Progress.... but totally not in the way you think!  Yes, making good progress on the medical side, but this is progress on the justice side (or as much justice as I can get from all of this).  I mentioned in an earlier blog post that I finally put a formal complaint in against my original surgeon and orthodontist with the Dental Board of California.  I tried to get my story in a nice little summary for them and submitted it back in late 2016.  I knew it could take a while for them to process the paperwork and notify me of an investigation, but I've heard nothing in the last 5 months.  I was honestly starting to get concerned. I have read tid bits that said the dental board won't investigate a complaint over two years old.  At the time I put mine in it was just over 2.5 years old.  Why did I wait so long to finally put this in?  Multiple reasons.  First and foremost I wanted to take care of me medically.  That was exhausting and overwhelming enough.  And at first I was actually talking to a lawyer and was going to go full on legal with all of this.  That too was exhausting and overwhelming.  I just thought this was going to be one more thing to battle in the middle of everything else and I wanted to wait.  Turns out that the process wasn't that bad (so far at least), so in hindsight I should have done it earlier.  Anyway, I was afraid they would tell me my complaint was too old, but I got a letter today saying a case is open and they requested more information from me:

I actually already sent them this information with my original complaint, but I didn't waste any time putting it all together and sending it again today.  I looked at the list of doctors after it was done and it just blows my mind.  I bounced around between a dozen docs all over CA (some of which I drove 6 hours each way for) on the path to fix me.  All of them will have to have records released to the dental board about my case, and more than likely I bet they might actually interview and chat with my current team.  I talked in the previous blog post about how I spoke with my surgeon about that.  How unsettled that left me.  Time has helped me get over that a little and things are totally kosher between us,  but it still sits in the back of my mind.  And now getting this letter from the dental board just brings up all the anxiety again and I am left wondering if any of my doctors think I am wrong or a bad person for going after my first surgeon and ortho like this.  I'm not suing them or anything, but this is still going after them the best I can otherwise.  And then it leaves me thinking, "What will they tell the investigator if they have to talk to them?"  Who knows.  I am not asking them to do me a solid and speak to the level of care I got in my first treatment with these guys, but I hope them explaining  my records and answering questions offers enough information where it all just speaks for itself.  

I am cautiously optimistic that this is the direction this will go.  I mean, there are many things that were wrong in my first round of treatment, but some of them were blatantly illegal/negligent, IE: my surgeon totally abandoning me.  Pretty sure that is illegal.  You are not allowed to abandon a patient like that.  And my ortho taking forever to get me my records and giving me a hell of a time with that.  And then both my surgeon AND ortho were missing or "lost" all of my records pertaining to my surgical planning and anything pre op having to do with my surgery.  Nothing.  Whether that was done on purpose (and come on.... what am I supposed to think here?  How convenient is it that both of them "lost" all records pertaining to most of what was in question in terms of the level of care and negligence factor in all of this?)  or it truly was a mistake that everything in my records relating to my surgery or any notes,  discussions, plans, etc were gone, either way it's illegal and they can be dinged for that.  EVERYTHING is to be charted during treatment.  Even looking at my charting when I am sitting in my current ortho's chair I see a ton on the screen for me.  If my ortho so much as called my surgeon and spoke to him for 30 seconds, that call was annotated in my records.  If they email, then that email is saved.  If they got together and talked, then those notes were saved and discussion date/time annotated.  Nothing was kept from my first treatment.  When I questioned why there wasn't even so much as a mention of an email back and forth between my surgeon and ortho talking about even the simplest of things, my ortho's office told me, "We don't keep those kinds of things."  Hopefully they will be dinged for that because you ARE supposed to keep those kinds of things.  And I have a feeling they do keep those kinds of things for their patients.... but it was conveniently lost for me because they knew they screwed up and it was going to come and bite them.  

