all i had was a greek yogurt for breakfast before i left around 11:20 for my noontime oral surgery appointment. i decided to dress up a bit, putting on an undershirt and a clean shirt on top of that, figuring if i looked respectable, that maybe it'd get better service, versus going in just my usual rags. the temperature was already up at 82 degrees as i debated whether or not to take the bike instead. in the end i decided the subway was the best option, so that i wouldn't arrive all sweaty and i can return home afterwards safely if i'm groggy from the surgery.
i recharged my charlie card before leaving south station. for some reason all the machines i tried didn't work until i found one that only accepted cash. i arrived at the doctor's office a few minutes before noon, signing in with the pretty blonde receptionist and then taking a seat in the waiting room. i was lost in thought, a little anxious over what was about to happen.
the chinese head nurse called me inside. the first thing we did was to take a panoramic x-ray of my teeth, to check on the status of the bone graft i had done back at the end of december. the bone had bonded perfectly, no problems from the x-ray.
then it was time to operate. they gave me a bib to wear. i jokingly told the doctor and the nurse that i was worried about booking a noontime appointment, since it's right around lunchtime and they might be hungry so wouldn't be able to concentrate. the doctor told me he actually doesn't eat lunch because it makes him sleepy. they injected me with novocaine. the painful needle stabs went in deep, like it was hitting my jawbone, but if they were going to open me up, i didn't want to feel anything, so the more novocaine the better. i felt the area (including my lips) go numb within seconds after the injections. while i was waiting for the drug to completely kick in (10 minutes), the nurse gave me a bunch of consent forms to initialize and sign.
first, some sort of scaffolding was put at my upper right jaw, the operation site. the gum above the missing tooth was cut open, and i could feel the drill cutting into a window into my jawbone to gain access to my sinus cavity. while the doctor worked, the nurse was siphoning out the blood through a vacuum straw. i kept my eyes on the glaring swinging overhead examination light, at the bright lightbulbs in the dropped ceiling. i could sense what they were doing was pretty major because even through all that novocaine i could feel a dull ache.
the doctor tested the site: apparently there was enough regrown bone (at least 5mm) to do both the sinus lift and the dental implant today, saving me some recovery time. since i couldn't talk with my mouth open, i gave him the okay sign when he told me, which caused the nurse to chuckle.
the sinus lift procedure: through the window in my jawbone, he carefully lifted up my sinus cavity and being pumping liquidized bone graft material into the space above the missing tooth. a few times he asked me hold by breath, then he'd closed my nose and asked me to exhale through my nose. this causes the sinus cavity to inflate, so he could check to see if it'd been ruptured. the sinus cavity inflated without problems, and he told me i have pretty thick membrane, so there was no danger of rupture. all of this filling the gap with new material reminded me of the insulation work i had done last week. the doctor covered up the window with a rectangular piece of biocompatible membrane.
2 more nurses came in to assist, both hispanic. it was a bit surreal, both chinese doctor and head nurse conversing in cantonese, while the two hispanic nurses speaking in spanish. only in america! apparently they've done so many dental implants that were just casually going about their business. oh, a patient with his jaw all cut open and blood everywhere? did you see that photo i sent you?
next came a second round of drilling, this time into the space where the missing tooth used to be. i now know what a piece of wood feels like when the doctor then drilled the dental implant into my jawbone. the nurse gently put her hand on the other side of my head so i wouldn't turn away. imagine doing this without novocaine! once that was done, the doctor sutured me up. i don't know why, maybe he was being dramatic, but the sutures were really long, like 2 feet, as i watched and felt him sewing close the incision.
with that i was done, just had to take another x-ray to make sure everything was okay. i sort of stumbled to the panoramic x-ray machine, almost dropping my glasses, and banging my forehead against one of the adjustable head brace prongs.
back in the operating room, we looked at the x-ray. now instead of an empty gap was the silhouette of the dental implant. i now officially join the ranks of metahumans in being part flesh and part metal! when i asked the doctor if it was a titanium implant, he said no, but something even better, even though he didn't say what it was. the operation was a complete success, no complications whatsoever. my sinus cavity was intact, just pushed up a little bit to make room for the additional bone graft. my right nostril felt stuffed up, the doctor said this was normal after a sinus lift (it cleared up soon after i left). he said that my jawbone was the optimal hardness level (scoring 35 on this fancy bone hardness meter), so the implant is extremely stable.
