Author Topic: Knocked off - tell me what I need to do  (Read 41468 times)

Re: Knocked off - tell me what I need to do
« Reply #100 on: 28 September, 2016, 05:33:13 pm »
Some can't cope. My daughter doesn't know the details of the operation on my arm. She knows it was moderately major, and she knows she can't cope with the idea of bones being sawn, etc. If she'd seen the xray of my arm with the displaced and shattered bones she would have probably been physically sick.

In DrMekon's case, it's not an injury that can be hidden away under a cast, it is literally in their faces and connected with how they identify their father/partner. That's a very hard thing to deal with.

When I had my recent, um, little episode with a broken leg and some external fixators, the younger two kids took some days to come to terms with it. My daughter, in particular, was very squeamish and it took Mrs L "putting her up to painting Daddy's toenails! for her to be willing to come near it.  ;D

Good luck DrM. I'm in theatre tomorrow - on call on Friday so will text if there isn't transplant work to do. Coffee?

Re: Knocked off - tell me what I need to do
« Reply #101 on: 29 September, 2016, 05:28:50 pm »
Coffee would be ace.

I have to say, I feel very lucky to have collaborators in dentistry. Felt really looked after yesterday. However, the news wasn't great. Fracture right across my midface (consultant to student - "look, you can see the whole of it is mobile by the way the teeth wobble all together), which has lead to my sinuses filling with blood. Also, fracture to the upper jaw, and tooth socket broken. Upshot of that was that they did't want to remove the splint until the end of November. Howvever, they've since relented, and it's been moved forward to the end of October. However, the good news is that the teeth that got bashed have a 70% chance of survival. The only other bad news was that I might need a bone graft for the planned implants - "not the legs doctor, anywhere but the legs"

Re: Knocked off - tell me what I need to do
« Reply #102 on: 29 September, 2016, 09:55:44 pm »
Crikey. Even with friendly care, that's rough. Thinking of you.

Re: Knocked off - tell me what I need to do
« Reply #103 on: 30 September, 2016, 08:11:57 am »
Coffee would be ace.

I have to say, I feel very lucky to have collaborators in dentistry. Felt really looked after yesterday. However, the news wasn't great. Fracture right across my midface (consultant to student - "look, you can see the whole of it is mobile by the way the teeth wobble all together), which has lead to my sinuses filling with blood. Also, fracture to the upper jaw, and tooth socket broken. Upshot of that was that they did't want to remove the splint until the end of November. Howvever, they've since relented, and it's been moved forward to the end of October. However, the good news is that the teeth that got bashed have a 70% chance of survival. The only other bad news was that I might need a bone graft for the planned implants - "not the legs doctor, anywhere but the legs"

Blimey. Who are you seeing? And have they got the max-facial surgery folks involved?

Re: Knocked off - tell me what I need to do
« Reply #104 on: 30 September, 2016, 08:14:15 am »
Saw Mr Palmer in maxfax, but  long term, seeing Dr Bhakta in adult restorative.

Re: Knocked off - tell me what I need to do
« Reply #105 on: 04 October, 2016, 12:24:47 pm »
Coffee would be ace.

I have to say, I feel very lucky to have collaborators in dentistry. Felt really looked after yesterday. However, the news wasn't great. Fracture right across my midface (consultant to student - "look, you can see the whole of it is mobile by the way the teeth wobble all together), which has lead to my sinuses filling with blood. Also, fracture to the upper jaw, and tooth socket broken. Upshot of that was that they did't want to remove the splint until the end of November. Howvever, they've since relented, and it's been moved forward to the end of October. However, the good news is that the teeth that got bashed have a 70% chance of survival. The only other bad news was that I might need a bone graft for the planned implants - "not the legs doctor, anywhere but the legs"

Jesus H Christ.... either way. I hope it all works out ok! Sue for maximum amount of money to cover this!

