Thursday, April 19, 2012

Implant Post Allergy

This is a Tale of Two Implants.

Because of my childhood cancer (long story for another day...or month!), on the bottom left side of my mouth I haven't had teeth. For like 15 years. And the bone on the half of the jaw was taken from my leg (the fibula) so it is verrrrry little and thin and generally fragile (Translation: no sports for Mare).
So last February I had a bone marrow graft from my hip into that weak jawbone, to prepare it to get some implants so I can eventually have fake teeth. This procedure was not cosmetic at all--you can't even tell the teeth are missing--it is to secure the remaining teeth on the bottom of my mouth because they are starting to lose gum tissue without anything there to protect them, and I obviously don't want perfectly healthy teeth falling out like dominoes.
So, February 2011--bone marrow graft. Youch. Then in July he went back in and put some posts deep into the bone, took a graft from my palette (roof of my mouth) and laid that over the top so it healed over and my gums were solid again. A few months later, he punctured through the gums to get to the posts (now healed and looking perfect on x-rays), and added another attachment piece.

Everything was going according to plan, and the only pain I was having was normal (from getting cut open and such). Until... November 2011. He added the external post attachments--2 little titanium rods that screwed into the internal device. And then the false teeth go on top of these and I would be done with the whole process. These little guys looked like this ------.>

For the first few weeks, everything seemed fine. I felt a little more tired than usual, but figured I was just recovering from the surgery.And then the swelling started.

First it was between my last real tooth and the first post--a little knot of irritated gums. I went to the oral surgeon and he was concerned with this abscess because it got very nasty very quickly and we were worried about an infection disrupting the implant site.
He took a biopsy, it just showed an infection, and I had surgery to remove it and 2 bouts of antibiotics (which completely killed my stomach!).

But still I was getting a constant ache around the implants. I figured they were taking a while to heal.

And then, just a few weeks later, another infection. My cheek/gums were so swollen that they began to wrap around the post and even start growing over the top, and I was struggling to literally pry the skin off of the posts so I could clean around them and prevent another infection.
I was thinking what the hell is going on?! because I had never had an issue with any part of the process and then suddenly, 2 painful infections.

Again, surgery to cut out the infection and a ridiculous amount of antibiotics, me writhing on the floor from stomach pain (I have serious digestive issues and a sensitive tummy).

My surgeon was thrown off by why I was suddenly getting these infections and everyone kind of assumed I must not be keeping the area very clean. I asked him about the possibility of me being allergic to the posts, but he didn't think that was plausible because the external posts are the same material as the internal pieces, and those never bothered me.
I explained to him that I am highly allergic to nickel--if I wear nickel earrings or belt buckles I have a severe rash within 30 minutes, and yet I have nickel inside of my body--in my heart, actually, and that has never given me a problem.
He dismissed my concerns, saying "I have never had a patient or heard of a patient in my 30 years doing this with an allergy to titanium." 

I bought a WaterPik and used his rotten prescription mouthwash (which stains your teeth brown--lovely side effect!) and obsessively tended to my mouth, but it kind of stopped healing at all.
It hurt all the time, to the point where you just stop mentioning it or complaining because you think people won't believe you, and they are just sick of hearing it. I learned to live with it.
It was a constant throbbing on the left side of my mouth and I struggled to stop taking Lortab. I literally needed it all day every day if I wanted to function. And I felt exhausted all of the time. I would need to load up on B vitamins or a 5 hour energy to make it through the work day and then I would get home and collapse. I also had a bunch of other illnesses, and just felt shitty 80% of the time, and in pain 100% of the time. Not a fun way to live, friends.

I expressed my concerns about having an allergy to my hubby and my family, but we figured an allergic reaction would come across as different than the bizarre swelling/infections/constant pain that I was suffering through. Personally I thought it must be some kind of allergy, but when I called my allergist about a test, he asked if I had been referred by a doctor (nope) and later let me know they didn't test for metal allergies and that there are few doctors who do. So I let it go until...

A third infection!! The third one in 2 months. The second post was completely swollen over so you couldn't see it anymore. I cannot express the frustration! This time the oral surgeon decided to take that second post out. His reasoning was that my cheek on the left side is extra fatty and has some scar tissue in it, so it was rubbing on the post more than regular cheek skin should. So we decided I would only have one post, and therefore one fake tooth. I was very disappointed but would do anything to get rid of the infection and the pain. Desperation kicked in.

That surgery was over Easter, just 2 weeks ago. Before I went under I asked him AGAIN "what if this is an allergy to the posts?" He repeated that he has never seen it (there is a first time for everything buddy). He didn't advise I get tested, or refer me to anyone. He kind of shrugged it off.

And although he cut out the swelling and part of my cheek and stitched it all back up, a few days later the vicious cycle began again.
This time, I'm proud to say, I fought through recovery without Lortab. Yes, it was a challenge (it still is), knowing that I have a full bottle in my purse and I can take away all my pain here and now.

So there I am, with one post, more pain, more swelling, and things looking not better from the removal of the 2nd post, but worse.
I called up my insurance and began the hunt for an allergist that does the metal testing.
There is one. ONE. in the Utah valley.
And they don't accept insurance, but if you want to try you have to do the Medical Review Board thing. WTF?!?!
So I went the natural route (and thank God). I saw a Naturopath and he did some kind of electro-something test on me (I don't remember the exact term, but it was not ElectroDermal).
 It was the coolest.thing.ever.  You hold these two metal rods that are connected to a machine, and the machine is connected to the computer, and basically it runs electrical waves through your body and detects imbalances and health problems in detail (it came up with my exact teeth that have infections, my various food allergies, everything).
This test revealed that I am heavily allergic to nickel (which I knew), as well as bismuth and antimony (2 metals very common in alloys).

I called the oral surgeon, told him as much, and told him to get his ass in gear and contact the implant manufacturer to see exactly what are in my posts.
He called me this morning and SURPRISE! They are not 100% titanium, they have quite a bit of nickel and alloys (probably bismuth and atrimony).

I felt justified, and angry, and not very surprised. I kind of thought it was an allergy all along, and I am peeved with myself that I didn't seek out the test sooner (I tried, but gave up when it became difficult).
And...this metal allergy has been putting some toxicity into my body and causing a lot of the other problems I have been having, namely the Chronic Fatigue Syndrome I've been diagnosed with.
The oral surgeon didn't apologize, or acknowledge that I was right all along.
He scheduled me for surgery tomorrow in the morning to get the other post out ASAP, because it is making me so sick.

I have been mad about it all day. All of these surgeries (the 3 previous ones, tomorrow's, and the future one to get new implants, made of a different metal) were totally preventable.
All of the antibiotics that wiped out my stomach lining (the previous bout gave me colitis) were unnecessary. The pain was unnecessary.

The great news coming out of something this crappy is that we know what is wrong. So we can treat it, and I can get better, and eventually get new posts, and 2 teeth!!
And lesson learned: if I suspect something, I should follow my instincts instead of letting someone who is "qualified" falsely reassure me. I know my body better than anyone, renowned doctor or not.
Lesson 2: Naturopathy is badass, and shouldn't just be an alternative to traditional medicine.

So under the knife tomorrow I go, and it is only downhill from there!

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