Pheealzabraces: Stage 2, 2 days out

So all four Wisdom teeth are gone, almost thirty years after appearing without incident (aside from confusing and causing slight pain to their owner as they erupted). The second extraction and the recovery are going as smoothly as the first (although the gum flap over the upper socket on the left side (the one worked on yesterday) has already dropped out, almost 24 hours earlier than the right side did), but I'm not too worried. Dr. Brownfield called last night to check on me and said that it was actually a little easier than the right side. I know what to do and not do to avoid complications (he says, knocking on wood). Next up (after the follow up in two weeks) will be coordinating the ordering of the braces and subsequent scheduling of the PAOO surgery.

At Clint's (and my once I was appraised in greater detail of the annoying and hilarious details of my state immediately after the first surgery) request I was given more time to wake up before they called him to come whisk me back to the house. I don't remember coming to in any capacity during the procedure (see the infamous 'trying to scratch his nose" incident during the first surgery), but definitely was lucid afterwards while I was still in the room both in the dental chair and the wheelchair (I imagine they need to have me in one until I'm in the vehicle out front) having conversation with both Dr. Brownfield and the DA who assisted her. I was sharp enough to notice that the ice packs and headwrap that I brought with me to reuse (apparently I was their first patient to ever do that, serial recycler that I am) and remember the entire ride home as well as to wait for Clint to stop the truck, help me out, and help me to the front door. None of which I did the first time, apparently.

Now for some surreal and befuddling communication between the surgeries:

After the first surgery, Dr. Brownfield sent a treatment letter (SOP) to my regular dentist, Dr. Tim Hung. I have been seeing him for about 4 years, and he had put some fillings in on both the top and sides of some of my teeth as well as cutting one of the dead teeth down and placing a crown on it (the tooth in question (6) had darkened over many years mainly due to (voracious) coffee and tea consumption in my younger years. He had also asked me about whether I wanted to explore the possibility of braces, and I told him that I didn't, thinking that he was asking with cosmetic considerations in mind and not the issues that Drs Brownfield and Hall highlighted.

When his office received the letter, they were, shall we say, less than thrilled, called Dr. Brownfield's office and proceeded to espouse in a passionate and a little less than diplomatic manner on how THEY did extractions, and THEY did braces and had spoken to me about them (Dr. Brownfield's office manager Kelly actually fielded the call, which is a normal part of her gig, albeit a pretty crappy one). Dr. Hung then called me to "answer any questions that I might have" about everything that was going on. I spoke with him for a bit and wasn't really sure where things stood with he and I even after the conversation. I spent a couple days before the follow up after the first surgery (about two weeks ago) wondering if I had done something wrong in not going back to him after the visits with Drs Brownfield and Hall (this being my first real experience with a referral). Once I had the follow up with Dr. Brownfield we talked at length about it (she had called Dr. Hung back since he called me) she gave me her take on things which boiled down to the fact that Dr. Hung was trying to offer as many services as possible out of a single facility and that his office was encouraged to try to keep as much as possible procedure wise with established patients in house. While this is certainly the way things are moving in the world that we live in today (think big box home improvement stores and grocery store size sections in Targets and Wal Marts) it doesn't sit too well with me when it comes to the medical industry. Specialists are called that for a reason. Dr. Brownfield tried to assuage Dr. Hung's apparent confusion about why I followed her and Dr. Hall's counsel concerning the braces when he had mentioned it to me earlier by explaining that sometimes it takes a person being told more than once that a certain course of action is preferable. I was also a little confused about Dr. Hung and/or his office's angst over my electing to follow the treatment regimen that Drs Brownfield and Hall had proposed since he had referred me to Dr. Brownfield and she had referred me to Dr. Hall (which she agreed with). Dr. Brownfield also said that she had told Dr. Hung that he wasn't qualified to do the Orthodontic treatment on me due to the lateral cross bite, the over bite, the crowding in the lower front, all of which he ended up agreeing with. It seemed that Dr. Hung's major concern is the two teeth in the front from the accident and how they were going to be addressed. He expressed a desire to try to save the lateral incisor (7), which Dr. Brownfield expressed doubt about, and she felt the conversation ended on a good note.

