get through the night without too much trouble. Today the numbness and tingling in my upper lip, nose and under my eyes is really bad. I went for a walk this morning, to the pharmacy and the grocery store. I see Dr. Karlis first thing tomorrow morning. I won't be going in to work tomorrow.
It's now two days after my surgery. Today the swelling has subsided somewhat, and I while I look pretty bad I no longer look alarmingly terrible. I managed to get through the night without too much trouble. Today the numbness and tingling in my upper lip, nose and under my eyes is really bad. I went for a walk this morning, to the pharmacy and the grocery store. I see Dr. Karlis first thing tomorrow morning. I won't be going in to work tomorrow.
Saturday, July 19, 2003
The Surgery Yesterday
I got to the hospital by 6:30 a.m., and cheked in. When they asked for $1,023.78, I asked if I could pay half now and half later, they said OK and I gave them my American Express card. They had me sign and initial a bunch of forms, and I was brought to a prep room, where I had to take off my clothes and put on a hospital gown and booties and cap. I also got the wristband. One of the doctors who introduced himself as the chief resident came in to speak with me, but unfortunately I do not remember his name. Dr. Karlis and Dr. Weston came in and spoke with me briefly. Then the anesthesiologist and a second doctor came in. For some reason, when these doctors were talking with me I became terribly nervous, and I felt like I was about to faint. I broke out into a sweat, and they got me some tissues. The anesthesiologist told me to try to calm down and think nice thoughts. When the male nurse came to take me to the OR, I told him I felt like I was going to faint, so he put me in a reclining chair and wheeled me into the OR. There were about 8 people in there, including Dr. Karlis. I got on the table, and it took them about three tries to get the IV going. Then a breathing mask was placed over my mouth and I took about three breaths before losing consciousness. I remember Dr. Karlis telling me that it was all over, and I was taken to the recovery room. I was in pain, and they gave me a shot in my leg for the pain, which worked. Shortly I felt very sick and I vomited blood. My friend Andy showed up shortly thereafter. The nurse called Dr Karlis and she came to talk with me, and she said the operation went well. Soon I was moved to another room, with reclinging chairs, and as soon as I got there I vomited blood again. They gave me some ginger ale, but when doctor who introduced himself as the chief resident came to see me, I vomited again. It was a rough afternoon, and Andy was there with me the whole time. Dr. Karlis came to see me again and gave me some instructions.....ice on my face for the first 24 hours to stem the swelling, soft or pureed foods, small sips of liquids, no teeth brushing that night. I was also to sleep with my head elevated. The nurse Elizabeth was very nice, and Andy and I joked with her that we watned to take her home with us. Andy got me home, but unfortunately on the way home I vomited in the cab into a dish. Andy went to the pharmacy to get my perscriptions filled (penicillin and pain medication) and he also got some yogurt, soup and other food. I was able to finally get some food and liquid down without vomiting. That night I spoke with my family on the phone, and Ceci from next door stopped by and sat with me for a little bit. Also, Dr. Karlis called to check on me and to see that the ausea had stopped. She told me the swelling would be worse tomorrow. Andy stayed over, and I am very glad that he did because I was afraid that I might be sick again or have complications. In the morning, I was able to eat and drink, but I was still feeling numbness in my nose, upper lip and under my eyes. NYU called to check on me, and they told me that if I was still feeling numb later in the day to call Dr. Karlis. In the afternoon, I was still numb and I called Dr. Karlis, who told me that the numbness would last for two or three weeks, as she had spread the nerve. Andy went home this afternoon. I am incredibly grateful for all of his help. He is a true friend.
Now I am feeling much better, although the swelling is horrible to look at in the mirror, and the numbness is quite uncomfortable. I did brush my teeth this afternoon and rinse with salt water. I have not looked at the stiches yet (I'm afraid to), but I can see there is a slight gap between my two front teeth already. I am to see Dr. Karils first thing Monday morning, and she is going to show me how to adjust the key and give me instructions on that. She recommended that I try to go for a walk, so I am going to go down for a paper in a little bit.
