Friday, July 29, 2011

Appointment #23, My 1st Crown and My 6 Month Anniversary At the Dental School.

Today...was a very special day. Little did anyone know it but before today's 1:00PM appointment and 4 hours at work that morning, I had spent nearly 6 hours straight working until after 5:00AM on a variety of Thank Yous for all of my student dentists and faculty who have made a difference in my life thus far in my journey. Today was also the day when I would finally get to see the first two new teeth created for me in the lab. I must admit, sitting on the blue context of my cast, they didn't look like they would seem quite right in my actual mouth! Something about the color or the size seemed off, it was weird. Maybe being upside down didn't help either?

Sorry #3, you are in timeout until I get another root canal. Go back to your little white box.
It seemed appropriate to me that the crowns came in a little box kind of like a wedding ring would come in. I couldn't help but think, what a great gift a crown or an implant would be if I had a fiance who truly loved me. Just as expensive as a wedding ring, something that would change my life, help my mental and physical health, ease my pain, and make eating more enjoyable. Frankly, a dentist puttign a new tooth in my mouth almost seems far MORE symbolic and certainly more tangibly able to affect my real life than any ring with a jewel unearthed by some poor, oppressed minority ever could be. I would rather sport a $2,000 implant from my wife anyday over a diamond and gold engagement ring. Would certainly make for an interesting pre-nup too, no doubt.
Me, awaiting my ringbearer, Rakhee. I guess I'm marrying all of you who donated?
We took the temporary crown off that Rakhee had fashioned and checked out the fit, also taking new X-rays. The look on her face as the first came up on the computer monitor made me a little nervous. It had been some time since we had last seen an X-ray of this tooth before the root canal, and it appeared as though the bone was considerably weak at the root or it was still infected, etc. at first glance. Uh-oh...
Upon a consultation and pulling up the X-ray from several months ago we would see that in fact, the bone was looking much BETTER and it was clarified that it was not uncommon to see a shadow such as that one with such a short amount of time passing since the root canal. DEEP sighs of relief. Proceed as planned. Let's get this show on the road!
For this magic marriage of tooth, cement and porcelain, the whole community came out. Rakhee had not one but two assistants to help with the perfect timing needed to manipulate the acid (?!) and cement and welcome my new tooth to its new home. Though it was a little shocking at first, it certainly looked far better and natural in my mouth than it did on my model.
We went to take another X-ray to make sure there was a visible line of cement along the whole seam where the tooth and the crown were joined to make sure it had adhered correctly.
Upon doing doing so and flossing Rakhee noticed there was a tiny bit of remaining glue, or flash remaining between my teeth, and since she was in fact doing this procedure for competency and just because she is awesome and a perfectionist, she made additonal refinements before a final X-ray. I signed off on the new tooth for color, shape, size, etc and gave it my approval, though I commented that "I don't even remember what it ever looked like before!" and "You guys should know better than me, right?" Also, that it was by far, the smoothest thing in my mouth. Can you tell?

This concluded the appointment, but it was still far from over for me. I still had to give out my "surprises!"
I will let these pictures tell the story:
I cut out over a dozen molar-shaped cards to personally thank many of the students and faculty who have helped and supported me in the 6 months since I first walked through those terrifying doors of Arizona School of Dentistry and Oral Health.

Upon doing so, the paper fragments leftover from my own form of artistry reminded me of the wreckage of so many days of bloody tool trays at the end of my appointments and I took this picture to show to my dentists to compare.

Here are all of the finished teeth and their envelopes, along with my original "Ask for help!" stencil and my gag gift for Rakhee.

I also made 4 dozen of my vegan, gluten-free, peanut butter chocolate chip cookies I regularly use for fundraising for everyone.

I wrote this 2 page letter addressing everyone and made copies for all, giving the original to Rakhee.

Page 2. I included a copy of this letter, a personalized hand-cut card and 2 of my blog promo cards in each envelope.

