Stitches are out!

Today is Day 13 post surgery.  I had an appointment with my surgeon who said that the healing was very good and removed the stitches with only one little "ouch" from me.  Yes, he was happy with the progress.  I'm starting to eat foods other than mush, so the world seems a brighter place.

I haven't had a cigarette since yesterday, but have been chewing nicorette gum.  The surgeon took one step into the examining room and exclaimed "you're smoking!"  Oh good grief!   There is some good news and I'll post it tomorrow with more facts on the data I've uncovered about smokers and dental implants.

Stay well and keep smiling!

Am I doomed to failure?

Everything I have researched says that implants fail in smokers.  There's something called peri-implantitis, an inflammatory condition which results in bone loss and eventual loss of the implant, also associated with chronic infection (Wikipedia).  The inflammation is around the implant as the implant itself cannot become infected, and prevents my old friend, osseointegration.   All warnings were that a smoker needs to cessate anywhere from 4 to 8 weeks prior to the surgery and for at least 4 weeks after surgery.  Even anti-smoking aids are not recommended, such as gum or "the patch".  I smoked until the night before, and had 4 cigarettes within 24 hours of my surgery.  And I've been smoking half a pack a day since then.  When I'm not smoking I'm chewing nicorette gum.  I'm definitely doomed.

On the upside, if there IS an upside, I took antibiotics for the first 8 days.  This would have prevented any infection.  I've also been taking double the amount of calcium and 2000 IUs of vitamin D, over and above my regular daily vitamin.  Hopefully, this may counteract some of the ill effects and help the bones strengthen.  In my research I didn't find anything about smokers taking calcium to help with the implants.   I did, however, see that Vitamin C helped since that is one of the vitamins that smoking saps from your body.  Maybe, if I'm very very very lucky, I'll make implant history.  Maybe it will even be a successfull story.

In the meantime,

Confessions of being scared

Now that things have quietened down, I have time to wonder if I made a rash decision.  Some basic research on dental implants tells me that there is a  95% success rate.  Implants themselves have truly advanced in the past decade, and we know that bone will integrate with titanium although no one really knows why.  Success depends on the quality and quantity of bone, the health of the tissue and teeth surrounding the bone, the patient's oral hygiene, the surgeon's skill and the willingness of the patient to follow the surgeon's post-operative instructions.  Well, at least I'm confident about the surgeon's skill.  I am almost as confident that he thought my bone and tissue were good enough to proceed although, from past experience, I will always be a little skeptical when large sums of my money are going to be passed over.  As for my oral hygiene?  I brush 2 to 3 times a day but floss less often.  Quite a bit less often.  More like when I remember.  However, I'm trying to remember more often now so I'm almost there once a day.  But not quite.

Now there are two Major concerns.  One, I have just learned that I am borderline on the osteoporosis scale.  At the age of 55, there's only one slope and I'm pretty sure I'm headed downhill.   Will my bones be able to sustain?  I'm doubling up on the calcium and vitamin D and I do exercise.  I can only hope it will be enough.

Secondly, I'm a smoker.  The dreaded "S" word!  Yes, I am a smoker.  Society now associates smokers as being evil people but I can't start a rant because that's discourse for another whole blog.   I've been a smoker for 40 years, give or take about 10 intermittant years when I've been able to stop for periods.  Smoking is the singular most important cause of failure of dental implants.  Have I just thrown away 6 years worth of house mortgage payments?  Wouldn't my surgeon have told me not to proceed?  He knew I was a smoker.  He advised not to smoke for 24 hours after surgery, which was almost impossible.  But he must have thought it was worth it, wouldn't he?   Now I'm worried.

I'll be back again, with more research on the effects of smoking and implant success or failure. 

Life resumes

Tuesday and Wednesday were, thankfully, uneventful.  I still had some soreness, of course, so I continued on my program of ibuprofen and antibiotics.  Still eating soft foods too.  I was able to resume my power walking on Tuesday night, with no adverse effects.  It was wonderful to start feeling normal again. 

Just call me Chippy!

