I discover I have had major surgery …

I wish there were no such things as Teeth in the World; they are nothing but plagues to one, and I dare say that People might easily invent something to eat with instead of them. —Jane Austen, Catherine, or the Bower

Friends,

Can you imagine yourself being surprized to discover you have had major surgery. That’s my case. Not until the ordeal was almost over did I realize that was what had happened, and not until today, the fourth day afterward and I still have strong pain in my lower jaw and gum, and can’t eat most foods, what major surgery brings on one. I have had major surgery voluntarily three times: all three (of four such volunteering) I have had a hemmorhage (twice vast). Maybe I missed it because the knives (tools they are called) were not aimed at any central body organ or vein, but my mouth.

Gentle reader on Wednesday I had 4 implants planted in my lower gum — implants are thin pieces of metal, two different kinds melded onto a structure that from a x-ray looks like the bottoms of my teeth used to when X-rayed. You might recall I said I had had an abscess in one of my three remaining teeth on the bottom of my jaw, that the one near it became infected, and the one left (poor lonely calcium) could not support my partial denture any more. That I decided I want teeth in my mouth, tired of dentures coming away, not quite fitting, the horrible tasting “adhesive glue-cement.” Well I arrived at my dentist at 9 — I shall call her Veronica Archer. She had said she was cancelling all her other appointments, but I didn’t realize or didn’t think that meant this ordeal (as I began to call it by noon) would go on all day. It took from around 9:15 am when we started, until around 4 pm, with one hour off when one of her three assistants was preparing the denture. Basically she has built me a new jaw. The morning was drilling long holes in my bone in my mouth, and then inserting these pieces of metal, and then on top of them screwable buttons. The insertions had to be done three times to get it right. She then sewed my all over the bottom mouth, everything tucked in. I needed more anesthesia for that; I’d already had two full bouts.

Time out a bit as my legs began to go into spasms.

She had two assistants for this first phase, one was guiding her, someone sent from the company who sells all the material. I am the first patient Dr Archer has done this operation too. She was learning on me. Hitherto she had done say two implants, but never the whole jaw. I didn’t know that. I knew she has a certificate as a dentist and that she puts implants in and does other surgery (root canals, crowns, whatever). She never refers me anywhere; she does everything. Then her assistant from Ohio, also a dentist but specializing in implants. He does nothing but implant over and over — Abdul Gawande says this is the kind of person you want doing a particular procedure, someone who does it as his central trade. put four tiny screws in and then he worked at fitting the actual denture. At that point we took an hour off. The dentist took me out to lunch and I had a bit of pasta but couldn’t eat it really.

Then back for 2 hours to get the screws and denture to fit one another.

Dr Archer is a young black woman of around 43, and there are probably more black people coming there than white. It’s a toss-up; many Asian people. Not so many hispanics, probably because of the expense. I like her and for 10 years now have been more or less satisfied with her work — Jim (I admit) was thinking of switching dentists before he became so mortally ill; he hated the blaring TV in the front but I can’t remember any other complaints. She is Kaiser dentist, which means she agrees to give me a discount and Kaiser pays part of a bill according to a published schedule of prices, and she is much cheaper than “outside patients,” even if you have dental insurance. I can through Kaiser get supplemental dental insurance, but I have not done that. I did go for two other opinions to see if what she proposed was not crazy — there was something in me that thought what we did on Wednesday, 7/26 crazy. One very expensive DC doctor said to be “the best” and things like that (he’s expensive, and a Trollope says, people are impressed by those who charge high and are said to be very good); he was thorough and articulate and said it is what some dentists do and he said he charged ballpark $45,000 for this, not including everything. She charged $19,000 for everything. I also went to Izzy’s doctor who is a Kaiser man — it was he Jim wanted to switch too. He said that he might have done it slower; two one week and two the next and then a final day for dentures. But I did have the Scottish trip coming up and there is a brand of thought that one should do it all at once because this way all the implants are in the right spot. What was happening in the afternoon was this guy was making sure all the implants were centered in the right spot and that’s why he put the denture on because that showed the implants were all in the right place.