I got to the hospital by 6:30 a.m., and cheked in. When they asked for $1,023.78, I asked if I could pay half now and half later, they said OK and I gave them my American Express card. They had me sign and initial a bunch of forms, and I was brought to a prep room, where I had to take off my clothes and put on a hospital gown and booties and cap. I also got the wristband. One of the doctors who introduced himself as the chief resident came in to speak with me, but unfortunately I do not remember his name. Dr. Karlis and Dr. Weston came in and spoke with me briefly. Then the anesthesiologist and a second doctor came in. For some reason, when these doctors were talking with me I became terribly nervous, and I felt like I was about to faint. I broke out into a sweat, and they got me some tissues. The anesthesiologist told me to try to calm down and think nice thoughts. When the male nurse came to take me to the OR, I told him I felt like I was going to faint, so he put me in a reclining chair and wheeled me into the OR. There were about 8 people in there, including Dr. Karlis. I got on the table, and it took them about three tries to get the IV going. Then a breathing mask was placed over my mouth and I took about three breaths before losing consciousness. I remember Dr. Karlis telling me that it was all over, and I was taken to the recovery room. I was in pain, and they gave me a shot in my leg for the pain, which worked. Shortly I felt very sick and I vomited blood. My friend Andy showed up shortly thereafter. The nurse called Dr Karlis and she came to talk with me, and she said the operation went well. Soon I was moved to another room, with reclinging chairs, and as soon as I got there I vomited blood again. They gave me some ginger ale, but when doctor who introduced himself as the chief resident came to see me, I vomited again. It was a rough afternoon, and Andy was there with me the whole time. Dr. Karlis came to see me again and gave me some instructions.....ice on my face for the first 24 hours to stem the swelling, soft or pureed foods, small sips of liquids, no teeth brushing that night. I was also to sleep with my head elevated. The nurse Elizabeth was very nice, and Andy and I joked with her that we watned to take her home with us. Andy got me home, but unfortunately on the way home I vomited in the cab into a dish. Andy went to the pharmacy to get my perscriptions filled (penicillin and pain medication) and he also got some yogurt, soup and other food. I was able to finally get some food and liquid down without vomiting. That night I spoke with my family on the phone, and Ceci from next door stopped by and sat with me for a little bit. Also, Dr. Karlis called to check on me and to see that the ausea had stopped. She told me the swelling would be worse tomorrow. Andy stayed over, and I am very glad that he did because I was afraid that I might be sick again or have complications. In the morning, I was able to eat and drink, but I was still feeling numbness in my nose, upper lip and under my eyes. NYU called to check on me, and they told me that if I was still feeling numb later in the day to call Dr. Karlis. In the afternoon, I was still numb and I called Dr. Karlis, who told me that the numbness would last for two or three weeks, as she had spread the nerve. Andy went home this afternoon. I am incredibly grateful for all of his help. He is a true friend.
Now I am feeling much better, although the swelling is horrible to look at in the mirror, and the numbness is quite uncomfortable. I did brush my teeth this afternoon and rinse with salt water. I have not looked at the stiches yet (I'm afraid to), but I can see there is a slight gap between my two front teeth already. I am to see Dr. Karils first thing Monday morning, and she is going to show me how to adjust the key and give me instructions on that. She recommended that I try to go for a walk, so I am going to go down for a paper in a little bit.
Thursday, July 17, 2003
Surgery Tomorrow
It's Thursday evening, and the surgery is scheduled for first thing tomorrow morning. I am not to eat or drink anything after midnight. I hope I will be able to sleep tonight and that I will not be too nervous. I got a voicemail from the hospital this afternoon, telling me to bring a thousand dollars. My friend Andy is going to escort me home tomorrow when everything is finished.
It's Thursday evening, and the surgery is scheduled for first thing tomorrow morning. I am not to eat or drink anything after midnight. I hope I will be able to sleep tonight and that I will not be too nervous. I got a voicemail from the hospital this afternoon, telling me to bring a thousand dollars. My friend Andy is going to escort me home tomorrow when everything is finished.
Tuesday, July 15, 2003
First Day and a Half With the Torture Device
I am struggling to get used to the expander device. It's difficult to speak, and and today on the phone at work, I had difficulty communicating and was rather embarrassed. I am also finding it is difficult to eat. Before this happened, I was most concerned that chewing would be painful post-surgery, but I am finding that the real challenge for now is negotiating around the metal in my mouth. I had a cup of coffee today, but because of the metal I was unable to enjoy it. I had soup for lunch and salmon for dinner. Both worked out fine.
Insurance Check Arrived
Yesterday I received a check from the insurance company for the cleaning, so NYU pulled through on that after all. Unfortunately, the insurance only pays $75 for a cleaning that cost me $100, and there was a $50 annual deductible, so the check was only for $25. But it's better than nothing. I hope the insurance covers the extraction.
I am struggling to get used to the expander device. It's difficult to speak, and and today on the phone at work, I had difficulty communicating and was rather embarrassed. I am also finding it is difficult to eat. Before this happened, I was most concerned that chewing would be painful post-surgery, but I am finding that the real challenge for now is negotiating around the metal in my mouth. I had a cup of coffee today, but because of the metal I was unable to enjoy it. I had soup for lunch and salmon for dinner. Both worked out fine.
Insurance Check Arrived
Yesterday I received a check from the insurance company for the cleaning, so NYU pulled through on that after all. Unfortunately, the insurance only pays $75 for a cleaning that cost me $100, and there was a $50 annual deductible, so the check was only for $25. But it's better than nothing. I hope the insurance covers the extraction.