Anyway, this is the only form of justice I will ever have with this.  My last chance.  I will never get a chance to look my surgeon in the face and get answers for what she did to me (or what she allowed her resident to do to me unsupervised or ill supervised), let alone get an apology....which doesn't even matter to me honestly; I'd rather have everything explained to me instead and have the answers for what happened.  The best I can hope for here is that the board that holds her license will find that she really did do me dirty and she'll have some consequences to face.  Same with my first ortho.  If anything, hopefully I am doing a service so something may come of this and help a future patient avoid what I had to go through.  Maybe they will be put on performance plans and have to take training on something.  I dunno, but I hope it's something that gets done and I can have a little bit of closure over all of this.  And again, I really hope none of my current docs think I am a bad person for doing this.  So far they are not even close to giving me the impression that they are against what I am doing, but they're not showing outright support either.  They're just super mum, and damn they do a good job of it!  Drives me crazy, but I know this is the way it has to be.  So I am going to wonder what they really think and get anxious thinking they're not too fond of what I am doing with this and then think less of me.  Ugh.  Hopefully they're on my side.......hopefully. 

Totally different topic and to end on a lighter note-- I was up in  Tahoe snowboarding this weekend and got some pictures for the first time post treatment.  They automatically got added to an album that has pictures as far back as 2011 from the same resort.  I was slightly amused by a few people (it was mostly people who have only met me in the last year or two and don't know what the pre op teeth looked like) who did a whole "whoa.... this is a totally different person," comment on some of the pics from 2011.  Not going to lie, it's nice to see the difference after this really long and tough journey.  I try to enjoy those moments and be thankful for what I've got now, but at the same time it always comes back to "but it wasn't worth your 7-8 front teeth."  It's the truth.  I would have never traded all of my front teeth for this, but it is what it is.  Here are the pics!

Double duty appointment yesterday with my surgeon-- 1 year jaw post op follow up, and then a follow up on the hardware removal from last week too.  I just love seeing my surgeon.  Guy is just always so warm and friendly and for me personally I just love being in a place where I go to see him and it's all usually good news now.  And if it's not good news, then I know I am being well taken care of and got good eyes on me to fix whatever is going on.  

Luckily yesterday was all good news!  He's really happy with how everything is looking right now both on the 1 year jaw side and the aftermath of the hardware removal last week.  My stitches have fallen out and incisions healed VERY quickly. I thought this was going to be similar to the jaw surgeries where my stitches took 2-4 weeks to fall out and feel decent like this, but this happened in less than a week.  I was pleasantly surprised!  Only complaint I have about my incisions is my right side actually feels really smooth and uniform, and the left side is a little bit of a lumpy mess.  I know this was now the third time cutting through all this scar tissue and I can probably realistically expect that the incisions probably won't heal as smooth this time, but I for sure need to give whatever lumps are around a long time (like, it can take 8-12 months for scar tissue to work itself out and smooth out a little) before I start really getting worried.  It's up in the top crease of my mouth anyway, which is not some place I am feeling around with my tongue or anything so it's not even going to matter probably.  Anyway, if that is my main complaint, then that means things over all are going really well.  My swelling has come down quite a bit, but I am still quite puffy.  The shiner has quickly resolved itself and just a little black/blue remains under my eye(s).  I was supposed to take 1 year pictures/records yesterday and we're going to push it off until May when I should be all healed and not looking like a prize fighter from the hardware removal.  

Doc mentioned my bones healed beautifully.  Usually after a revision he expects some gaps in the osteotomy  but he said he didn't even see a single one.  AMAZING news since this has seriously weighed on me quite a bit through my healing.  After being opened up for revision and so largely non-union 2 years after my first surgery..... I was just worried there could be some biologic factor from me causing that.  My surgeon has previously assured me he was pretty confident it was all the twist/torque of the misalignment literally creating a separating force and not allowing those bones to heal right, but you just never know 100% for sure there.  He said enough yesterday to reiterate again that he's pretty sure it's 100% to do with the bones being that offset and not allowing them to heal properly the first time.  Phew.  This is REALLY REALLY good news for me and has lifted the last bit of heavy weight off my chest with all of this.  And it's also more evidence and confirmation that my first surgery was just THAT BAD.  It's good to get that validation here and there.  Still drives me crazy that I don't really get enough of that (hardly any of it really... my surgeon saying something like this is about as much as I get) and I still have closure issues because of it.  Anyway, only other thing was that I definitely did hear my surgeon correctly in my anesthesia haze last week-- the top screws were for sure loose.  Sounds like he's indeed happy now we went in and go them when we did because you usually end up with infection/abscess around screws that are loose in the bone like that.  Phew.  Now I feel more justified for saying these bothered me enough that I wanted them gone.  Not some crazy patient that complains for nothing.  I mean, I am pretty sure he knows me well enough by now to know that if I am complaining about something it means there is something valid and causing the complaint.  Overall I am pretty easy going and won't say something unless I absolutely have to.