Re: Knocked off - tell me what I need to do
« Reply #106 on: 04 October, 2016, 12:31:29 pm »
If it's of any reassurance, bone graft material in my case was a powder (bovine I think) stitched into the gum and allowed to bond with the jawbone.  I think that's a fairly common way of doing things.
The sound of one pannier flapping

Re: Knocked off - tell me what I need to do
« Reply #107 on: 04 October, 2016, 12:44:53 pm »
Yes - that's the expected route - however, he's of the view that it may be significant enough to need to take it from me (not legs, probably inside my jaw).

Re: Knocked off - tell me what I need to do
« Reply #108 on: 04 October, 2016, 01:19:40 pm »
For me it was shavings from my hip, packed into my femur.  (I can still feel the notch in it.) Do they like to take bone form close to where they will do the graft ?

hellymedic

  • Just do it!
Re: Knocked off - tell me what I need to do
« Reply #109 on: 04 October, 2016, 02:40:15 pm »
I think the iliac crest (uppermost part of the pelvis) is a popular harvesting site for bone grafts for almost any recipient site.

Re: Knocked off - tell me what I need to do
« Reply #110 on: 04 October, 2016, 06:06:03 pm »
Well I said "not the legs Doc, anywhere but the legs - I'm a cyclist". He said that that was useful to know, as I'd limp a bit. He said inside the jaw would be fine. The face is a state anyways.

hellymedic

  • Just do it!
Re: Knocked off - tell me what I need to do
« Reply #111 on: 04 October, 2016, 06:26:07 pm »
The iliac crest is hardly 'legs' as it's only just below the waist, though the sartorius muscle originates on the anterior superior iliac spine...

Paul

  • L'enfer, c'est les autos.
Re: Knocked off - tell me what I need to do
« Reply #112 on: 04 October, 2016, 06:39:30 pm »
I'm lost for words. GWS.
What's so funny about peace, love and understanding?

Re: Knocked off - tell me what I need to do
« Reply #113 on: 04 October, 2016, 07:41:09 pm »
The face is a state anyways.

Blame your parents?  :P

Re: Knocked off - tell me what I need to do
« Reply #114 on: 04 October, 2016, 09:20:39 pm »
Harsh

 ;D

Re: Knocked off - tell me what I need to do
« Reply #115 on: 04 October, 2016, 09:56:18 pm »
But fair

Re: Knocked off - tell me what I need to do
« Reply #116 on: 06 October, 2016, 07:31:12 pm »
 ;D ;D

Re: Knocked off - tell me what I need to do
« Reply #117 on: 08 October, 2016, 03:56:42 pm »
I can see dental being  a four figure sum.
Claim.

5 figures if it's 4 implants (or even 2 and a bridge) and bone grafting (particularly if block graft). Plus you have to build in replacement costs, as they are not lifelong, and will need at least the crowns replacing during your lifetime. Crowns and possible root canal treatment on any fractured saveable teeth. Plus the risks of later pulpal issues. You will be having multiple appointments, and therefore loss of earnings/time off over the next year. It all needs to be claimed for.

GWS DrM, you look like you have a good dental team lined up.
The older you get, the better you get, unless you are a banana.

Re: Knocked off - tell me what I need to do
« Reply #118 on: 08 October, 2016, 04:30:31 pm »
Thanks. The only thing that's playing on my mind at the mo is what they'll do about the broken tooth socket. At the mo, it feels like the back side has been knocked right back, and it makes me lisp dreadfully.

One of the teeth they are trying to save looks like it's gone grey, and despite the splint, looks loose.

Brace wax is an absolute godsend. I wish it had been mentioned to me on discharge. The sharp edges of the splint was scouring the sides of my cheeks to the point that blood blisters were forming.

Re: Knocked off - tell me what I need to do
« Reply #119 on: 08 October, 2016, 05:04:21 pm »
If it is changing colour it has probably died. I assume they have xrayed it to see if the root is fractured. If it is restorable it will likely need root canal treatment, post and crown. These are not always pedictable long term and so need to have replacement costs in the future ( implant etc), claimed for now.

