Wednesday, October 27, 2010

Obdurator, oh would you help me place this call?


(Sorry. The only other song-pun I could come up with would've been "OburATOR obdurATOR OB dur ATOR obdurATOR obdurATOR OB dur ATOR" to the tune of "Amadeus", and that one's already gotten me threatened.)

Obdurator Numero Dos went into my mouth and, eek, the back of my throat today. The process of molding these little dudes and fitting them is fascinating because I do not understand it at all, but it seems to work. Next time, I promise, I'll get into posturing and why it's bad for a brain.

So: Obdurator. The primary job of this thing, which looks like the mother of all retainer tops and is held in place by four tooth-wires, is to keep the wearer (me) from shooting liquids and solids out of her nose, and to keep her from choking. It also makes speech much more intelligible.


The first obdurator covered only my hard palate. That meant in practical terms that I could sip small amounts of liquid and eat very soft or very hard food--nothing in between--and that my friends could understand about 90% of what I said. All in all, it wasn't a bad deal, aside from the fact that it couldn't be removed for the first week (Dr. Crane had to tie it to my teeth with some suture, long story) and thus it got to be The Single Nastiest Thing I Have EVER Seen. I'll spare you that story.

This second obdurator is really *cool*. Not only does it cover the part of my hard palate that it did before, it takes care of the soft palate that isn't there any longer as well. Parts of it are hard, parts of it are flexible, and parts of it are strangely in-between. To give you some idea of what this thing is doing, look at the picture above.

See the pointer that's labelled "Hard Palate"? Take everything from the tip of that pointer to your left/illustration's right away. Take it off, throw it out, and leave a fucking huge hole there instead. I searched Google Images for some time, and even logged in to the various med portals I can get to through work, and I can't find anything even remotely comparable. I'm missing not only that much palate, but that much of the back of my throat as well.

You can see/imagine that the loss of that much soft palate is a big deal. Not only does your soft palate keep you from sounding like a Charlie Brown cartoon adult when you speak, but it moves around to shut off your airway when you swallow, it flexes to help you swallow more easily, it bounces up and down with certain consonant sounds...it does a lot. It's immensely flexible and muscular and can move about eight different ways without your even realizing it.

The prosthetic guy made three molds of my soft palate and the back of my throat. The first was with a hard-setting, awful-tasting acrylic, and focused on the center back of my throat and the palatal portion of my nasal airway. The second was made of this slightly squishy, foamy sort of stuff, and goes from the spot where my right second molar used to be to just to the right of midline of my palate. The third is I guess kind of flexible a little; I can't dent it with a fingernail, but it doesn't feel as rigid as the acrylic, and bridges those other two bits.

Unfortunately, this one only kind-of-sort-of works at the moment. The primary problem is that I've only got a week's worth of healing done on the soft stuff in the back of my throat, so swallowing feels like I've got strep. The other problem is that somehow, the rigid part of the prosthesis, the middle bit, shuts off my nasal airway unless I hold my head in one specific position. I won't be sleeping in this obdurator, so that doesn't much matter, but it is a little freaky. Plus, I hate breathing through my mouth.

But think of it: one week ago, a surgeon took out most of the back of my mouth and enough of the back of my throat that I am a freakshow. Today, I can speak intelligibly, sounding only as though I have a bad head cold. The prosthetics dude says I will sound completely normal--not hypernasal, not like a muted trumpet--in just a couple more weeks.

A. Mazing.

When I start my second, after-nursing career, I think it might have to have something to do with dental prosthetics. It's unbelievable the difference an hour and a half in the chair did for me today.

I sound like myself again. My voice is back.

22 comments:

messymimi said...

You never know how much you miss being able to communicate clearly until you are in a foreign country and can't get your point across, or lose your voice.

I'm glad you have it back.

Silliyak said...

You're amazing.

Celeste said...

I'm so happy for your amazing progress, and I'm overjoyed that you can speak again. It's every bad thing not to be able to make yourself understood.