Last but not least he checked my implant and he's super happy with what is going on there and complimented Dr. Lew's handy work on the crown.  He wants me back in May to do our 1 year records and then this was interesting to find out-- I am pretty much going to be a life long patient (or at least for as long as he's here practicing).  He said he'd like to see me in May and then maybe another 6 months after that and then yearly after that for the indefinite future.  Because of what happened, what was done, what my joints have been through, he wants to keep tabs on me and check my bite and monitor for any possible changes.  I for sure don't mind this at all because I am scared to absolute death of idiopathic condylar resorption that can happen to some patients.  Some patients are more suseptible than others.  I've read literature that mentioned relapse risk may be higher for certain cases, IE: class II open bite may have more relapse occurance vs. straight up class III cases.  Since my joints went through the trauma being malpositioned 2 years between surgeries AND I have suspected Ehlers/Joint Hypermobility Syndrome, it's better to keep tabs on me.  I'm actually really thankful and touched that he's putting in the time to keep tabs on me.  He doesn't have to do that and that extends WAY past his surgeon fees I paid him.  Most surgeons release you after 12-18 months.  Just another example of the amazing care I've gotten and continue to get the second time around with all of this.  I am forever grateful and reminded Dr. Karas yesterday to always please let me known if there is anything I can do for him or his office.  Hell, I feel like I owe him my first born or something at this point.  For now only thing I can do is offer up whatever I can do for them in terms of letting them freely use my case however they need (for study, teaching, outreach to other patients, etc) and remind them I am available to talk if they want to refer any of their other patients to me if they want to be peer to peer and get the skinny on jaw surgery from somebody who's been through it.  I know I was looking for that when I was first pre op and least I can do is make sure I make myself available for others to get that as well.

So that is that. I feel like we're really closing the main chapter on the jaw work with the records they'll take in May and my check ups will be much fewer and farther between after that.  Get the vaneer work finished on my front teeth and hopefully ride those bum roots out for as long as possible.  I joked with Dr. Karas that as much as I like him and his staff, it would be really nice to not have to be sliced and diced by him for a little while now.  He laughed and said for sure lets try to keep those front teeth as long as we can.  I'll probably check back in after the vaneer work gets done, but if that is not done before my next appointment in May...... I may actually be quiet on the blog front for a while!  I'll still be here.  Still checking any contact form submissions and chatting with people who reach out.  Kind of nice to getting to a point now where things are calmed down with all of this. I deserve it after the last 4 years of absolute hell!!Idiopathic condylar resorption

What a week!  I was looking forward to getting my implant crown in and FINALLY getting these bothersome plates/screws out from around my nose, but this week ended up being a doozy.  Was in Tahoe last weekend and my husband was sick as a dog.  Then I came down with it like a ton of bricks.  Nasty sinus/ear/chest infection kind of thing.  I have no clue how I pulled it off, but I was able to tough out sitting in my prsoth chair for the crown and then get to my surgeon yesterday to be well enough to still get the hardware out.  Phew.

So, lets start with the crown.  I feel like such an asshat going in to my prosthodontist's office when I was REALLY sick, but this appointment was dependent on everything else I had scheduled this week.  My surgeon didn't want to take the hardware out unless the crown was done and put in, and then all the other appts I had for follow ups and stuff after would have had to be rescheduled too.  I already had the time booked off work.  It would have been a mess to reschedule all of this.  So, I owe their office some donuts when I go back since they took my sick butt in and dealt with me.  But this crown.....wow.  I didn't realize how incomplete my bite felt until this thing was in.  That little bit of off I had this whole time where I couldn't get my left side to feel settled-- it was this missing tooth!  Duh.  Makes sense, right?  My bite feels complete.  I feel comfortable.  I feel whole.  My muscles are calming down, I am clenching less, and my headaches are better too (despite the constant sinus headache with the pretty severe sinus/ear infection thingy I had going on).  I've had a smile on my face all week after this got finished up.  I go back in two weeks to get the final check on it and they'll give it one more crank down on the implant post and then permanently fill it in and be done with it.

