Do not go gentle

Up til now it has been so unheard of for a head and neck cancer patient like me to have implants that the procedure is not much written about or explained in the HNC service. When I’m done I’ll write a step by step list of the process. 

It’s especially rare after radiation so I’m very lucky that I’ve been given the chance to take this risk.

This is what I have experienced so far for my implant-anchored  bridge/denture on my lower jaw. 

Step 1: Implants screwed into the jawbone: metal screws that come up to gum level and have little tops on them, often buried under the gum. (Done during cancer surgery) 

Step 2: After 5 – 6 months the implants should have integrated themselves into the bone. The gum is sliced open, tops of the implants unscrewed and abutments or caps that rise above the gum are screwed on. (Done with great difficulty  – and that is when the trouble began because one abutment is digging into my swollen inner lip.)

Step 3: After 2 – 6 weeks of healing, the abutments are unscrewed and metal posts that rise to or above normal tooth level are screwed in – called dental “copings”. An impression is made with these posts showing the location of the implants. (Done). 

In my case the above was very hard. With limited access to my mouth (trismus) it was hard for the prosthodontist to engage the screwdrivers. Several screwdrivers were used (I think one was an Allen key) as well as what looked like a foot pedal screwdriver. Or were there two? 

The prosthodontist had to squirt the impression material into my mouth because the custom made tray wouldn’t fit over the posts in my awkward half-opening jaw. Two different coloured materials were inserted and wrapped around the implants ending up with a pretty good looking multi-coloured impression (I was two shy to take a pic). It was hard work for the prosthodontist and his assistant because every little bit of the impression had to be dried. The room looked like a crime scene after two frantic hours.

But it didn’t hurt. It was tense because I knew they were struggling, they had patients waiting and what if it didn’t work? I went into my zombie state, going through the alphabet, place names and so on and sometimes physically crossing my fingers.

I felt absolutely fine but after two hours in the chair with people coming in to clean up the room for the next patient, with cables on the floor and the cluttered tray jutting out, I had to pick my way carefully back to my bag trying not to show how stiff I was.

The precious impression will have gone to the lab to make some teeth but at some stage in the next little while I’m going to need surgery to untether my limp left lower lip from the gum. Scar tissue. I will need a full thickness skin graft possibly taken from one of the “bingo wings” under my upper arms.

Never a dull moment being me. I hope it will work out in the end but in the meantime it’s all about the journey, not the destination. I am in very good hands; I’m so grateful but I’m still crossing my fingers.