New tooth for Christmas

 All I wanted for Christmas was a new front tooth. Ten long months ago, on Waitangi Day, one of my front teeth snapped off. It had been crowned and then recrowned (due to a poor initial piece of dentistry) but had seemed perfectly solid. Alas, the peg inside was not.

I've gone through implant surgery, bleeding issues, gagged daily on my ghastly temporary tooth, faced my friends looking like the Wicked Witch of the West and so I have been keen to complete this lengthy, painful and expensive process.

Following discharge by the surgeon, I was then back in the hands of a dentist. I was told to come for an impression (mould) to be taken so that the new prosthetic tooth could be created. That should be easy I thought. Sigh! Will I never learn?

As I sat back in 'the chair' the dentist told me I would need local anaesthesia. Heh? I was not happy as I find this really painful, even though it may be necessary, but this time I wouldn't work out why it might be necessary. The healing cap would be removed, a long screw inserted into the implant while the mould was made and then everything reversed. No surgery was required. I felt every one of those injections all around the screw/implant socket, leg-trembling stuff. Taking off the cap and popping in a screw was easy. I was told the mould would take a while and the dentist would be jamming it in place and then holding onto it, my mouth would fill with impression and I would want to gag. "Please don't move or gag, just concentrate on even breathing to get through it," said the dentist.

It seems this sort of impression is more complicated than that needed to create a standard crown. The dentist inspected the end result and declared it useless - there was an air bubble. We'd have to start again.

I was starting to gag and cough this time, towards the end of the process. Then the lower jaw was moulded to get my 'bite' right. Xrays were taken and the moulds sent off the prosthetics laboratory where my new ceramic tooth would be made. The dentist informed me I would need to go to the lab and have them colour-match to the rest of my teeth. My painful gums and socket did exactly that the following day.

The dental technician was nice and knowlegeable. He showed me my moulds and explained the work is very technical and must be precise to the last micron. Every step of the implant process must be precise. Just the right amount of space needs to be on either side of the tooth to allow flossing, it must be at the right angle and the tooth needs the correct alignment with its neighbours. My bite is very close so I will effectively be biting on the location of the screw and socket. Because of this, the sexy veneer could only be applied to the front of my tooth.

The day came when my new tooth could be fitted. More nasty needles. The cap was removed again and the new tooth and screw were inserted, Considerable pressure was applied to secure everything in the socket. It was uncomfortable but this faded within 30mins. I was told my gum would turn white [which it did] but would gradually return to pink. The tooth colour was good and it fills the space well. I cannot say it looks exactly like my original tooth at age 17 before a Christchurch dentist massacred it. The gumline is not the same, the angle isn't either and there's a back section that annoys my tongue as it juts out further into my mouth than my natural teeth or crowns. 

However, it is permanent, I can eat what I want, I will not be gagging on a partial plate and I no longer look like a witch. I will be able to eat normally in front of others. I will also be able to go back to singing. Having this 'almost normal' option is likely to be the best way to protect my current and future heart health. 

Right now my gum and socket are pretty sore but that will subside. This is an horrendously long and expensive process and, for me, has not been without pain and trauma. It is not for the faint-of-heart but if you are a long-term planner and persistent it can be a good option.

For info on earlier posts detailing the beginning of this process check out posts for the past 4-5 months.

Bloody dentistry - implant complications

 I waited three months from my tooth implant surgery for a followup consultation to determine if the implant was successful. How do they do that? I thought it would be through some sort of Xray. Ha, too easy!

The maxillofacial surgeon put a tool in my mouth and seemed to be ratcheting away at the implant. " You might hear a clicking," he said, Well, yes, I certainly felt it too but it wasn't painful. "That seems to be holding," he said. Thank goodness for that after all the wrenching, I thought. He then informed me that my gum had grown over the implant a bit and would need to be trimmed off. I would need local anaesthesia. Always painful, those ones through the roof of the mouth are particularly bad. 

I reminded him about my defective heart valve. Well, I would have needed to be on antibiotics before my visit but now it was too late. How was I to know? Nothing for it but to do it intravenously. My heart sank. More pain and difficulties as my veins are finely engineered. He totally failed in his attempt to put a luer in my right arm. Better try the left one next. After some anxious moments he finally got that one. It took a fair bit of time to get the antibiotic in, in small increments.