[This is probably as good a place as any to point out that Dr. Hung has a pretty thick accent and his tone is pretty consistently flat and neutral, making it hard to read him when he speaks to me about issues and procedures outside the scope of day to day tooth care. I outlined this to Dr. Brownfield during my first appointment, which she heard and agreed with after their first conversation.]

So Dr. Brownfield and I decided to do the other two Wisdom teeth next and the PAOO surgery after that (the two together would be a pretty long day in the chair, which I am happy to forego) and Kelly and I scheduled the appointment for Tuesday the 3rd. Then last week (Thursday, I think it was) who should call but Dr. Hung's office asking me to come in so that he could walk me through my options for the next several stages of treatment. I was getting ready for a call at the Opera and was getting close to my limit with him. I asked the woman on the phone (who I'm pretty sure is his wife) what exactly he wanted to talk about since I was already on a set course of treatments that I had discussed with Drs Brownfield and Hall. He came to the phone and eventually made it known that he wanted to walk me through the different replacement options for the two dead teeth in the front. After further conversation with him mainly getting across that I in fact did not have any questions and that (according to my understanding gleaned from discussion with Drs Brownfield and Hall) the replacement of the two front teeth was something we were going to consider after the PAOO and Ortho treatment I got him off the phone (not without him getting his stock way of ending a call out; "If you have any questions don't hesitate to call") and decided not to bother Dr. Brownfield with it and see if he was going to call her office.

Which is indeed what happened. She came into the room before I went under from the oral sedatives (it seems like it took a little longer than the last time) and told me she spoke to him again (I asked resignedly "when did he call you?", to which she replied with a knowing and slightly weary smile: "after he called you." She was more firm with him this time, again attempting to explain that it sometimes takes a person more than once to hear something before deciding on going forward with it. She ended the conversation on a slightly firmer note, stating that she and Dr. Hung didn't need to speak again until after the Ortho treatment at the earliest (I mentioned that it seemed to me Dr. Hung was asking me to make decisions pertaining to "step 7" of this process when I was mere days away from "step 2", which she agreed with). She did mention to me that one of the things he said to her during the conversation was that he "just wanted me to be happy" with the end result, which apparently is something that she'd never heard from a Dentist before. I greeted all of this with a bit of relief (not at the fact that she had heard from him again) but at the fact that it seemed as though he was going to back off a bit (one of the other things he kept mentioning was "coordination between the three offices of our efforts").

I mentioned a couple possibilities that had crossed my mind during the course of the phone calls between Dr. Hung and Dr. Brownfield and I to Dr. Brownfield:

He was fearful of losing control of the overall course of treatment (which I felt he had relinquished with the referral, but this being my first referral experience I am not so sure of now) and potentially me as a patient.

He was concerned about the fate of the two front teeth that prompted the referral in the first place (one of which he had done significant work on with the crown). I don't know, concern over the legacy of that work or the potential that I or Dr. Brownfield or Hall or both would consider that work a failure or at best a stopgap measure?

(A third that I didn't mention to her was the possibility that he didn't appreciate being told that he "wasn't qualified" to do the Ortho on my teeth, especially by a woman. It's another aspect of Dr. Brownfield that I admire pretty highly: establishing an independent practice in a specialized area of a field that is (to my limited observation) still rife with patriarchal attitudes while raising a pair of 2 year old twin boys).

She didn't agree with either of them outright but didn't disagree either, so I have a feeling that it's a combination of the two. Maybe this post should have been subtitled "Ego and Politics in Dentistry"

One of the other things that Dr. Brownfield has mentioned to me more than once is that my case is refreshing in that the history of the two teeth that are eventually going to have to be removed and replaced is a known one and that I'm at peace with that fact. She has told me of patients who, upon hearing such news, have refused to acknowledge that as a possibility, not understanding or being able to remember an incident that might be the underlying cause of the current need for the removal of the tooth and have burst into tears in the chair, left the office and weren't seen again by her for two years. At one point during one of our conversations when this came up I asked if there were one or more Psychology or Communications courses that were a part of the Dental School course load. She answered that there weren't, but that her Undergraduate degree was in Humanities, and that she finds herself using it every day, contrary to what many people say to her ("it's too bad that that degree is going to waste") when they find out that she has the degree and yet is a Dental Specialist.

I'll close this out before I think of another tangent to start rambling about. More after the follow up and potential additional scans/models.