Everyone's stuff

Rakhee's stuff

Rakhee, of course, deserved a special card of her own.

This is what I wrote in her card. If she is okay with it, I will post her emailed response soon.

Thursday, July 28, 2011

Appointment #22 and 4 more fillings.

On July 18th I went in for my 22nd appointment. It had been almost a whole month since my last visit and it was a refreshing and refocusing time to finally see Rakhee again and remind myself of this journey we are on instead of my other dozen daily distractions. I came to this appointment with both good and bad news, that I had raised another $400 bucks for my treatment from my recent fundraiser (and also that the store owner Kimber may even be trying to find a way to match it) but also, that the recent increased sensitivity on my first maxillary molar, tooth #3 seemed to be grounds for a new X-ray and possibly another emergency root canal that would take precedent over all other scheduled procedures. Nonetheless, it felt very good to be back in the chair and to see all of the familiar faces of students and faculty of ASDOH.

First things first, we took a new X-ray and lo and behold I did in fact need another root canal as you can see by the infected darker area at the root on the X-ray. It's crazy to me to see however that the bone behind that tooth that was the site of my second set of extractions on February 25th seems to have regenerated and filled in by now (or maybe I just don't fully know how to read X-rays) which seems to be a good sign.
I had already arranged with work and scheduled my next 8 appointments through August so luckily we were able to just block out two of the upcoming ones a week apart for the two step root canal process and unfortunately put seating my upcoming crown on #3 on hold just a little bit longer. With a deep breath and adding another $600 to my grand total for an approximately even number of $22,000 now, we prepped for the day's procedures.
It occurred to me that day that I rarely ever remember to capture an image of a CLEAN and neatly arranged tray.
Hello again, friends. We meet again.

How nice of you, always watching over me.
Today I went in to have four more cavities to be removed on the teeth that are tentatively scheduled to be supports for bridges for my two missing upper first premolars. You might remember these as looking like THIS from Rakhee's "before" pics in January after my gross debridement:
It's a little confusing cuz these are mirror images. These are the teeth on the LEFT side of my mouth, #s 11 and 13.
And these are the teeth on my right, first molar #3 scheduled for the root canal, #4 and #6 to be worked on today and later fitted for a bridge, and #7 which also was the site of my first root canal. Numbers3 and 7 both have crowns in the works being made in the lab as we speak.
 So first, we removed the cavities. After today this will make 12 total fillings I have had. Upon drilling out all the caries the possibility was presented to perhaps go with an implant instead of a bridge on the left side of my mouth since they were less significant than the other side. One more thing for to add to Rakhee's upcoming consultation with the Doctors now that more progress has been made to determine if any more modifications should be made to my treatment plan.

Fuur more teeth packed with composite like a little thanksgiving turkey ready to be baked by Rakhee's magic Harry Potter light curing wand as I called it, though we both agreed this particular one looked more like it belonged on Star Trek.

More tooth spackle, more shaping and polishing, and I'm almost ready to go with four teeth that don't remotely resemble what they looked like a few hours ago.

Taking some more pictures to see the changes, it occurred to me that this was not only the nicest those 4 teeth had looked in months, but that with the exception of that last remaining ugly tooth, number 8, and not including my two temporary crowns, that this was the nicest and most complete I have seen any of my teeth look in YEARS.

Slowly replacing more of my "broken windows."
It is mindblowing to look at myself in the mirror and see teeth that have smooth and shiny surfaces, even if they are not all there. I feel I am almost starting to begin to forget what a horrific sight my mouth used to be for me, to be rewriting in my memory what it looks like when I'm not looking at it, to be able to remember it in its present state, not lost in 20 years of sadness and poor self esteem whenever I looked in the mirror. That is an amazing gift, whatever the cost. It is a gift that I know that my dentists will never fully understand the power of, but that I try my best to communicate with them and the world in this blog, how much they are helping to rebuild so much of who I am from the wreckage of what I first walked in the doors of ASDOH with six months ago.