The procedure was 'mostly' painless, no stitches and an Xray was taken. Time to take out the luer. The surgeon had his nose in his computer and the nurse had immediately walked out of the room. A bit more care was needed as I had to draw the surgeon's attention to the stream of blood running from my arm, down the chair and onto the floor. Surgeon called the nurse back to clean it up and apply a bit more pressure on the puncture site. I was discharged completely and sent home but my mouth was full of blood as I drove home and my jersey was stuck to my arm from leaking blood. Hmm.

As the hours ticked by the bleeding did not stop and my mouth was full of 'raw liver' clot. I was unable to eat or drink anything. All I could do was shove tissues in my mouth and distract myself by playing bass. Dislodging the tissues meant dislodging the clots. It wouldn't stop but I thought going to bed might be a good thing. Using an old pillow and a towel I tried to sleep but the 'liver," now very thick and fibrous, kept growing, along with the bleeding. I could no long talk so I wrote a cry for help on some paper and at 2.30am the next day I knocked on my neighbour's door. We contacted healthline who recommended going to A & E at the hospital.

A & E did not seem busy yet I had to wait in acute care for hours, bleeding. Nursing staff seemed intent on their computer screens. Not much else was happening. Eventually a doctor found me. He wanted blood tests done but insisted it must be done through an intravenous line. I'd had more than enough needles by this stage but I had to comply to check my blood was clotting OK. The nurse had trouble coaxing my terrified vein but we got there. Bloods were normal. A bizarre bruise appeared on my arm, some distance away from the IV. The doctor hadn't seen that reaction before so we ignored it. 

The doctor then took a look in my mouth. "I think the bleeding is slowing down but I'm not touching that clot, too risky," he said. "This is specialist surgery and I don't know anything about it," he said. I needed to wait a few more hours for outpatients dental department to open so, complete with IV still in my arm and my box of tissues I had to walk myself down the road in the cold wind to the big orange building. Check in and wait for a space.

The dentist on roster did not want to do much with the clot either. "I think it has stopped now but I won't touch the clot except to tidy up around it so you can drink something as you'll be dehydrated after nearly 20 hours of no food or drink." Sucking through a straw proved to be a bad idea so I suggested I drink on the opposite side via cup. Never has a juice been so appreciated.

My neighbour kindly came and picked me up and drove me to the chemist where I filled a prescription for tranexamic acid in case bleeding took off again. I could eat only liquid food, such as melted ice-cream and cold tea for a couple of days and then gradually got back onto my usual diet by day 5. I let the surgeon's office know there had been a problem and looked forward to an appointment with a dentist to complete the implant process.

More on that later.

By Alexmit art - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=99733632

Credit source of photo of implant scew in situ to show what an implant looks like at initial surgery. https://burbankdentalimplants.com/shaping-and-forming-gum-around-front-teeth-dental-implants-ramsey-amin-dds-reviews/  

Not the same as my gum tidyup episode.

How to hang a tapestry

Most Kiwis have probably never seen a large tapestry, certainly not one in the style of 16th-17th France. I've seen and admired so many hanging in museums and chateaux in France. Jean-Claude had stored a hand-made tapestry, made by his mother over the span of two years, in his attic. He decided to give it to me as he knows how much I appreciate French history and culture. But, how to get it to me? He realised he should have thought to give it to me when I was organising my move back to NZ in 2017. We both knew that trying to send it in it's framed form would now be prohibitively expensive. 

The decision was made to take it off its mounting frame (not an easy task given the length of time it had been mounted by JC's DIY skills), have it cleaned and then post it to me in a standard international posting box. The tapestry had been superbly needlepointed in wool and was flawless so I was thrilled. I knew I wanted it in my bedroom. Hardly able to contain my excitement, I waited for the process of getting it to me to be completed.

I asked a neighbour with a fair amount of DIY skills to make me a stretcher frame so I could staple the frame around it and attach it onto the back. He did a nice job of smoothing the frame and we laid the tapestry out onto it but no matter how hard we tried it would not fit. It was no longer rectangular and even. Horrors, the cleaning process had deformed it.

