Hey all welcome to my 5 to 10 yr cleft site. If you want to see my 0-5 years click here http://www.pbase.com/stella97king/cleft_lip

As you can see I still have a long road ahead of me as far as dental work is concerned.

My scar lip revison done back in August is healing nicely too! A little pure coccoa butter, rubbed twice a day heals up real nice.

After all the insurance claims were paid..I believe my lip revision cost just over 12,000 or so clams!!

The "alveolus" is the bony part of the gumline, the placement of bone to this area is referred to as "alveolar cleft bone grafting" (ACBG).

I'm here this morning for my yearly check-up with my Craniofacial Team. When you have a team meeting like this be prepared for at least a two hour process.

First thing is the weight check....hmm..should eat some more rice.....

"Now Stella stop standing on your tippy toes"

They also measure the cranial.....

Dr. Patel....he the big cheese or director of the Craniofacial Center...Chris is an intern in training..for the next generation of fine doctors..I'll be there soon too...

Msssssssssssss....Weinstein....say "Spider"...."Ssssssssssssssssnake"....
BUSTED..looks like I need to take some extra
ssssssssssspeech classes in the first grade....

Well here is some good news,
Ear fine,Nose fine,Throat fine.
Done with him for now...hurray!!

Helene helps with my personal needs, family issues,
schooling, emotional needs, good to have when you
need a shoulder to cry on sometimes.

Dr. Nini...lets just say he is the special doctor!
He gave me my smile back!

Well.."looks like we will wait a while on the bone grafting for now"...

Dr. Kaminker if you remember is the one that installed the Latham.He also says I will have to wait a little while longer for the next big operation...

Well your ears look great!! Nice clear ear canals....

Wells seems your hearing is quite good....

The final doctor of the day!! This is my Orthodontist,
and the final verdict....envelope please!
Hurray! Wont see him for another two years!

My where has the time gone? I just lost one tooth and the tooth fairy hooked me up! But I never expected this to happen now!

Just like a shark! One tooth falls out the replacement moves up to take its place.

I didnt forget about you guys! No new updates other then a good paint job will hide my scar..lol. I will have another update in August when I go back and see the Craniofacial team. Stay cool!!

Let me put my glasses on and take a look here.

You have been doing a good job Stella brushing your teeth.

But it appears we have an unwanted guest up here hiding.

Where your cleft fault line is so to say...look at the arrows...you have a horizontal tooth growing!! This could become a problem very quickly since it will likely collide with your vertical tooth right next to it. I suggest you get a full frontal xray and have your pediatrician dentist make a plan of action to remove this.

I found this on the internet and modified it so you can see what it would look like on a X-ray.

I know this is an extreme example, but as you see the top teeth growing in a horizontal position.

Kamila found me on the internet. She needed to paint some forensic medical paintings for college credits in the UK. Once she was done with them she sent them to me.

This X-Ray finally reveals my anomaly of a tooth growing sideways with the red arrow. They will have to pull it at a future date. The green arrow is the tooth with no bone around it and they will pull next month.The X-ray is over a 100.00 make sure you dentist is in network..and your insurance pays for this type of x-ray for a dental visit. If not have them do it at the hospital and bill as a doctor visit.

This tooth will be pulled since it has no bone mass around it and to make way for the tooth behind it which is in the same situation. That one will also be pulled once I have my operation to put a piece of bone in my palate and so they can eventully be able to drill a post for a future tooth implant. Maybe next year for that dreaded procedure.

Today I'm getting snaggletooth taken out!! The doc said he will rub a little gel to make my gum numb, and a little laughing gas all should be fine.

Well that there looks like a shot...no mention of that before..gee thats a long needle.

I was worried he didnt listen to me when I told him I was numb already...

Where did that come from? Feels like hot water going into my gums....ah...I cant stay still....

How much more do I need? My jaw is getting tired...I feel light headed..o..must be the gas...

Ok Stella, now we will pack your mouth with gauze. You ever hear the term cottonmouth? No I'm not talking about a snake....

Ok..Hmm..which way is the best way to get your Snaggletooth?

Ok..now I got ahold of it..you will feel some pressure on your tooth....

So I got a good grip on it Stella...

Ok..here we go..I'm going to count 1,2,3 and then yank it....ok Stella?

Sorry Stella I was never good at counting past two....now just bite down on this and it will stop the bleeding...

Well thats how you pull a tooth. Papa still wanted to wrap some string around it and tie to a door handle and slam the door..I like this way better I get a balloon!

My tooth, you can see from the back of it that poor brushing habits made it start to rot.

Here you see two weeks after the extraction, all healed up.

Tomorrow I have a consultation with Dr. Kaminker who specializes in Maxillofacial Surgery. He will show me what my next surgery will be about. Something about harvesting bone from me and putting in the roof of my mouth.

All I know is that this surgery will take place right when school gets out. So I have recovery time during the summer. Once the bone starts to grow in, then come the next phase of pulling these teeth and getting implants with braces....

I was very happy to see Dr.Kaminker. I know now my journey will be coming to an end soon. He will now fix my teeth so I look like any other child.

He is checking what baby teeth I have left and when my grown up teeth are coming in which is now. This means we will have to do this bone graft now.

The only down side with this is that Dr. Kaminker is "Out of Network" so when dealing with dental insurance, as you know can and will be costly. But he knows my daughters history and was the first surgeon to work on her at 6 months. I would trust no other to do the next step in her complete restoration.