Anonymous said...

This is absolutely fascinating. Thank you for explaining what has been going on. And what incredible progress.
Anne

Anonymous said...

I have a question for you, something I've been wondering about since your first post-surgery post. You wrote that you remembered everything. The last time I had surgery I was given Versed and told only that it would "relax" me. After the surgery I was freaked that I didn't remember what I usually do after surgeries - going into the operating room, getting on the table, talking to the doctors and nurses, recovery room.

Did you refuse any meds that cause amnesia, or did the anesthesiologist just not give you any?

Bonnie said...

Do you realize you can sing 'obdurator' to just about any Beach Boys song? Just a fun fact.

Elaine said...

Major progress! Yeah! Very happy for you.

Earl said...

How did the prosthetic guy work in the back of your throat, without you throwing up?

Thanks for the education. Very interesting.

Scrub Ninja said...

That is both coolmazing and awesometacular.

'Drea said...

Just a reminder of how amazing the human body and is and, of course, technology is pretty amazing too.

In addition, I agree with Silliyak...

girlvet said...

Wow I cannot believe what you have gone through in this short period of time. Hang in there.

Penny said...

Tears of gratitude on this end!!!!!

Penny said...

And P.S. regarding the back of Jo's throat: I could see up into her sinuses, and in the right back of her throat, instead of soft palate it looks like a bomb went off and left a good sized crater. As a wannabe medical goon, I blurted out several wondering statements that all started with F-bombs upon seeing this. It really is the most freaking amazing thing I've ever seen. The CAN-SUHHHHHHH is gone, she's up and walking around and the whole thing is a straight-from-God MIRACLE. Seriously. It's THAT amazing and I am THAT thankful.

me said...

Thanks for all the info ~ the science geek part of me loves all of it ~

The more human side of me says ~ you are all kinds of awesome ~~~

AM said...

So - is your uvula gone? I just can't figure out what a soft palate is. Google images is basically worthless on this subject. When you're feeling up to it, could you discuss in more detail?

Jo said...

Answers for Anon, Earl, and AM:

Anon, I didn't specify anything in terms of anesthesia, and I don't know what they used. Versed's used a lot in what we call "conscious sedation", which might be why you didn't remember anything--Versed is great for that. If you use a lot of it, poof! No memory!

Earl: Beats me why I didn't barf in the doctor's lap. I've never had that strong a gag response in the first place, but you think I'd've at least had a nasty moment or two. Maybe I'm just getting used to hands in my mouth.

AM: Yes, they did take my uvula. The easiest way to find your soft palate, by the way, is to take the tip of your tongue and put it against the back of your top front teeth. Slide your tongue back along the roof of your mouth until you can feel the roof go from hard and ridgy to soft and smooth. That soft and smooth part is your soft palate, and it extends all the way back.

Heidi said...

"He's a smooooooooooth obdurator...."

Sorry, just trying to help you think of songs.

Cr0w$c@lling said...

Glad the talking is back. Sxks that you still have a sore throat. Miss u @ Sunndydale.

Anonymous said...

Wow! Thanks for the update. Hooray for progress:)

Elsie said...

Thank you for blogging about your fascinating experiences! On the one hand, I feel all squeamish about the idea of losing the protection of the soft palate and all that ensues but on the other hand, I feel all wondrous at what modern medicine can do to fix stuff up right. Thanks again for sharing! I'm so glad you sound like you again. Yay!!!!!

Melissa RN said...

So I've been lurking on your blog for years. YEARS.

And I've been lurking while rooting for you for awhile.

So I just wanted to de-lurk for a moment to say best wishes and I'm glad to hear that, so far, things are going well.

If I get cancer, I hope I'm as brave and witty as you are.

Urbie said...

Obdurator? Information! Get me Jesus on the line! :-D

http://www.youtube.com/watch?v=FGj7R68W5uA