I sought advice from a picture framer who said they could try to stretch the canvas back to being where it should be. First they would build a stretcher frame, then stretch the canvas over the 40mm thick stretcher but, of course the edges folded around would be visibly tatty. I would then have to purchase a  thick custom frame and hope my walls could withstand the massive weight. If you are rich or a museum this is what you would do. I could see a bill of $2000 looming and there would be no garantee it would be  back to right-angles. I also felt it would look too massive for my furniture and the rest of the room. Feeling dejected I left.

Determined to find a solution, I discussed my problem with a Canterbury quilt-maker. She came up with an affordable solution to protect and hang the tapestry but could she get it back in shape? Not completely, she said, as it was badly deformed.

This job was outside her normal expertise but she was willing to try to make it work. It was my last hope. Many weeks later, after misting the tapestry with water and pinning it to her dining room carpet to encurage it to shrink back into shape, reinforcing the damaged canvas edges which were now fraying, and sewing a backing material onto it through which wood slats could be threaded, I arrived to collect my completed wall tapestry.

She had done a great job with the sewing but when I got it home I discovered there was little improvement in the deformation. It was still badly skew-iff by 10 cms with a somewhat buckled surface. My tapestry was now a parallelogram and it could never be stretched in any direction as it was sewn permanently in place. A crushing disappointment that annoys me but I have had to adjust my sense of aesthetics and just appreciate that it was lovely once and still retains some sentimental value to me.

Hanging it was also a mission. Trying to hang something so large with only two of you to do it is really difficult, especially when it is visually deformed to start with. My neighbour and I were tempted to rush the hanging process and consequently it fell down. I was using heavyweight 3M command strips. Instructions say you should leave the backing strips on the wall at least an hour before reattaching the front strips. It works if you do not skimp on this. There are 4 command strips across the back wooden slat along the top edge. It has not been necessary to insert the bottom slat to make it hang flat as it will never be flat and, being sewn into posisiton, will never stretch again. 

What a learning curve:

1. Do NOT dryclean/wash a woollen tapestry. Just vacuum it and hope it cleans up.

2. Do not put any glue on when mounting on a wooden frame as it will be impossible to prevent canvas damage when removing it to post.

3. Unless you are rich, forget about framing your tapestry. Some can be hung over a rod but if it is a raw canvas with raw backing edges which are fraying you need to fold it over and hide the edges so sewing on a backing is necessary.

4. Find a seamstress who will not baulk at the task.

Having an angiogram

 When 'bad engineering' means you need to fix a heart problem it is important to know if the rest of your heart is performing well. Mine has probably never performed well due to a mitral valve that never closes properly so the blood leaks out as the chamber never closes. No wonder I got tired playing sport at school. The only strenuous exercise I could tolerate was dancing. For most of my life the leakage was mild. Then, just before I left NZ in 2010 it had climbed to mild-moderate. This year doctors informed me my condition is severe and will require a valve replacement but I could feel myself deteriorating and wanted more detailed info on what was going on. Were increasing symptoms just the failing valve?

I've always been an active person; out and about, dancing in its many forms, gardening, running around after my daughter and working full time, not always office-bound. Keeping my weight down has been a priority since I was 26, when I realised I could no longer just eat what I wanted and get away with it. I've had to endure a lot of criticism and snarky comments from people who did not approve of my careful life-style. No matter, it always seemed the right thing to do to give myself quality of life as long as possible. Yesterday I discovered I was being rewarded for my efforts.

I checked into the day clinic cath lab in the cardiology section of Christchurch Hospital bright and early for an angiogram to look at the state of my coronary arteries, was allocated a bed, signed the forms the nurse had filled out from my answers to her questions and disrobed in favour of the hospital top and bottoms. Hospital nurses had varying degrees of friendliness and thoughfulness but all made sure I was informed and all necessary attention given.

Being admitted to a hospital usually means you have to have a luer inserted into a vein for IV support. I really hate those painful things. A nurse said a young anaesthetist was passing through and could do it for me with a local anaesthetic. Great. He was fast and competent and it really helped. I'd recommend insisting on a local to help the pain of the insertion.

Just in case the doctors have a problem with accessing your wrist for the catheter you get a groin shave on the right side in case they have to insert the catheter there. Fortunately that was not necessary as the groin route is more risky. I was informed that the angiogram would be diagnostic only; in other words if problems were found requiring stents or angioplasty  they would not be performing that.