My 2nd Phoenix Fundraiser

On Sunday, July 10th I hosted my second fundraising event in Phoenix, this time in the form of a concert and dinner party in the courtyard of my friend Kimber Lanning's record store, Stinkweeds. I wasn't sure how it would go--for those of you not from Phoenix, I would say that it is often hard to get the locals to come out of their air-conditioned hiding places until the sun goes down for most events, and also hard to get them to make the extra trek of a few more miles out of their normal routine circles of places they frequent, but I was both surprised by the turnout and the amount of donations I raised.
I made a bunch of food which was all vegan and gluten-free, which included chickpea curry with rice donated by Angela Riccobono at the last minute when I realized I'd misplaced the guts of my rice cooker, chips with fresh salsa I made, and also my usual moneymaker, my gluten-free, peanut butter chocolate chip cookies. My friend John Sagasta from Jobot Coffee was also kind enough to donate a bunch of iced toddy, and my friend Alia Souissi was my savior of the day who drove me all over the place to trek everything there and get last minute supplies.

First up to perform was Green Light District, who I had only just met a few weeks ago on First Friday at the Longhouse, where I normally sell cookies.

Their upbeat youthful energy continues to steal the ears of passerby and no doubt is earning them a bunch of youtube videos from strangers, and their re-imagining of some other artist's songs is the first time I've enjoyed listening to them in years. (i.e.- MGMT) For the record I still like their original song, something about rock and roll (?) the best. I am glad that more people got to be introduced to them.
Next up was another of my Scorpio friends, Daryl Scherrer who practically allowed me to write the whole setlist, which is a rare honor considering the sheer size of his catalog of songs he has to pick from, normally plucking songs at random from a coffee can for 3-4 hours sets when he plays regularly at Carly's Bistro downtown.
It's kind of ironic. Though Daryl has informed me that his own teeth are far from perfect, in the past he has been a perfect example of the sort of confident, open screaming mouth I wish I could have one day if I ever write and perform music in public. You hear that Daryl? I just said I wished I had your mouth. Haha.
Daryl makes the darnedest faces.
One of the seemingly rare pictures snapped of me in public in a while. Thanks Robyn Kingsley. That's my friend Jeremiah in the white with the sunglasses who also was nice enough to share some of his drumming skills between sets as Porches was setting up. He is an amazing djembe player if anyone is looking for one for back-up or anything. Message me for his info.
Local celebrity Ben Gallaty of Andrew Jackson Jihad shows off his new food baby. What a proud papa! And what a silly awesome stenciled shirt. "RUBBLE RUBBLE!"
It was Chris Cranny however, who won the awesome shirt award for the day with this thrift store score.
Next up was the band Porches, who I had mostly only ever known as its acoustic singer/songwriter/audience heckler Ben Horowitz. Tonight he was backed by friends Tristan Jemsek on drums and John Martin on bass closing out the evening with the loudest rockin' set of the night.

Thanks to all who came and stayed for the duration and helped me make this event a fun success for all on a hot and sweaty Phoenix evening. Thanks again to Kimber for offering the space and Dario who did everything possible to make the show run smoothly AND still man the store. Thanks John for keeping us all caffeinated, everyone who reposted the event and braved the heat to come out and play with friends. Thanks to all the bands who offered their talents for free in support of my cause, and for all of you who kindly and generously donated, making this my biggest fund-raising event yet, raising over $411 without even having a single set price on anything! I am hoping to organize one big event like this one once a month, so watch for that on facebook. More dinner parties, more concerts, possibly some movie nights and bake sales. Next up, an open mic/poetry event at local used bookstore, Bard's Books on August 20th. I will be reading selections from my blog and inviting everyone to share writing and stories of their own secrets, fears and confessions over vegan snacks and refreshments for donations. It may also be a book drive. Will post a flyer real soon. Thanks again, everyone, for all of your continued support and openness to work with me pulling events together. I'm excited to see you all again soon!