Monday, July 14, 2003
The Expander is Put in Place Today
Today at 11 am I went in to see Dr. Weston to have the expander device put in. After wearing the spacers for a week and a half, the metal bands fit over my teeth without too much trouble. He put it on for size, then Dr. Hahn looked at it, then he took it back out, adjusted it a little, then put it back in with the bonding agents. The glue came in two separate tubes and was only activated by a special vibrating light device. Anyway, the device consists of four metal bands, on my second molars and first premolars on the upper teeth, connected to a metal box that sits in the roof of my mouth. And it is now glued in place. It does not hurt at all (not yet anyway), but I have been having trouble speaking all day. One of my colleagues said it sounds like I am talking with a jawbreaker in my mouth. And eating is going to be very difficult. Today at lunch I started with baked ziti and a strawberry yogurt. Sounds easy, right? Well the ziti kept getting stuck in the metal, driving me nuts, and later a piece of strawberry from the yogurt got stuck on top of the device, and it took me 30 minutes to get it out. The whole experience was yucky. So I am going to have to stick to soft foods, protein shakes, soup, and lots of milk. Dr. Karlis, who is going to perform the surgery on Friday, was not available to come to orthodontics, but Dr. Weston called her and I spoke to her briefly on the phone. Dr. Weston is going to be there on Friday for the operation as well. He gave me a quick lesson in how to use the key device (the thing I will use to adjust the expander every day), but I don't feel like I have the hang of it. They are going to have to show me again on Friday I guess.
The Receptionists Sometimes Don't Know What They Are Doing
This was the day I was supposed to have to pay, and I had my check for $3,000 all written out and ready to hand to the receptionist. But when I cheked in, he was on the phone, not really paying much attention to me, and didn't ask for they money. When I told Dr. Weston this, he said not to worry about it, that they will ask for it eventually.
I had also scheduled a consultation appointment with Dr. Sommerville in prosthodontics for 10 am, figuring I would have enough time to make it to Dr. Weston by 11. This is the department that will create the crown for my missing tooth after I get the implant. I arrived on time and checked in, but after waiting for 35 minutes I went back to the receptionist, who told me that he had been unable to locate my chart because it was in orthodontics. I reminded him that when I made the appointment I told him I had the 11 am appointment in orthodontics and that he had assured me all would be fine. He asked me to come back after ortho, but I said that after I finished there I would be going directly to work. I was greatly annoyed. I did get to meet Dr. Sommerville, and later he came up to orthodontics to apologize for the mishap. Anyway, this whole debacle was a true waste of time since Sommerville will be out in one year and I won't get the implant for a year and a half.
Today at 11 am I went in to see Dr. Weston to have the expander device put in. After wearing the spacers for a week and a half, the metal bands fit over my teeth without too much trouble. He put it on for size, then Dr. Hahn looked at it, then he took it back out, adjusted it a little, then put it back in with the bonding agents. The glue came in two separate tubes and was only activated by a special vibrating light device. Anyway, the device consists of four metal bands, on my second molars and first premolars on the upper teeth, connected to a metal box that sits in the roof of my mouth. And it is now glued in place. It does not hurt at all (not yet anyway), but I have been having trouble speaking all day. One of my colleagues said it sounds like I am talking with a jawbreaker in my mouth. And eating is going to be very difficult. Today at lunch I started with baked ziti and a strawberry yogurt. Sounds easy, right? Well the ziti kept getting stuck in the metal, driving me nuts, and later a piece of strawberry from the yogurt got stuck on top of the device, and it took me 30 minutes to get it out. The whole experience was yucky. So I am going to have to stick to soft foods, protein shakes, soup, and lots of milk. Dr. Karlis, who is going to perform the surgery on Friday, was not available to come to orthodontics, but Dr. Weston called her and I spoke to her briefly on the phone. Dr. Weston is going to be there on Friday for the operation as well. He gave me a quick lesson in how to use the key device (the thing I will use to adjust the expander every day), but I don't feel like I have the hang of it. They are going to have to show me again on Friday I guess.
The Receptionists Sometimes Don't Know What They Are Doing
This was the day I was supposed to have to pay, and I had my check for $3,000 all written out and ready to hand to the receptionist. But when I cheked in, he was on the phone, not really paying much attention to me, and didn't ask for they money. When I told Dr. Weston this, he said not to worry about it, that they will ask for it eventually.