You then walk to the operating theatre and climb onto the bed. It was a very chilly room with just a sheet on top. A green plastic sheet is then popped on top of you so you can become the team's table for their instruments. A heavy 'apron' is placed on your lower half to stop radiation to that part of your body. Numerous electrodes are placed on you for the heart monitor. This is important because for an unlucky few, 'rust' (highly technical term used by my cardiologist) can get dislodged from your arteries and cause a heart attack or stroke.

Sedation is introduced via the IV and local is injected into your right wrist. That's the painful bit out of the way. Then a liquid is put in that relaxes the artery so it doesn't spasm. They then open an artery in your wrist, insert a catheter and then feed a wire through all the way up your arm , across your chest and into your heart to introduce a marker dye that is shown as a contrast seen by the Xray machine. This machine moves across your chest and effectively killed my field of vision so I couldn't see what was happening on the TV screen. They do the front two coronary arteries, then back out a bit and go around to the back one. Then everything is withdrawn from your artery and pressure is applied to stop the bleeding. They put a clear plastic sort of bracelet, a TR Band, on your wrist which has a pocket of air in it to put pressure on the incision. It stays on for about an hour or two. Gradually, at 15 minute intervals, back in the day ward, a syringe is used to remove small amounts of the air so gradually there is less pressure. 

I was given a sandwich, piece of fruit and as many cups of tea and water as I wanted, to help flush out the dye which is a bit nephrotoxic. In other words, you need to flush out the dye to help your kidneys.

My wrist and lower arm swelled up so a cold pack was popped on top. This helped. It's reuseable so I took it home for use in case of later first aid needs. Better than using a pack of frozen peas. After all the air had been taken off the bracelet was removed and the incision cleaned. A waterproof bandage remains on my wrist for 5 days as it takes time for the incisions (artery and skin) to close.

While this procedure is not pleasant, it is very useful to see if anything major needs to be done in conjunction with my valve replacement. The cardiologist informed me my arteries are great. I was a bit surprised given I have familial hyperlipidemia; an inherited condition where the body makes too much cholesterol. My mother's readings were nearly off the charts and mine are frowned on but I try to follow a somewhat mediterranean diet as a consequence of my years living in France. It has all paid off. Advice? Keep your weight down and avoid alcohol where possible, stay away from drugs and smoking. Be active.  I will continue to ignore pressure from my GP to go on statins. In my case they would pose a risk rather than any benefit. High cholesterol doesn't mean your arteries are clogged. If you need to know for sure, get an angiogram.

I had not received any written instructions before the procedure on what to do beforehand so I had not eaten or drunk anything beforehand. It appears you should take your usual medicine beforehand. They weren't keen on letting me check out when they discovered I live alone. You are supposed to have someone stay with you overnight in case arterial bleeding breaks out. Fortunately I had my procedure early in the day so I stayed a few hours in recovery and then left. You cannot drive yourself home as you are still under sedation effects so a kind neighbour provided transportation. I was told not to make any important decisions or sign any important papers that day, for the same brain-fog reason.

The wound isn't very painful if you don't use it so I tried to avoid using my right hand and arm for the rest of my first day. Sleeping is not a problem and I have managed to avoid painkillers. The day after I am still being extremely careful as the riskiest time is the first 48 hours but I'm clearly back at my laptop.  After a few days I can start to take back my usual activities such as showering and maybe bass playing though bruising will continue for a couple of weeks and I'm currently not allowed to lift, push or pull anything more than 5kg for several days. By two weeks I should be back to normal.

Here's a NZ video on the procedure. Skip the first 2 minutes as it relates to Waikato. https://www.healthnavigator.org.nz/videos/a/angiography-procedure/

The cardio team will decide when and what to do with me as I am in a grey area. Too healthy to need immediate attention but not healthy enough to leave too long. Surgery is needed but we don't know when.

Photo source https://www.southvalleyvascular.com/treatments/angiogram

Planting a tooth

 The day of my operation arrived with some impatience and some nervousness. Getting something permanent into your body gives pause for thought. What if they do it incorrectly? It takes many months to go through the tooth implant process and I remind myself that it's a bit like pregnancy; once you start down that track you just have to cope with what happens 'til the end.