Beginning sometime the next morning I have been in bad pain on and off, sometimes it’s as if the denture is too tight (pressure), sometimes burning (some of my gum tissue is raw — Dr Archer showed me that on one of computer mirrors), sometimes indescribable. So I’ve been taking pills, trouble is they make me woozy, unsteady on my feet. I’ve had two night of 9 hour sleep, unheard-of for me most of the time. If I stop for 7 hours say, then I am driven to have all four at once. Better option: take one of them every 3 hours.

I can eat only a limited kind of food. No acid, not even prune juice, or a fresh tomato or peach. They burn. I can eat pasta and eggs, drink tea after it’s cooled off. Honey graham crackers bananas, quiches. I keep biting my tongue. I am most worried about this for my Scottish tour. Dr Archer tells me it’s usual to have such pain and it usually takes two weeks before usual diet can re-commence. The tour starts a week and one half from tomorrow; it will be 16 days after this operations. No need to cross fingers, as I will go no matter what – but I feel I should be better by that time.

I have to admit I’m glad the teeth are in, I can see if I was not in pain, that this will be big improvement over my removable denture. I also look better. It’s not the original contour of my face: my high cheekbones fell sometime in my sixties after all the previous dental work and their crowns and so on fell apart. My face dovetailed into an oval. Now the jaw is slightly squarer. She has said (half-kidding) that there is something we can do for the top gum, which would allow a semi-permanent denture too. Implants after some other procedure (an x-ray says I have no bone in my top jaw — gum disease of many years, slowed down by the deep cleaning and pills I once took, but still relentless over the years since Izzy was born — I was around age 38).

One result is I have had to cancel my NYC trip to a friend in Manhattan. I am sorry for this; if I thought this would be well by Monday, I’d go, but instinct tells me that Wednesday maybe I was be out of continual pain (without pills) and able to eat more. I am sleeping an enormous amount for me. The first night 11 hours altogether, and since then 8 hours both nights. Part of this is the painkillers put me to sleep (especially a huge Ibuprofen — dentist did warn me about this one), partly why it’s said babies sleep a lot: it’s a natural restorative, a reaction to stress and helps individuals regain strength (for babies to grow).

Generalizing, age wears many of one’s parts down. Samuel Johnson’s words come to mind:

Year chases Year, Decay pursues Decay,
Still drops some Joy from with’ring Life away…

Also how dentists fleece people, gouge them. It cost me for enclosing my porch, painting the house, including all new electrical work and a beautiful lit ceiling fan, $21,000. It took several different men over 2 and 1/1 weeks to do it. A story in the Washington Post about how the American Dental Association pulls this off: “The Unexpected Political power of Dentists.” One in every four US citizens have lost all their teeth by age 65. For millions regular modern style dental care is out of the reach of their income. I’ve seen middle class types (and receptionists) resentful of those who come with medicaid to have their teeth whitened. What are they not equally in need of acceptability as anyone else? I rescued my boy cat from a life-threatening procedure one veterinarian told me way the only way to clean his teeth: anesthetize him, which means putting a tube down his throat, and other of these high-tech applying force. She said she had only lost one cat in five years. She killed that cat. The cost $495. But I need teeth to eat with and to look minimally socially acceptable.

I know that dentists take pride in their work. The man I went to for years, and who built me a sort of mouth of teeth around the ones I had — 20 year period — did regard himself as a sort of artist. Dr Archer was excited and happy that morning, and assumed I was too. She has looked proud when I said that she had done careful careful good work — she gave me her cell phone in case of emergency. She had a photograph taken of the team, me and her.

I will see my friend in New York City at the EC/ASECS conference (small 18th century regional group) this November and she said we’d do a better job of planning four days in the later spring. I did have a very enjoyable lunch yesterday with a young friend from EC/’ASECS at La Madeleine: I was able to eat the inside of a quiche and drink water; it was not the food but our shared friendship over scholarly she is scholarly) interests. My idea of good fun is good company.

I shall have plenty of time for my projects — I seem ever to end up reading, writing, watching movies, studying.

Miss Drake