Just another summer night, hanging out in the Stinkweeds parking lot after hours.
For more info on any of these bands and businesses, please follow the links below. Thanks!
Green Light District
Daryl Scherrer on facebook and on the web.
Jobot Coffee Shop

And also check out another of Kimber's projects, Local First, "a non-profit organization working to strengthen communities and local economies through supporting, maintaining, and celebrating locally owned businesses throughout the state of Arizona.
We educate citizens, stakeholders, business leaders, and legislators about the significant environmental, economic, and cultural benefits of strong local economies. We build vibrant communities that make residents proud to call home."

Thank you!

Monday, July 25, 2011

Appointments 19-21 and Crowns on the brain.

This entry is very overdue. I was hoping to originally combine the visits and write before and after entries per tooth, but I then I had almost a month-long break from the dentist and then one tooth apparently decided it wanted a root canal before it would wear its shiny new porcelain hat, so I am documenting it all a little differently. I didn't really take a lot of pictures at these three individual appointment and they were about a month ago now so I will remember the details as best I can and move on to the more exciting stuff happening now.

On June 17th I went in to refine the prep for a crown on my first molar (and ONLY molar we are saving), tooth #3. Rakhee let her mentee Meyer take over this time. It was a surreal change of pace, actually--it seems the majority of all the time we have ever spent together she has been on my right side but was now assisting from my left. How often do you have THAT sort of relationship with a person?
Hard to get a good picture of this one. Keep in mind I am virtually always taking all of these pictures myself so as not to distract or contaminate my dentist's gloves. Funny, I can usually still take better pictures than anyone else who has offered to help.
 Basically today we would grind the outer surface of my tooth structure down to resemble a sort of "top hat" as I called it, though later it seemed more like a Lego to me. We had to shape the top of my tooth into basically a peg of sorts that would fit into the corresponding hole in the crown made in the lab and get cemented on top of it. Little did I know that today, this would be far more painful than I imagined. I seemed to be experiencing a little more sensitivity than predicted lately on or between teeth 3 and 4. It was hard to tell, and there was nothing clinically detected to explain why. I would however discover a few appointments later that unfortunately that this crown would need to be put on hold while it first received a root canal. (My second.)
Meet Meyer. Say "Hi!" Meyer. Oh, nevermind. You seem lost in my mouth...

After the prep was finished I would receive a temporary crown to cover all the exposed and sensitive tooth surface. This particular type, an ProTemp, reportedly cost $30 and came in a little package like a contact lens:
This was squished on over my new Lego tooth and cured by light like the composite used for my fillings and cemented on. In all honestly, for the duration it has remained in my mouth, it has felt kind of like a hard piece of chewing gum, and I can't wait to finally get it out.

For my next appointment on June 20th, we would begin the prep for tooth #7, the last of my remaining front teeth (and seemingly most visibly important for society's perception of you) which, if you will recall, was initially possibly going to be extracted but we decided it was worth saving and gave it a root canal. I guess maybe #3 was just jealous. In trying to imagine what I would one day look like again with a smile full of teeth, flipping through some of the few old pictures I have before I lost them, I found this one I brought in to show Rakhee, though it is still pretty hard to see my actual teeth:
Though I trust Rakhee wholeheartedly, with all of the brainwashing I have imprinted upon myself over the years, it in my head still made me a little sad to watch my tooth, a front one especially, be whittled down into a little spear. It is still hard to believe that any of this is even happening sometimes, Hard to remember if I do not look in a mirror that I don't still have the same old teeth I always have, but I am getting better. I told myself for so long that every little bit of me that rotted away was a piece of my existence gone. It made me incredibly morbid, feeling years older than I was and one step closer to death than everyone else my age. Hell, I already had necrotic pulp as I would later learn in half my teeth. When you consistently watch small parts of you die, it certainly doesn't help to ever make you feel particularly "alive." At least not if that is the main part of your being that you can ever focus on. For years I always said if I ever died in a flaming car wreck, no one would ever even know because I had no dental records. I happened to realize just the other day that that is totally not the case anymore! Hell, I have more X-rays than probably most of my friends. In a weird way that realization seemed to welcome me back to the land of the living. Like it was PROOF. I was here. Look, here's my papers. I existed. Or at least, these crazy teeth did.