Loaded to the gills with antibiotics to protect my heart from  possible infection, I lay back in the chair. I was told to rinse my mouth very slowly with an antiseptic wash. There were several gowned nurses present. A table loaded with tools was placed across me and a screen so I couldn't see what was being done but I had a fair idea.

Anaesthetic: I was given 7 injections. The ones into the roof of my mouth were quite painful. It seemed the process went on and on. There was no effort to numb anything before this process went inexorably on. By the time my bum was about to exit the chair the anaesthesia was already starting to wear off. My suggestion to those of you undertaking the  procedure would be to take heaps of paracetamol in advance.

Extraction: Since my tooth had sheered off at gum level, the rest of the tooth needed to be pulled out. With all the tools at his disposal the surgeon seemed to effect this procedure quite easily, maybe because front teeth do not have double roots.

Drilling: Boys and their toys. There seemed to be endless changing of drills - different speeds and diametres. Check out the video link below for a better idea of what they get up to. It is not distressing but you do know what they are doing and you do hear and have a sensation of your jawbone crunching into crumbs. The screw was put in using various screwdrivers. It seemed there were as many screwdrivers used as drills. At the start of the procedure the surgeon uses a transparent guide made from a previous mouth impression, to make sure he gets the location and angle right.

Bone graft: It was at this point I was in for a surprise; the doctor said there was space between the socket and the newly installed screw so he would pack that with a combination of calcified cow bone and bits of my own jawbone he had harvested. Yes, I could feel the gritty mixture being packed in. There was enough bone density in my jaw for the screw and to support the implant in future but having extra space would not have encouraged the bone cells to migrate and fuse to the screw. So, I have cow DNA in my mouth? MOO!

Suturing: I discovered the anaesthesia coverage was becoming inadequate at this stage. I could often feel the needle going in. It made my eyes water. Later on I mentioned this to the surgeon. He replied that injecting me with more anaesthetic would have stung as much as the suturing. No warm fuzzies there.

After surgery I was driven home by a good friend. The pain probably could have distracted me from my driving though I was not sedated so it was great to have someone to get me home and spend some time distracting me by jamming with music. Make sure you have plenty of paracetamol. It takes the edge off the pain for the next few days.

Ten days after surgery I still had some localised swelling and discomfort. I was very careful not to get any food in the socket area as it hurts if you do. The wound remains tender. After 15 days I had the sutures removed. In three months there is a check up to check if bone integration is a success. Osteointegration is critical, otherwise the entire process has failed.

Unfortunately for me I developed a really violent and persistent cough. It was so violent it caused a 4-hour nose bleed from both nostrils and quite a bit of blood-loss. The worst was feeling what that cough was doing to my bone graft. I could feel 'something' being ripped away inside the socket. Each time that I coughed there was instant stinging. Three and a half weeks after the implant operation I have still a lot of painful swelling around the socket. I think this is the cough trauma to the bone graft but I can get no response from the surgeon's office.We are in lockdown and the timing couldn't be worse. I copied in a dentist who rang me after a couple of days to discuss. If the area does not become infected and if inflammation does not increase and if my persistent cough calms down a bit my bone graft should gradually sort itself out. Maybe the bone cells keep trying to regrow. I hope so as it is not painless after all these weeks and it should be. 

Hygiene: You need to brush the area with a softened baby's toothbrush after 2-3 weeks. I am doing that and it seems to be a good idea for simulating blood circulation. I have also never stopped flossing on either side of the socket. I sure hope the horrendous expense and some suffering is worth the result (whenever that is).

A detailed instructional video for surgeons and curious patients like me

https://www.youtube.com/watch?v=A7FYMRExufg&t=262s

 

Dumbed down and disappointing

If you have ever wondered why NZ is plummeting in the education ranks this may enlighten you a bit. I have now completed my first semester of Ara's Certificate in Music Level 4 but I will not be continuing.  That would be throwing good money after bad. They don't know how to teach (they are musicians, not trained teachers), how to organise and how to encourage keen learners. They are very good at walking away when regular problems arise and at supporting (by abrogating responsibility) bad behaviour and lack of student commitment. It seems ingrained into their culture and curriculum. Their marketing was misleading. I am not commenting on their degree course.