Monday was a whole new day.  I looked into the mirror and saw the fattest face I'd ever seen!  And oh how it ached.  My gums felt like big fat sausages all trussed up in my cheeks.  I bore a striking resemblance to Alvin the Chipmunk.  I grabbed the Ibuprofen but it was too late for prevention.  Vaguely I remembered the dentist telling me that I should not let the ibuprofen (anti-inflammatory) get completely out of my system, but to continue to take a steady amount for the next several days.  What caused this facial swelling?  Leaves aren't heavy!  A fruit tray isn't heavy - particularly since it was all cleaned!  And I'd only moved some clothes from one dresser to another.  Ahhh yes, I "only" did this or that, but every time I bent over my teeth clenched and I put pressure on the bone surrounding the dental implants.   The lesson here is that it doesn't matter if something is as light as a leaf - you still clench your teeth.   Hadn't my dentist told me to rest?  Oh yes, I remembered that then.  I guess that's why he has so many diplomas on his wall.  So I lost another day which I can add to the ultimate cost of my investment and sat on the sofa reading.  I kept eyeing the carpet that needed to be vacuumed and the floors that needed to be washed.  "The floors can stay that way forever, for all I care", said the chipmunk to her bottle of ibuprofen.  I'm letting these dental implants osseointegrate!

I thought I was clear.....

Sunday.  48 hours after surgery.  I was alone as my caretaker had to attend to family matters.  Just how many movies can a person watch???  I was sooooo bored and feeling really pretty good.   All that rest left me pretty antsy.  What to do when you're bored - get at those little jobs that have been nagging at you!  That isn't really "work", is it?  I mean, I was supposed to take it easy, so putting away some laundry and straightening out my dresser seemed pretty safe.  Then off to the supermarket to just pick up a couple of things.  It was more for the fresh air than anything else.  But when I went outside there were all these leaves that had fallen in the last couple of days.  It was such a beautiful sunny day that I thought I could just rake up a few of them.  Just enough leaves for one large bag.  That's not a lot.  Besides, I was all bundled up just like you're supposed to be. The sun was shining.  I was active.  Life was good.  Continued on to the supermarket and picked up a big fruit tray and some small items.  Still felt good.  Had a pleasant evening.  Ate leftover soft mushy stuff and generally figured I was "on the mend".

I woke up on Monday morning to a whole new me.  I'll tell you about that tomorrow !

Saturday - the next day

This was a boring day and I drifted through it.  Stayed in my PJ's until mid afternoon and only poked my head outside for about 15 minutes.   I read, drank more tea and did little else than lie about.  I didn't really feel like doing much else.  The oddest thing was my hair.  It was sooooo limp and just hung from my head.  I believe this is an after-effect of the anaesthetic, at least that's what my hairdresser said and we all know that "Only your hairdresser knows for sure!".  I had pancakes and scrambled eggs for brunch, ice cream and jello in the afternoon and spaghetti for dinner with bread with the crust neatly cut off.  Thankfully, my dear caretaker was able to spend all Friday and Saturday with me.  I would highly recommend that you have a friend stay over, even if it's only for a little company as you drift in and out of sleep.  There was no actual pain, just discomfort from the swelling and stitches.  My cheeks were stiff.  Oddly, I thought there would be brusing but there wasn't.  I don't know if other people have had bruising and if I should attribute the general well-being of my appearance to the expertise of my surgeon.  If anyone ever reads this I'd like to know if you experienced bruising.

The day dragged on.  Finally, after dinner I poured the tiniest glass of red wine.  2 or 3 ounces at most.  I'm sure the alcohol was forbidden in the interest of my tissue healing but at that point I figured what the surgeon didn't know wouldn't hurt him.  Hope I'm not wrong!

Post surgery day

The rest of the day was unusual, or usual, depending on your outlook.  I made an appointment to interview a potential tenant for an apartment.  I figured this was safe since I'd still be frozen for several hours and I was right.  I was very frozen. However, I didn't anticipate barely remembering anything else from the day.  A dear friend dropped by with bananas, puddings and ice cream - you know, all that high caloric stuff - and I vaguely remember her visit.  Everything is a blur.  I know I watched television and drank lots of tea.... but that's it.  Was the anaesthetic that strong or is my age bending to the will of drugs greater than myself?  Am I back in the 1970's? Would it have been different if I were 20 years younger?  If I'd had fewer implants placed?  No answers are forthcoming, but I lost a day.  Still no pain though!