I had also scheduled a consultation appointment with Dr. Sommerville in prosthodontics for 10 am, figuring I would have enough time to make it to Dr. Weston by 11. This is the department that will create the crown for my missing tooth after I get the implant. I arrived on time and checked in, but after waiting for 35 minutes I went back to the receptionist, who told me that he had been unable to locate my chart because it was in orthodontics. I reminded him that when I made the appointment I told him I had the 11 am appointment in orthodontics and that he had assured me all would be fine. He asked me to come back after ortho, but I said that after I finished there I would be going directly to work. I was greatly annoyed. I did get to meet Dr. Sommerville, and later he came up to orthodontics to apologize for the mishap. Anyway, this whole debacle was a true waste of time since Sommerville will be out in one year and I won't get the implant for a year and a half.
Wednesday, July 02, 2003
Questions for Dr. Weston, Then Spacers Today
Today I went in to see Dr. Weston to get spacers put in my upper teeth. Before we began, I had a number of questions for him. I asked him to show me the expander device, and I was pleasantly surprised to see that the box that will sit in the roof of my mouth is much smaller than I thought it would be. I also asked him to show me on the model of my teeth where Dr. Karlis will cut the bone. He explained that she will cut the gums open above my theeth, and cut along the bone several millimeters thick. He said most of the swelling will occur around my upper lip and nose area, and that the discomfort will most likely last for two to three weeks. I asked him if I would keep the bands on my teeth after the expansion, or if they will be switched to brackets. He said that we'd have to see. He could do either. The bands will be cemented on, so he might just keep them on for the whole course of treatment. I also asked how big the gap will be between my two front teeth, and the answer was a few millimiters, probably three. Had it been much bigger than that, I would have been concerned. I also asked if Dr. Varnai's decision to recommend "light pressure" on my front upper teeth would result in a longer treatment time, and Dr. Weston said that it would not. In fact, he said, orthodontists today typically use light pressure rather than heavy pressure and they have found that light pressure works just as good, if not faster. Another relief for me. Finally, I asked Dr. Weston to explain the type of retainers I would have at the conclusion of the braces, and the answer was basically as I expected, they will be the same as I had when I was a teenager. The upper will be bonded plastic or acrylic with the metal wire, and the lower will be mostly molded to the lower front teeth. For the first few months, I will have to wear the retainers pretty much 24/7, then after that every night, forever.
The Spacers
After our conversation, Dr. Weston put in the spacers between my upper teeth. The spacers are little plastic rings, sort of like mini rubber bands, which he uses floss to jam between my teeth. This is necessary to create room for the bands/appliance a week from Monday. The first time we went though this, things did not work out too well and I had to be re-fitted with brass wires, so I was greatly relieved that the plastic spacers worked today. (Those brass wires really had been torture!) I bled a little bit, no big deal, and now I have the bands. They are blue. While I have them in, I am not allowed to eat sticky foods like candy, caramels, protein bars, etc., nor will I be able to floss between the bands. I hope none of them come out.
Today I went in to see Dr. Weston to get spacers put in my upper teeth. Before we began, I had a number of questions for him. I asked him to show me the expander device, and I was pleasantly surprised to see that the box that will sit in the roof of my mouth is much smaller than I thought it would be. I also asked him to show me on the model of my teeth where Dr. Karlis will cut the bone. He explained that she will cut the gums open above my theeth, and cut along the bone several millimeters thick. He said most of the swelling will occur around my upper lip and nose area, and that the discomfort will most likely last for two to three weeks. I asked him if I would keep the bands on my teeth after the expansion, or if they will be switched to brackets. He said that we'd have to see. He could do either. The bands will be cemented on, so he might just keep them on for the whole course of treatment. I also asked how big the gap will be between my two front teeth, and the answer was a few millimiters, probably three. Had it been much bigger than that, I would have been concerned. I also asked if Dr. Varnai's decision to recommend "light pressure" on my front upper teeth would result in a longer treatment time, and Dr. Weston said that it would not. In fact, he said, orthodontists today typically use light pressure rather than heavy pressure and they have found that light pressure works just as good, if not faster. Another relief for me. Finally, I asked Dr. Weston to explain the type of retainers I would have at the conclusion of the braces, and the answer was basically as I expected, they will be the same as I had when I was a teenager. The upper will be bonded plastic or acrylic with the metal wire, and the lower will be mostly molded to the lower front teeth. For the first few months, I will have to wear the retainers pretty much 24/7, then after that every night, forever.
The Spacers
After our conversation, Dr. Weston put in the spacers between my upper teeth. The spacers are little plastic rings, sort of like mini rubber bands, which he uses floss to jam between my teeth. This is necessary to create room for the bands/appliance a week from Monday. The first time we went though this, things did not work out too well and I had to be re-fitted with brass wires, so I was greatly relieved that the plastic spacers worked today. (Those brass wires really had been torture!) I bled a little bit, no big deal, and now I have the bands. They are blue. While I have them in, I am not allowed to eat sticky foods like candy, caramels, protein bars, etc., nor will I be able to floss between the bands. I hope none of them come out.