Did I learn anything? Very little. Fees-free provided by the taxpayer encourages those without talent or discipline to waste time and free money for a bit and then maybe the taxpayer will pay for them to go on the unemployment benefit. The 'me, me' generation is a horror to try to work with though there must be individuals amongst it that are productive citizens. This course boasted maybe two? The other three older students (including myself) suffered, but most particularly me, because I did not have the oppportunity to learn what I went there for and I saw through the whole thing.

 Most of the students on this programme should not be in tertiary education but it keeps them off the unemployment statistics for a few months. Some will fail yet have student debt to pay back but they just don't give a damn. Some of the tutors should not be responsible for certain courses because their idea of teaching is simply babysitting, at best. Serious content is just not there. I believe students who pass completed courses should be reimbursed by the government rather than throwing money away on the useless ones up front. That is simply an investment in failure and mediocrity. How about rewarding Kiwis who make a decent effort after they have proven their worth?

I was determined to finish the first semester but felt I should report my disappointment and despair somehow so I approached student services and student advocacy. Both, after reading my almost 6 page analysis, commented I should expect a refund.  I was eventually invited to an interview with management to discuss my concerns. They understood each point and wrote copious notes but at the end I was hearing corporate-speak and knew my cause was lost. I was the only one on the programme with sufficient relevant qualifications and experience to have realised what was going on there and to articulate it. 

They have refused to reimburse me despite a list of problems the length of your arm, which they acknowledge and say they will action (cue Tui Ad). On moral grounds they most definitely should have given me at least some money back but they have hidden behind a convenient condition which says reimbursements will only be given for students who withdraw within 2 weeks of starting a programme. No justice there.

As I did when I studied for my degree in communications and PR at MIT, I wanted to see how good I could be at each course in the programme. With the exception of one (theory) I was not given the chance. One course lacked content of any value. It was simply time-filling.  Another course, Performance, never delivered even the basics for me to learn band musicianship. They knew it too. They also told me that realistically nothing would improve for the rest of the year. I was told by two tutors that if I wasn't getting any satisfaction I should go elsewhere. Alas, there isn't anywhere better.

I didn't have a functioning band to learn from or to perform in for the first term and that situation continued into the second with a different mix of students of the 'me' generation. They couldn't be bothered making their studies a priority and their families didn't support them to have the right behaviour. Not only did they let themselves down but they ruined MY learning experience which I had paid for myself. There was absolutely no team commitment and they always got away with it.

The other band members often did not turn up for weeks or were very late, unprepared, wasting time on cellphones or teaching others in the group chords they should already know. Vocalists didn’t know the songs even when they actually chose them. I sat there with nothing to do while guitarists tried to borrow cables from tutors or restring guitars or try to work out how to tune their instruments. Heh??? They knew they are supposed to turn up in tune, warmed up and knowing the songs. This never happened. Each time there was band practice I turned up tuned and ready to go after at least 2-3 hours practice beforehand to warm up. I really don't think starting at 10am is too early for students to get up and be on time.

A very belated pep talk by the course coordinator had zero positive effect because there are no consequences for bad behaviour. Most of the time the tutors aren’t there to take the rolls near the start of practice, if at all. They were aware of my predicament.  Tutors told me that some years’ intakes are good or less good and that this year is bad. Why should that determine my learning experience? I pay the money and I don’t get fees-free, my application for a scholarship was declined and I don’t know why. Where was the value of this course? There was only one functioning band on the entire course. Unfortunately it wasn't mine and I wonder what I might have achieved if it had been. I seem to have passed all my courses but that's down to my own determinated efforts, no thanks to Ara.

I am happy to say that the music theory course is excellent. The tutor is kind, caring and uses good pedagogy. If you want extra help he gives it. There is plenty of good teaching in each lesson and he tries to make it fun which simply highlights the gulf between him and the other teachers/courses. In his course I exceeded the competencies I had when I was 15 and 'hummin.'

This blog could detail all the ways Ara disadvantages good students (5 pages worth) but it would get too lengthy and depressing. I feel utterly let down and at rather a loose end now with no structure to my days and limited opportunities to play in public. I have decided to take some private bass lessons with a reputable teacher who instinctively understands how to actually teach me bass. So refreshing, so I will do that until my limited money runs out. I'm getting out and about to open mics to meet musicians and support those folks who support my dreams. Currently I am hoping a rock band might invite me to join them on a regular basis in the near future. I'm willing to put the work in for them and am putting this sorry episode and disappointment behind me. I remain determined to succeed.