Payment

My surgeon takes all the plastic.  This is not meant to denigrate his position or office, merely to say that he is prepared to service his clients.  I had, of course, predetermined the amount that would have to be exchanged but it seemed somewhat surreal.  Never before had I ever put a credit card down to charge such an amount of money.  Notwithstanding that I have purchased four homes in the past, but mortgages are just that - mortgages.  The bank owns the house and it's like monopoly money.  But this.....  well, it was just different.  I didn't get 25 years to pay this off.  I got 30 days.

I made sure the card offered had a limit larger than anything I could anticipate as a final bill, and which didn't have any of my Christmas shopping splurges on it!  If you intend to go this route, please, please, make sure you have all your finances arranged prior to the surgery.  Post surgery isn't the time for surprises.  Your legs will be weak enough!

Post surgery instructions

Maintain regular oral hygiene except for the surgical area, eat soft foods (as if I could eat anything else!), what to expect in terms of bleeding and swelling , not to smoke and not to exercise for at least 24 hours. The doctor gave me his cellular number and advised me to call at any time... day or night, for any reason. Oh, and I wasn't supposed to spit, either!

Nothing unusual happened. There was no need to dial that emergency mobile number, thankfully.

I was confident with my surgeon, something I should have mentioned from the start. He reassured me at every stage of the procedure, has a wall of diplomas and a serene chairside manner. This all added to the feeling that I was in very good hands which was important.  Since I had just remortgaged my house for this I needed to feel it was all going to be worth it.

It's Over!

Finally, after much noise but no pain I am stitched together. A panoramic radiograph was taken and I was given prescriptions for antibiotics and Peridex, an antigingival mouthwash. When I stood up I felt very unsteady but that could have just been from inertia. Whew - It was over!  More than 2 hours but in truth it did not seem all that long.  Kind of interesting, in a morbid way. 

The Surgery

I was given a strong antibiotic and extra strength ibuprofen for the swelling. It was my choice to be awake for the two hours it took to place not 6 but 7 implants!  I forgot to count the number of injections but there were lots and lots. I didn't care as long as I wouldn't feel anything!  The doctor worked on my right side first, placing the 14, 15 and 16.   All of those were considered "long" implants, 13 mm (?). I felt nothing, of course. The doctor was marvelous, assuring me that what I was hearing was "just noise!" When that side was complete he asked whether I wanted to continue. In truth I would have liked to have replied "no", but I knew if I did I might be reluctant to continue at a later date.

Since I was there already, and well frozen, I decided to continue. While the doctor was working he decided to place a 7th implant for stability. He inserted the 24, 25, 26 and 27. The 24 was long, 13 mm, the 25 was 11 and the 26 and 27 were 9s. (If I am wrong using mm's for length I will correct it at a later date.)

A sinus lift was also performed above the 26 and 27, but I was not aware of this until the procedure was complete. Bone grafting was performed but I do not know to which teeth. For those who do not know, bone "grafting" is not what it sounds like. It is a thick liquid product which is inserted around the implant which will harden and meld with the implant and existing bone.  "Osseointegration" is the connection between living bone and an implant.  This has to occur for the stability of the implants.  Let's just hope I "osseointegrate" !

Implant Day - On my way

Friday, Nov. 19th.  Got a good night's sleep. Somehow I knew it might be awhile before I felt better again. Nervously got dressed and ate a big hearty breakfast. Off I went to the doctor's office with my friend who would wait for me. Got there right on time and they were waiting for me.  I was ushered straight in.

Almost toothless

I am, woefully, almost edentulous.  That word, for most people, has never been heard before.  It means "toothless" in dental lingo.  Over the years I have lost all but my anterior (front) six teeth on my upper palate, making chewing and digestion almost imposssible.  Your front teeth are your steak knives, your back (posterior) teeth, or your molars, are your chewers.  Without molars to chew I have had to run from the table because I've choked on food that had not properly been chewed before swallowing.  Not pretty, believe me, particularly in restaurants.

Since I'm only 55 and potentially could live another 25 years, I thought about implants.  It was either implants or have the teeth I have extracted and an upper dent\ure put in place.  Not likely.  My mother floated her teeth and I have no desire to spend the rest of my life like that.  I checked pricing and WOW !!!  That's a LOT of money.  Did more thinking and then decided to remortgage my house.  So.....  implants..... here I come!