The fractured socket should fill in and remodel over time.

Assume any restoration has an average lifespan of 10-15 years and replacement costs on that schedule over your lifetime in your claim.
The older you get, the better you get, unless you are a banana.

Re: Knocked off - tell me what I need to do
« Reply #120 on: 10 October, 2016, 01:56:22 pm »
The iliac crest is hardly 'legs' as it's only just below the waist, though the sartorius muscle originates on the anterior superior iliac spine...

Despite my going all doom and gloomy about my recent experience of this, it is recovering very fast.

5 weeks + 4 days post op and I can do situps, cough without pain, lift leg in any direction. There is a substantial lump and scar over the graft harvest site but little sign that there is any permanent muscle disability.

I had assumed that they were taking a 20p piece out of my hip but having seen the xray and now able to feel my arm, what has gone into my arm is more the size of a 50p piece, so they must have  chopped substantially into my hip to have got enough to have turned that into the right shape of wedge and it still be so large.

So I don't think you need to worry about illiac crest harvesting interfering with future cycling. If they do take from there, it will feel terrible at first (like they've cut half the muscles in your belly and you'll have pain walking and lifting your leg) but it will rapidly pass.
<i>Marmite slave</i>

Re: Knocked off - tell me what I need to do
« Reply #121 on: 10 October, 2016, 02:00:03 pm »
Just wondering, is it possible that Boris Johnson had a similar cycling accident in the past and they grafted bone from his hip into his mouth, only they used the bone nearer his posterior orifice?

(GWS anyhow)

Re: Knocked off - tell me what I need to do
« Reply #122 on: 22 October, 2016, 12:23:30 am »
So, yesterday saw the metal splint that had been taking lumps out of my cheeks hacked off, and got the "best guess" denture they fashioned from the mould they managed to take while I had the splint in and my face was all wobbly.

Yes, it's pretty terrible - cosmetically, it works. That's great. Speech - lispy, incredibly effortful, and uncomfortable. Eating - the teeth are useless.

The issue appears to be that the busted right hand front tooth socket has blown out at the back, and the big lump where it currently resides has to be accommodated.

Unfortunately, the blown out socket isn't currently a viable site for an implant, and the "gate" it has left is right near a nerve and blood vessel that would be a risk. Current plan is to look again in 3 months, when they'll take another mould and give me another denture. Hopefully some animal bone product will suffice to patch up whatever the mess that's there remodels itself in to, but if not, I get a visit from the "harvester". I've been told to expect having the implants buried for 4 months before the crowns are fitted. My expectations are being managed for a 12 month process.

The prospect of lecturing over the next year isn't something I'm relishing, given current reactions to my speech, but maybe it'll improve. If not, I'm going to have to see how my teaching load can be managed.

Re: Knocked off - tell me what I need to do
« Reply #123 on: 22 October, 2016, 09:38:54 pm »
I had been thinking about this- how I would manage teaching if I couldn't speak as normal? Huge problem.
Your employer should be able to come up with a solution that involves you not having to speak publicly for now- be it someone doing that bit for you or an online alternative. If not then they would have to accept you being off sick more long term, at least for part of your contractual obligations. I hope your employer is being supportive about this?
GWS xx

Kim

  • Timelord
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Re: Knocked off - tell me what I need to do
« Reply #124 on: 22 October, 2016, 09:49:06 pm »
I had a lecturer with a speech impairment.  Larynx damaged by a tumour, IIRC.  For lectures he would whisper robotically (but reasonably intelligibly) into a special microphone, backed up with excellent slides and handouts, and it wasn't really a problem.  The course structure was such that I didn't have much interaction with him outside of lectures but the general impression I got was that he was quite happy to repeat himself or write/draw things as needed, and since he took the lead, people coped.

So I suppose it's a case of finding a way to make things work, and being confident with it.