Toofee or not toofee

 It happened while I was eating a ham sandwich at a friend's house. Something was very, very wrong. Here was the stuff of nightmares. My mouth had changed irrevocably; my tongue was poking out from between my front teeth. A front tooth had sheared off.  I managed to retrieve the remnant before I swallowed it but the horror was so strong. It meant a permanent change and major financial issues. That tooth had a history of dental cockups.

When I was 18 years old I developed a carie and it was filled but the dentist did something which encouraged a rampant infection which then resulted in root canal and a dead tooth. I was laid up in bed for a week with severe bruising, unable to see over my cheeks or eat other than through a straw.

Over the years, the inside of the tooth progressively blackened. When living in Wellington, years later, I had a crown put on but the dentist worried about my bite and made the tooth stick out like a rabbit. Hideous. I tried to avoid smiling from there on in, I felt so embarassed. In 2001 I had the tooth recrowned and this time it was aligned with the rest of my front teeth in time for my second marriage. Still, the peg inside was darker and slightly visible.

When I hooked up with JC in France in 2011 he considered

the NZ dental work I had had done to be substandard. Utterly unacceptable in France. Heavily filled back teeth from the 'dental nurse' era means teeth are disintegrating and we all know there are major problems for we elder folks in terms of the unaffordability of dental healthcare in this country. I was about to get a personal lesson in that.

It being Waitangi weekend it was really difficult to find an emergency dentist. After many dead ends I found one in Hornby, Goodbye to $1050. Simple Xrays were taken, an impression made and I was required to make a major decision on the spot. To have a permanent plate and all the awkwardness and inconvenience that entailed or to have a temporary one that could only look OK as a smile-saver. I instantly had to consider the long-term options.

The options: Live the rest of my life with a hideous gap in the front of my mouth. Not an option as it makes me look like the wicked witch of the west and I am trying to become an entertainer (again). I also have trouble eating.

Have a permanent partial plate which might not be all that great when eating and would need a fair bit of looking after and which might necessitate deliberately damaging the teeth on each side to get it to fit and function.

Or I could get a dental implant which would ultimately behave like a normal tooth. It would look normal and I could eat normally and it would never have a gap. Downside is horrendous cost. Just how horrendous could it be? I sought quotes but those don't exactly exist. At best you get an estimate because the process is shared between a maxillofacial surgeon and a dentist. One said $6000 for an implant, another one said $8000. I had already done a bit of research, looking for a satisfactory permanent solution. 

I sent the Xrays off to JC and asked his opinion on the best solution. We both felt that an implant was the only reasonable solution but the cost was way beyond my resources. JC offered to pay the cheapest estimate, bless him, though I told him he is no longer responsible for me. His generosity relieved a bit of the stress but the consultation with the surgeon since then has added more stress as he informed me I'd need to pay at least $1000 more than the dentist had told me. I am not sure how I will find that.

The implant process itself takes months but the wait to be seen by a surgeon for an initial consultation takes months too. I had to wait four months. I am now booked in for the procedure to remove the broken peg and root  and to insert a screw into my upper jawbone. That is then left to heal and fuse together, an abutment put on, and then a prosthetic tooth is created to fit over the abutment. I understand this is relatively simple but the cost for one tooth is massive. Once it is done it should last me the rest of my life, which is probably more than can be said for my other front teeth. Good teeth are essential to our health. Removing teeth can result in loss of bone in the jaw, digestive and heart problems.

I hate the plate. It took me a week to stop gagging with it in my mouth although the gagging relex returns at times. It takes up a lot of space in my mouth, pushes my tongue where it shouldn't be and makes trying to sing troublesome so I am not currently singing. Any time I want to eat something I have to take it out as it is not functional, other than for aesthetics. Eating apples or anything hard is impossible with it and almost impossible without it. Yuck, where to discretely stick it? I also have to warn anyone around me of what I am doing and to expect Witchypoo to appear over mealtimes. My other teeth don't like the pressure on them and I am scared of losing such an expensive appliance.

