The one with the needles.

 I had my first medical appointment of the year on the 15th. I visited the Surgical Hospital for continued treatment for the correction of my occlusion. Yesterday was the postoperative appointment for my most recent outpatient surgery. There's not a lot to report, but I want to try to be more thorough. I also left this appointment with a new referral.

I am currently seeing a prosthodontist. Her name is Jenni. She's previously been in charge of my night guard, and now she has been working on my implants and raising my bite. As I've mentioned before my bite has remained open since my original jaw surgery. This isn't exactly an ideal position, so they're working to get the best occlusion possible for me.

During yesterday's appointment, Jenni noticed that I had a random gum flap growing above my implant screw.  I noticed this about a week after my surgery. We called the surgeon who performed the last procedure, and she said it was perfectly normal. I guess this particular gum flap was kind of odd because Jenni said she had never seen anything like it. With that being said, she had to anesthetize me and cut it away with a laser. I'll be honest, dental procedures still freak me out. Yes, even after all of this. However, I wasn't too worried about this tiny procedure. I've had so many needles. I've had my entire maxilla removed, repositioned, and screwed back to my skeleton.  Anything else is pretty much a piece of a cake in comparison. So here's where things get interesting.

She begins the procedure by gently inserting the anesthetic into my gum. About 2 minutes later I begin shaking all over. This shaking is all too familiar. It's like I'm suddenly freezing, but I'm not. My hand's jerk around and my legs noticeably tremble. I was wearing my Apple watch, so I quickly checked the heart monitor. My pulse quickly jumped up about 30-40 beats per minute. Jenni got pretty alarmed, and the dental nurse just watched in surprise. They suggested to call a nurse into the room, but honestly, this happened before and I just attributed it nerves. I wasn't nervous or upset, but the likely answer to this issue has been in plain sight this entire time.

Jenni suggested that I may have had a bad reaction to the anesthetic. I don't remember the brand that was used, but it contains adrenalin (like most). Adrenalin is used for a variety of reasons in medicine. I believe it is generally for serious allergic reactions, cardiac issues, and low blood pressure.  It's also a naturally occurring substance in the body ( hormone and neurotransmitter). It's used often in dentistry because it's a vasoconstrictor to local anesthetic solutions. This slows down the systemic absorption, which in turn prolongs the anesthetic effect. This also translates to cheaper and more effective.

I began to think back about how often these tremor-like episodes have occurred. She also began to ask me about the last procedure. I guess she was also trying to connect the dots.  Especially since I had severe tremors for about 3 days after my Maxilla advancement ( first jaw surgery).  She also explained they used a significant amount of local anesthetic along with general. That explains a lot. This conversation was taking place while I was having impressions taken so I couldn't speak very much. Afterwards, I explained to her that before the last procedure (outpatient surgery), I took diazepam to help relax my jaw. Therefore, I didn't have the shaking episode, but I did profusely sweat. The time before that I was under twilight sedation, so I don't believe anything significant happened. Although, I did wake up once abruptly with severe pain in my arm. Each time that I have had any significant dental work, I have been sedated, so it's difficult to really understand the if this is the cause. It seems likely.  I haven't received an appointment date yet for the Allergist, but I will update my blog once I know when I'll be going. I think this is an interesting theory. It would also be really good to know if there is some type of allergy or reaction to anesthetic because I'm quite sure I'll have more surgeries this year. Not dental, but if I'm really not interested in any other complications. This was a great catch, so kudos to her.

On another note, I'm still waiting for my appointment at the Physiatric Polyclinic at Peijas Hospital. I've been thinking about it a lot. Stressing about it mostly. I've almost been making a presentation in my head. How do I present my symptoms in a way that this doctor will not immediately dismiss me? Also here we are again, me telling this long-winded backstory. This thought alone is extremely stressful.

Will she take Dr. Kokkonen's referral at face value or will she attribute everything to Ehlers-Danlos Syndrome and send me away? The referral asks for an MRI with contrast. I hope she will at least honor this. As we know I haven't had the best track record with the public system, so fingers crossed. I'm seriously hoping that this will go well. These past few weeks have been a bit rough ( as usual). I have shoulder pain every single day. It's usually paired with facial pain, neck, headaches, sinus pain, tooth/jaw pain, hip pain, fatigue, upper GI pain, and sometimes peppered with depression. I haven't done very much in 2018. Mostly just physical therapy, a few friends have visited, and I've been trying to stay positive.

Physiotherapy on the Public Side & Kela 

My last post was so incredibly long, I'm not sure if I explained my physiotherapy situation accurately or clearly. I mentioned that I currently go to private OMT physio at Orton Hospital, and it's pretty expensive. The Neuro Polyclinic made a plan for me to continue at Orton, but in order to so, I had to apply to specialized physio through the public health scheme. I had to apply through Kela. This is Finland's Social Security system. I have had significant battles with these guys for the last few years. This situation is no different. Kela recently denied my rehabilitation plan suggesting that my symptoms and diagnosis do not match. This is infuriating. They also suggested that I go back to my local healthcare center and ask them to assist. The main issue here is that OMT or manual physiotherapy is not available in public healthcare scheme. Therefore, they cannot offer it. However, they are required by law to honor this rehabilitation plan. This means they have to assist in paying for my private physiotherapy or provide adequate physiotherapy for my condition.  In the past 7 months, I have paid around 3000 euros or more. This is truly unfair. Every Finnish citizen or permanent resident should have access to the care they need at a reasonable cost (At least by Finland's standards).  It's not like I am asking for anything that doesn't belong to me. It's more like demanding the care that I require and deserve.  My primary physician has sent my plan back tot he Neuro Polyclinic, so I am waiting to hear if they come up with some type of solution. All of this bureaucracy is insane. I can imagine many people give up. Not me. I have already gone forward with a legal complaint against Kela's decision, and I'm definitely not done. Let's see how long this takes to sort out? They have had the referral at least two weeks already.  The clock is ticking!


I'll update again very soon. Thanks so much for continuing to follow my journey!

Best wishes,

Amie