The plates and screws around my nose came out yesterday.  I didn't sleep well Mon night ahead of this.  I am not really worried about it or anything.  This is a walk in the park (for me and for my jaw surgeon) compared to both jaw surgeries and all, but it was just seriously giving me the heeby jeebies thinking about how much they were going to be stretching my face to get all the way up to just under my eyes to take these plates and screws out.  So, get in and they start some nitrous to make me chill before they get going with an IV and stuff.  Nice surprise.  I wasn't expecting that.  Normally it doesn't really hit me, but this time it hit me and I was SUPER fine with that! ;)  Dr. Karas comes in and I was just comfy and good to go.  It's so nice to be in a chair and have trust again....finally!  He's just always so warm and welcoming when he comes in to see me and I really love it.  So, I felt pretty good drifting off in his chair yesterday.  This IV anesthesia was weird.  I didn't feel rested like I was all the way out for this one.  I felt like I was aware of most of it, but at the same time I can't remember details past them starting to squirt a few things in to my mouth just as I was drifting off.  And the 45 mins went by way too fast.  Not instantaneous like usual, but way too fast.  So, I guess I was out.  I also came around very quickly. I don't think I was in their little recovery chair for more than five minutes before I was wanting to be up and out the door.  I was just really glad to finally have this done.  

I have to see if this was a dream either the night before surgery (like I said-- didn't sleep well and had interesting dreams) or if he said this in my anesthesia haze when I was coming around, but I could swear my surgeon said something along the lines of it all went well and those sets of hardware were a little loose.  If that is the case then I for sure don't feel at all bad being bothered by them enough to go through the motions of getting them out.  Even if they weren't, it was still the right decision.  Just in the last day putting lotion on my face, touching under my eye, itching, etc, etc-- I am not feeling the screws sticking out and it's GLORIOUS.  And then this last week I've been sick, there is also a part of the hardware that sticks out through thin skin just inside the bottom of my nose and it makes me want to jump out of my skin a bit every time I wipe my nose and catch that screw sticking out there.  I can't feel that any more either.  And I feel less pressure (despite the pain/swelling right now).  I am just 150% happy I got these out!!  Speaking of pain/swelling, I definitely have some.  I stayed pretty well medicated and ahead of it yesterday.  My face down through my front teeth started to throb not more than 10 minutes after leaving my surgeons office and I could feel I was swelling.  Took something around 10pm before bed and by 7am this morning I was up and pretty sore, again aching down through my front teeth.  Otherwise, it just feels like somebody socked me one in the face good.  Pretty much what I was expecting.  Even with pain pills it doesn't really do much for the pain from the stitches around across the top of my mouth again.  The numbness out of jaw surgery is really a blessing in disguise!  I can full out feel all of this now.  Speaking of numbness, I actually do have some slight numbness on my right under my eye and in to my cheek (same exact areas that impacted me after jaw surgery), but it's really no big deal and I am sure will resolve itself again.  The right side is the side that bugged me more, and coincidentally it's the side that was more bruised/swollen/numb after surgery and is now again more bruised/swollen and is seeing some numbness.  I have a little shiner coming out under my eye on my right.  Again, all things I was expecting with this.  I'm sure in a few days I'll be feeling back to normal again and will just have to deal with the stitches that will be around 3-4 weeks probably.  So, get past next few days, deal with the broth/soft foods this week or so, and be onwards and upwards from there!

I see my surgeon for a double duty appointment next week-- my 1 year jaw follow up AND the week post op from plate removal.  I'm sure he'll comment on the implant too, as he should because it looks like it's doing great and his work is solid there.  I see my prosth for the final crown check in two weeks, and then after that we'll just schedule the vaneer work on the upper fronts. Only other thing I want to address with him for now is I think it's safe to shave just a smidge more off the back of my left K9 and lateral incisor. I still have a smidge too much contact there on that segment vs my other side which is very comfy.  After that my bite is going to be pretty damn dialed in, which is exciting to finally feel that!