I have opted for local anaesthesia as this is cheapest so I guess I will know all about the extraction and hole-drilling. I'm told I can drive straight after the operation and that pain can be managed for the first few days. Hmmm, I hope so.

This process takes many months so I am hoping I might have a proper tooth by Christmas.

The consultation with the surgeon takes the form of lots of waiting, high-tech xrays which are effectively 3-D modelling, information on current medications, checking bone quantity and density, preferences for anaesthesia and confirmation that I am happy to proceed, signing a consent form.I was told my oral hygiene is satisfactory and so are my gums. I reflected that I have not had a professional clean since 2008. This should be done before the operation to help protect my heart from subsequent infections.

I see a lot of dental decay in my age group, with a lot of teeth missing so I am grateful I can get this solution started.

Term one complete but...

 The first term drew to a close with exam week. It proved to be highly stressful despite all the work I had put in.

For starters, I failed my bass exam. Having been self-taught with only 5 lessons at Ara and playing for only a few months I was still expected to do the following: play all two-octave major scales, all major and minor triads, all minor two-octave pentatonic scales, know every note possible and locate it on my fretboard, compose a groove with fill to a given chord progression on the spot. Big ask, and I knew I was not ready to do all that with confidence. It doesn't help when the tutor makes a video using a 5-string bass whereas I only know a 4-string one, and the instructions were too fast. I find at Ara there is a fair bit of telling and very little teaching.  I know I am capable of doing what tutors want but I must learn at their pace and not mine. I can understand they have various standards but I need time and regularity. The old grey matter isn't as sticky as it used to be, therefore, the only way to survive is to work my butt off.

I sent out a cry for help to the only other bassist on my course. He's a professional with 30 years experience and kindly took the time to explain and repeat and draw patterns I could actually understand. In fact - teaching. Then it was up to me to go away and practise even harder over the next day for my resit. Failing my bass exam had been taumatising as you can get thrown out of the course. I asked if I could switch to singing? No.

Thursday morning was our theory exam. I ended up with an A+ which might offset reduced marks when I eventually passed my bass resit, which followed the theory exam. These two exams were followed by the group performance exam. I had no reason to be confident since Ara had never given me a functioning band to work with. With only the lead guitarist and two vocalists left we had to have loan players on the day. Never an opportunity to practise with them, unused to how they sounded, it was nerve-wracking. Under the changing light patterns in the concert room I mistook which fret I was starting on. I started Dreams on E instead of D so the band had to stop and start again. I felt crushed but made a reasonable fist of the five songs. They must be performed standing up and with no music ie memorised.

The next day we had to do oral and visual presentations on ourselves as musicians. We had been told to use certain sites or software to complete the assignment but as with any kind of digital platform we were told to do it but there is little teaching involved. We are expected to teach ourselves in our own time. Not a naturally gifted computer guru, I get very stressed by this. The less able students are certainly struggling because self-discipline and work is required and they are falling by the wayside, despite a lot of hand-holding in certain cases. Even when some areas are less difficult for me I always push myself to the limit to squeeze every possible mark out because I want to find out just what I am capable of and I might need a few extra marks further down the track.

On the whole, with two 'unknowns' in the mix, I am doing all right. Some superhuman cramming finally got me a pass in bass so to reward myself I have bought a better instrument. I started teaching myself bass with a cheap little precision bass made in China. It has reasonable tone but the action is difficult to play and noone will take me seriously as a dedicated musician if I continue to appear with my cheapie. My cheapie broke down recently. It was easily fixed by the sound tutor but I realised I needed a second instrument.

Having auditioned numerous basses over the course of two weeks and not finding anything decent on internet second-hand sites, I decided to invest in a new professional instrument. It's lovely but weighs a tonne. Its only downside is the weight but that's the sort of instrument professionals use and the weight is probably pretty standard. My shoulders are not happy about this but I'm hoping with time the pain will diminish and I'll develop more stamina. Don't they say what doesn't kill you makes your stronger?

Let me present to you my new best friend: a Fender American Pro II Jazz bass. Glorious neck finish for smoothe slides, perfect action, tapered neck for those of us with smaller hands, warm tone with more tone controls. Not as 'punchy' as my P-bass but should suit any situation. It's beautifully made from California. My mission is now to justify such a purchase by progressing as fast and far as I can before the end of this year.