Orthodontic work after moderate stroke.

[crooked rory]

I have had my braces since September 2011, and I had a moderate ischemic stroke (NHISS 10) in August 2012. I was in neuro-intensive care unit for 2.5 weeks, and an additional 1.5 weeks in a rehabilitation facility. God bless Helen Hayes Hospital. I doubt I would have been able to work without them. I <3 them for what they did for. My orthodontist has been supportive of my issues, and he has been advancing my treatment since getting out of the hospital in early September 2012. My last normal appointment was late February 2013. I was scheduled for elestics for my Class III malocclusion. I had a TIA on 2/28/2013. I got out the next day, and went to my ortho the next week. Dr B sent me back home and he wanted to consult with other orthodontists to go through my case. I got an appointment for yesterday, 4/8/2013. He changed my ligs, but is not trying to move anything. He gave me a note to give my neurologist to find out whether I can proceed with elastics. I am meeting the neuro doc on 4/12/13, so I hope they can move with my orthodontic work. I asked Dr. B if he had dealt with young stroke victims (or any stroke victim). He said he's not run into the issue before. I guess most of his patients are kids, where strokes are very rare. Granted a healthy 30 years old guy with no recreational drug use are also very rare. I was so pissed when the E.R. doc was talking about drug testing while I had no way of communication of that. He helped me though, but I did not realize it until later. I couldn't even say "mom" for 4 days. Needless to say the 10 panel drug test was all negative. The last I would have failed was 15 years ago.

I hope never to meet someone who had a stroke, especially when going orthodontic treatment. Hopefully nobody has to what I went though, but maybe someone maybe be helped.

[plugnickel69]

Rory, you seem to be doing quite a bit better. We're all pulling for you.

[amyhenna]

Do you have ever neurological symptoms like burning throat, ear pain, headaches, numb fingertips, or other? Did the stroke come out of nowhere? I'm glad someone was hestitant about the elastics. I get neurological symptoms from things like latex. Big time.

[amyhenna]

You're awesome for getting through all that/ this, by the way. Good job! The hospital did some of the work, but you definitely did the rest.

[isthistaken]

I would have been mad about overhearing those assumptions, as well. They always treat everyone that way in ER.

[crooked rory]

Do you have ever neurological symptoms like burning throat, ear pain, headaches, numb fingertips, or other? Did the stroke come out of nowhere? I'm glad someone was hestitant about the elastics. I get neurological symptoms from things like latex. Big time.

The stroke came fast, and kept shrugging the tiredness as it is normal thing for me if I get dehydrated. Lithium works well, but you have to watch out for that dehydration symptoms... I have been the best shape I have been for years, so having a stroke never occured to me. I did not realize the severity of it when I was spilling more soda on myself than drinking it. I callled my mom and she heard me and said to hang up and call 911. I have had headaches going since at least 2007, 4 years before the orthodontic work. Usually on my left side but changed when the stroked happened, though my headaches are now nearly exclusively on my right. I had burning in my throat, but that happened because of aspiration pneumonia (I vomited and inhaled it while under anesthesia). Only neurological issues were shaky hands which go way back.

I am more concerned that the elastics will aggravating my already frequent headaches than anything. My orthodontist will not go ahead until my neurologist is ok with it.

[crooked rory]

I'm back.
Its a been a while, and did major work on the computer.
I went to my neurologist a few weeks ago, and when I gave the letter from my orthodontist he seemed to be holding in laughter. He may be a brilliant neurologist, but he is very arrogant, and with a God complex. He wrote a note back saying that there is no need to postpone or modification of my orthodontic treatment plan I can't blame Dr. B as he never had to deal with a stroke survivor having orthodontic procedures. I was just surprised he did not raise the issue in September... I am very happy as I have effectively lost 3 months of my treatment and I want get back to normal I am going to Dr. B for my next adjustment and will likely put elastics. Sounds painful, but it needs to be done sooner or later.

[Ciara]

I'm back.
Its a been a while, and did major work on the computer.
I went to my neurologist a few weeks ago, and when I gave the letter from my orthodontist he seemed to be holding in laughter. He may be a brilliant neurologist, but he is very arrogant, and with a God complex. He wrote a note back saying that there is no need to postpone or modification of my orthodontic treatment plan I can't blame Dr. B as he never had to deal with a stroke survivor having orthodontic procedures. I was just surprised he did not raise the issue in September... I am very happy as I have effectively lost 3 months of my treatment and I want get back to normal I am going to Dr. B for my next adjustment and will likely put elastics. Sounds painful, but it needs to be done sooner or later.

Glad to hear you will soon be making progress again.

[crooked rory]

I got my braces adjusted after getting neurological clearance. I attached photos showing my progress showing rubber bands from upper first molars to lower canines (well, right premolar as the canine had to be removed). This is for class III malocclusion to avoid jaw surgery. It worries that I might need surgery as it is so close to my carotoid and I am a moderate/seriously bleeding risk. Plus I have a distrust of anesthesiologists.

I am going to brush in a few minutes and see if I can cant get the new rubber bands back on. I have very shaky hands, especially at night. My hands have always been shaky, but they have gotten worse recently.

New pics today

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[djspeece]

Glad to hear you are doing so well. I've worked with many neurologists over the years and while most are wonderful human beings, there are a few that I'd like to drop-kick through the goal posts of life. I think your ortho did the right thing with the consultation, and when I first read your post I thought "Well how in the world would braces impact a stroke?" (I am an RN) but then thought, "Well you never know, better safe than sorry" especially if there are any other medical issues. Best of luck to you.

[isthistaken]

Ditto on neurologists. Some MDs share the opinion. One told me "they think everything is a syndrome." Besides that, the one I've dealt with was an absolute posterior.

[BracedSurgeryStudent]

Hey I'm soooo glad you're orthodontist was really cool about everything and supportive. I had a pretty awesome ortho myself esp when I had like 6 kidney surgeries in the time I was in braces with her, and a lot of the time I was in a lot of pain, and I even went to her office completely out of it from the pain medicine unaware of my surroundings. So sorry you had to deal with the strokes, I hope you're better now

[BracedSurgeryStudent]

Random Fact, I'm a medical student going to school to be a trauma surgeon.

[crooked rory]

Well, my next issue will be fun... I have not seen my general dentist for about a year. She was concerned that being on 325mg asprin would excess bleeding. That was in October when I was on 325mg after a cardiac catheterization and she wanted to postpone the appointment when I was off it. I am back on baby asprin now. I did go to my periodontist in Jan, and got x-rays and cleaned them, so it is not an urgent issue. But when I had the TIA, I now have to take an anticoagulant in addition to baby asprin. Now I bleed a lot, as I found when I had to use a regular razor when my electric shaver broke. 25 minutes to clot a little nic under my nose. I like my dentist, but it is just her. I am concerned that if I bleed, could she stop while bleeding while calling help.

[Kipepeo]

She doesn't have an assistant? Who holds the suction stick?

The face bleeds a lot anyway. The mouth does not. I wonder if a nick in your mouth would bleed as much as the one under your nose. It's a valid concern. There should at least be an assistant there.