 After this was finished for the day, Rakhee prepared a new temporary tooth like, from scratch that I was kind of impressed by, though it was still kind of abnormal looking compared to everything else in my mouth. This was constructed of a different kind of composite called Integrity. Awesome. We also decided that the color was a little too bright, but for now at least, who cares. If it was still going to be hanging out next to tooth #8 for a while it would still be a much more popular tooth for everyone to gawk at at the party. Cyborgs are cooler than zombies anyway, right? Though technically, both teeth are dead. But you can't blame a metaphor for trying.

For my final appointment of preparations for the surprisingly long procedure of getting a crown, I met yet another student and friend of Rakhee's, Maryam, who would be assisting on my 21st visit on June 24th. Today both teeth would be checked off by the faculty and we would make another mold of my upper teeth without their temporary crowns to be sent to the lab to use to create my final new porcelain crowns over the next few weeks. Color me intimidated! Which meant we also had to decide on a color. We matched two colors actually to my bottom teeth for them to transition together from the base of the tooth to the more translucent edges. Honestly, I kinda closed my eyes and just crossed my fingers. Rakhee was, after all, using tooth #7 for Competency, and I believed in her own perfectionism (or paranoia? Haha) more than mine.
Today, I would learn of a new little part of this particular procedure that would go down in my dental history of most annoying pet peaves about all I have undergone, up there with the infamous mouth-stretching "Minnesota" tool, and those little plastic wedges jammed between teeth for better access during fillings. Today, we would pack cord. Ugh. So, imagine yourself flossing and that uncomfortable feeling when you go below the gumline, and then imagine wrapping a whole bunch of floss soaked in medicine to slow bleeding wrapped around the circumference of your tooth jammed and poked further below the gumline. From what I gather the purpose of this is to push the gums away from the teeth so as to get a perfect mold of all tooth surfaces the new crown is to be cemented to, so as to maintain perfect margins between the tooth and the crown. (Any students out there reading who want to confirm? I keep telling you it'll earn you prizes for answering my blog questions! Come on, kiddos--don't you like surprises? Or perhaps you haven't had my cookies yet.)

This is the CRAZIEST picture to me. It is like, 4 generations of my tooth family or something. If only there was a healthy, complete tooth in the picture as well I feel like it would be an awesome teaching tool I could sell to dentist textbooks or something! Haha, who knows.  These are teeth 6-11 from left to right. This is the most pain in the ass 2 inches of my whole body! Dunno what on earth it's going to look like when it is totally rebuilt, but it will most certainly be an improvement over this. I am still frankly pretty scared of the day when 8, 9 and 10 are to be extracted. 9 and 10 are also the first roots that are COMPLETELY buried and I worry how hard they will be to dig out and also if the process will damage any of the surrounding bone that must remain intact to support two implants. Deeeep breaths, think about something else, and wait and see, I guess. Trust I am on the right path, and in good hands.

Upon checking in with the doctors, Rakhee was advised to pack even MORE cord. (Grrr!) She also had to refine some of Meyer's earlier prep and drop the margins on tooth #3. Shhhh...don't tell him!
After that, I was ready for new mold.
Do you think even though they have masks on they still smile beneath them when I take pictures? Funny. P.S.-I make the darndest faces. I seem to usually forget what the hell my eyes are doing I spend so much focus on my mouth. 
Smile, Maryam! You're in the blog, and are one more soldier in my ever-growing army of dental students. Thanks for all your assistance.
This concluded the day while we wait for the crowns to be made. The school was also on break for a week and then in "seminar" for a week, making for my longest break in appointments since I began. Next up, 4 more fillings, seating these crowns, unfortunate emergencies, and some treatment plan revisions. More soon!