one thing he told me that i thought was a joke at first was not to blow my nose. "not to blow out the right nostril, right?" i asked. no, he meant not to blow my nose at all for the next 2 weeks. he said inflating the sinus cavity could potentially poke against the bone graft and rupture it. it wouldn't be the end of the world, but it'd be a complication better not to have. he suggested if i had a runny nose due to allergies, to take medication for it instead. some more restrictions: for the next several days, not to spit, not to smoke, not to use straws, and don't rinse vigorously. for 2 weeks i can't blow my nose, and try not to sneeze either (if i must, don't muffle the sneeze, which i don't do anyway). surprisingly there was no food restrictions (including alcohol), but the doctor did warn me about not eating anything hard on my right side (which i already learned not to do from spending the past 4 months with a missing molar).
my next appointment will be in 4-6 months. the dental implant right now has a temporary healing abutment, to keep the healing flesh from covering over the exposed nub. the next time i come back, he will simply unscrew that and screw in the permanent abutment, no surgery required. however, as a precaution, i'm to come in next friday for a quick check-up, to make sure everything is healing okay. not even to take out the sutures, which will disappear on there own. the doctor also gave me his cell phone number in case of an emergency. so how much was the bill? $2800! i was a bit shocked, because i thought it'd be $1900. i asked for a copy of the invoice: $1950 for the dental implant ("surgical implant body: endosteal"), but an additional $850 for the sinus lift ("sinus augmentation with bone or subst"). the doctor was flexible with the payment, said i could pay however much i wanted today; i decided to pay half now, and pay the other half in 4-6 months. i still need to pay another $800 for the actual crown. he wrote out a few prescriptions: i still had a bottle of unused hydrocodone, so he printed a slip for prescription-strength motrin (which i found out is just 600mg ibuprofen) and some amoxicillin/clavulanic acid. as a parting gift, he gave me a little ice pack for my cheek. the whole sinus lift/dental implant procedure from start to finish took about an hour.
i made my way home, a little self-conscious about using the ice pack, but occasionally putting it up to my face for some comfort. i was feeling a dull ache in my jaw and a mild headache so i couldn't wait to get my drugs so i could go home and chillax. back at home, i looked at myself in the mirror for the first time (prior to that, i only saw the occasional window reflections as i came home). i knew there was some swelling, and saw that my right cheek was swollen like a chipmunk. however i wasn't expecting half my lips to be puffy as well. there was also some dried blood, so people who saw me in the streets probably thought i was in a losing fight (fortunately the subway wasn't very busy).
i biked to rite aid to get my prescriptions filled then returned home. i took an ibuprofen tablet which soon eased the pain. i tried to look inside my jaw but it hurt too much to open it wide so i decided to inspect it some other time. i accidentally pressed up against my right cheek at one point and felt a shot of pain.
my parents stopped by in the afternoon after work on their way to market basket. my mother hadn't been to my place since i rearranged my living room. she thought it made the place look smaller, and said it'd be better if i pushed my couch all the way back. she also thought my house was a mess, from the clutter of unsorted mail (which she helped me sort), to the stack of boxes everywhere because i emptied out everything to set up my winter grow closet. my father helped me move the majority of my plants, to be relocated to belmont where it was much sunnier. curious about the insulation, my father went through my house with the infrared thermometer: a uniform 73 degrees everywhere, despite the fact that it was reading 86 degrees outside on my wireless weather station.
after they left, i went about dismantling the last remnant of my grow closet. with the weather now seemingly in summer mode, there's no reason to continue growing my plants indoors. i packed up all the remaining seedlings in cardboard boxes and turned off the lights. some of the pots had additional tiny seedlings which looked like columbines, so i rescued about 5 of them, putting them into individual pots.
later my parents dropped off a rotisserie chicken. i was planning on having porridge for dinner, but couldn't pass up on some chicken. besides, the protein would do me good. so ended up having dinner at 4:00.
i felt very tired, and decided to crawl into the guest bedroom and take a short nap at 6:00. i woke up 2 hours later. i still had a very mild headache, which probably comes from not drinking enough fluids on this hot day. not that the weather is so hot, i don't drink tea anymore. i've found a new kick: ice water. especially in my insulated contigo mug, which keeps everything freezing cold for 12 hours. at 10pm i took my first antibiotic tablet and another ibuprofen. or i thought it was ibuprofen, but accidentally took a hydrocodone instead (they're all white nondescript tablets of the same size). surprisingly, i didn't feel all that different. it wasn't hurting to begin with, i was just keeping up my dosage.
later in the evening i had a headache, then i started feeling nauseous. i thought maybe it was because i didn't eat anything other than half the chicken in the late afternoon, but even after a yogurt i still felt a little off. maybe i just need to go to sleep.