I saw the next big surgeon on my list- Dr. Kasey Li at Standford University. He definitely was not as warm as Dr. Gunson, and he didn't take even a tenth of the time Dr. G took with me for his consult, but I know he is a fantastic surgeon and this just must be the way he does business. He basically looked at me right away after glancing at my records and had a look on his face like, "well, what do you want me to tell you?" lol I know I am super informed with what is going on with me right now and I've already been to the top of the food chain essentially for a second opinion, but I would still like other docs to give me their opinions at this point. The only thing he really harped on and was kind of new news is he thinks there was a lot of shifting post op and maybe my plates/screws were put in incorrectly and are flimsy now. He said a lot of hardware may even be loose, although he looked perplexed that I didn't' have any resultant swelling/pain present if that was the case. He was pretty bothered by the fact that I have had almost zero post op monitoring and care. I mean, even if I didn't get left hung out to dry by my surgeon, it's pretty typical for her to see you at 2 weeks to unwire you, then 4 weeks, and then I think 4 months after that if all looks well. Definitely out of the norm for most surgeons who want to see you weekly at first and then monthly after that for a while. BUT, this is a little worse for me since she hasn't seen me since my 4 week follow up and then kept brushing me off when I asked for another appointment to be checked and to see what else was off on me. Anywho... I digress. So, Dr. Li said what I already knew. Both jaws need to be totally redone. He also confirmed that my top jaw had no business being moved forward at all and is causing the chimp face lip strain. He also mentioned that he wouldn't even think about operating on me for another 5-6 months since my bite is so far off and he likes to let scar tissue settle from the first surgery. He really threw my orthodontist under the bus big time. He echoed what Dr. G said in the sense that my ortho had ZERO business doing any work on me post op when he should of declared me as a failed surgery and sent me right back to have it fixed before the bones fused (as should have my surgeon!), but he was much more blunt and not as nice about saying it. Sucks to hear that, because now I have reasons for the recent lost faith in my ortho since the surgery, but glad to know I have been right all along really about everything, including the ortho. I knew when he started doing work post op that we shouldn't be heading in that direction. I could literally feel that the bones were off in my face and it wasn't something that moving teeth around would fix. I really need to trust my instincts from now on even though I'm no doc! So... all in all Li just confirmed everything I already knew so far. As for the loose plates... I have a feeling he's wrong about that and was just looking for a reason to explain why I am this messed up. Again, another surgeon who knows my surgeon and they want to look for a reason as to how she did this to me and try to rationalize it some how.
The next day I saw my ortho to have him finally start rebonding brackets on my top teeth to undo the cant "corrections" he made on me post op. I still can't believe he wasn't planning on doing it, even after Dr. G told him to. And now Dr. Li said the same thing. Everything has to be undone. Dr. Li basically said he's done nothing but make this whole situation worse for me, which at this point, I totally agree with him even if my orthos intentions were really good to begin with after the surgery. So, I'm just about a week out from those adjustments and I can see the crooked/canted smile coming back already. God, I never thought that would be a welcome sight for me, but it is! In the same day I had another ortho to consult with (one Dr. G referred me to) and also a prosthodontist. I have never even heard of a prosthodontist before, but after looking up who I should see for a dentist that specializes in missing teeth and all the restorative work I'll need after braces, sounds like a prosthodontist is my guy! I absolutely loved the doc I saw. He was very warm, and I could tell he genuinely cared about my case. He said I should go see a local surgeon in Walnut Creek, which coincidentally I already have a consult set up with on Aug 18th! He took it upon himself to call that surgeon and talk with him about my case after I left his office, so the surgeon already knows a little about me now. Overall it just felt nice to have a doc that I felt cared and was going out of his way to look out for me. I felt like he would be involved in my case-- keeping close contact with the surgeon and ortho. I really need a team like that now. He even kept me in the chair through his lunch break because he felt I deserved the time with everything I am going through. It really meant a lot to me!
I left the prosthodontist and continued on to another ortho consult (yes, it was a long day!). The ortho kind of gave me a look like Li in terms of "well, what do you want me to tell you?" And it was another ortho who knows my ortho well and totally didn't want to talk anything negative about his work. He basically said if I wanted to leave him and go with their office because he has a better relationship with Dr. Gunson and is used to working with him, then that should be my reason to switch. I didn't get the feeling he wanted to trip all over himself to have me come on board though. I understand. I am a SUPER tough case right now. The prosthodontist said on a scare of 1 (being the least) to 10 (the worst), I am about an 8. Dr. Li said finding another ortho is going to be almost impossible. They would rather take 5 regular cases over 1 of me right now. :\ Again, totally understandable. This guy seems to agree with Dr. Li that there was much additional shifting post op on top of what was done wrong. His take is that maybe one of my jaw joints was left displaced during the surgery (yes, they essentially unseat your joints to move your jaw and then re-seat them before wiring you shut), so everything was 'lined up' with the jaw joint out of position, and when it slipped back into the socket after I was unwired and got mobility back (that is what the joint naturally wants to do when it's displaced out of the socket), it shifted my whole bite off even further. This ortho wanted to call my ortho and chat with him in the best interest of me, the patient. Now my ortho is kind of echoing what this guy said and is laying it down that this could have happened and now he's pretty much left to hold the bag on everything. I am not sure what is what at this point. I've been saying all along that things were off for me from the surgery, but felt it got much worse the the two weeks after I was unwired. So, an explanation like this would support what I could feel happening. BUT.... something like this is also very obvious on xray and lateral scans, both of which I had done the first week post op while unwired, so why was this not caught? I have a feeling everybody is just looking for a reason to explain everything at this point. But then again, I wouldn't be surprised if something like this (which would be catastrophic to my surgery result) was missed since the ball has been dropped everywhere now.
On another topic... back to the prosthodontist. My last post was about loosing tooth #7. I wasn't surprised to hear about that one, especially because it's been so loose. Surprising news though is I am probably going to loose the two front main teeth next to it (number 8 and 9-- the two front teeth like a rabbit has) because they have already had 3 layers of root resorption and bone has already filled in in those spots. Doc thinks I can get maybe another 5-8 years out of the teeth if I can hurry all of this the hell up and get out of braces (which will stop any further root resorption from the forcing on the teeth from the braces), but regardless they are probably goners too eventually. So, I'll have to see if I want to immediately restore them with implants/bridge with #7, or waste time getting bonding or vaneers and try to keep them as long as I can. I guess I'll cross that bridge when I get to it, but for now it's really bad news. Nobody wants to loose this many teeth. I have no choice now in the position I am in. This is the reason my ortho wanted me out of braces asap after surgery (and if all had gone well, I would be out of them now probably), and now I absolutely have to be in braces to fix my bite good enough for revision and then hopefully line my jaws and joints back up with the revision. ::sigh::
I see another surgeon tomorrow. Last on my list for now. Maybe I should be seeing others, but I think I need to get around to making a decision now on who I want to go with. I wish Dr. Gunson was closer. He's definitely at the top of the list right now. This guy tomorrow is a local surgeon. Not really known. I can't even find any blogs with him in it from former patients. I've seen 3 other specialists (dentist, prosthodontists, orthodontists) that all threw his name out there, so I guess it's a good thing I am going to see him. I think the dentist that was subbing for my dentist when she was out on maternity leave said she had her lower jaw surgery with him too. Maybe that will be the hidden local gem that I find and I'll end up going that way. Would make life a lot easier if I didn't have to travel to Santa Barbara for everything!