This is a must now...just like when digging in your yard you have to get it scanned so you dont hit any pipes. http://www.vatechamerica.com/media-center/videos.php?vid=2

I was worried my dental insurance would not cover the 220.00 cost of the scan. But you really need this if you want the doctor not to run into any complcations when he starts the surgery. We found another tooth the standard x-rays did not pick up.

Once the scan starts it plays music and when the music stops you know its done. It then transfers the images to the software program.

The best part is the Doctor can burn this to a CD and then you take it to the Orthodontist. Then he and Dr.Kaminker can determine a course of action and what teeth need to get pulled and which ones can be shifted.

This is a 3d rendering of my teeth. in the next slide you will see the plan of action to give me my smile back.

The teeth with the X's will be taken out. Then I will be given special braces to shift the tooth with the right arrow to the right to make room for the other one with the down arrow grow in place. The black spot where the teeth are extracted will be replaced with bone harvested from my hip bone.

This is a quick shot of what I should look like once the braces are removed. The brown coloring is where my new bone will grow.

This Stella's father it has take me 3 years to update the info on this last surgery.

I apologize that it has taken me so long to update.

Health Insurance companies are ruthless self serving and liars!

Stella was so Happy to finally see the light at the end of the tunnel.

I spent three months getting all "Gap Requests" from #nited Health Insurance to cover the cost of this surgery.

I found on a cleft palate site that Health Insurance companies even pay for her TOP braces!

What you have to do is request from the Health Insurance company is the certificate of insurance.

Dr Kaminker laughed at me when I told him the insurance company will pay the bill.

I had all my Ref#'s...Gap requests..all confirmed and on paper! What was so funny?

Boy there is sure alot of people her all going to take care of my daughter.

Someone is not a happy camper.

The morning of Stella had a temp of 101. I dosed her with liquid aspirin and prayed her temp dropped in time.

I did not want to have to reschedule the surgery. That would mean she would have to miss school and deal with the bullies that made fun of her looks.

She has to be able to drink, swallow and use the bathroom before they let her leave.

Even after three years I still remember what she told me. But she got even ten minutes after this picture by peeing on my foot.

When they cut the roof of her mouth open they found an errant tooth growing sideways.

They had to remove the tooth. Then they took the bone graft from the hip and placed in the roof of her mouth and stitched it back up.

Eight hours ofter surgery I was ready to go. The nurse came in and took a temp. Stella was at 102 and would not release her till the next morning. I was not prepared for that and did not bring my tooth brush. Was going to be a long night sleeping in a chair.

You see the light gray area on the X-Ray? That is where the bone graft would be. The point is the bone will then grow and give the roof structure.

Fever went down and she was released in the morning. We got home and she had to rinse with antibiotic mouthwash.

She also was on anti-swelling meds. Her pain factor was on the 8 side. She said her hip hurt more then the mouth.

I had asked her. She was mad I did this to her.

I explained to her that this was her mothers last wish on Earth. That I would fix her and make her look like all the other girls in the world.

She didn't buy it...I told her one day she will appreciate all we have done for her.

You have to keep the lips coated with Vaseline.

Her step mother was now her new best friend.

Just a little bit more. Don't even bother to wipe of the dried blood.

Get an Ice Pack but put in a sock so its not that cold to the skin.

I told her to tell her friends that Manny Pacquiao went 8 rounds with her.

I want to go back to Theater Camp! I called the doctor up and he said sure. But no swimming for two weeks.

The anti swelling meds really worked good.

As you can see on the left by the tooth are the stitches where the bone graft went.

The stitch on the lip is where they took some of the fatty tissue out so the lip would not look as puffy and be more uniformed.

Its important for her to keep using the mouthwash. She had alot of oozing coming from her roof. At this point she still is on a liquid diet/soft diet. Protein shakes and the like.

I was still baffled why the hip bone removal would be more painful the the cutting of her mouth open.

So yesterday afternoon he decided to have an Appendicitis, Dad Goggled his symptoms and off to the hospital he went. So now we both have scars, and two parents without alot of sleep.

Doc removed my stitches, and check everything out.

My dad asked him why he thought it was funny when I told him the Insurance would pay for everything. The doc said they always do that, then you get the claims and there all denied. Sure enough dad got home he had a stack of denials waiting for him.

Even though I had all approved services and in writing by the insurance company, they still denied both Surgeons claims for services and the braces she would need to stabilize the teeth to keep from shifting. I was looking at over $19,385.00 out of pocket for the doctors and another $1600.00 for the braces.

My friend worked for #nited as an analyst.He confided that all birth-defect related claims initially get rejected the first, second and even third times. They expect you to give up fighting it. Bad for them, I had every name, REF#, GAP Request and approval letters to back my fight. It eventuality went all the way up to corp and they relented. Why? Because in the Certificate Of Insurance they had Cleft Palate conditions buried in there accidental clauses.

With my insurance battle I could not wait for them to pay for Stella's braces to stabilize her teeth. I had to pay upfront to get this started. Funny thing is the Plastic Surgeon wrote off the seven grand fee and just kept my 2500.00 deposit. When I walked in with #niteds check they told me I was the first to win that battle they knew of.

I needed an expander to make room for my adult teeth that were coming down. You get a key to turn it once a day. Copy the link below for detailed instructions on how to perform this. Once to the desired size the expander will stay in mouth until the stabilizer braces are removed.

www.youtube.com/watch?v=ifzSh56yscA

I was concerned by using this expander it will open her palate back up where the bone graft is. I will have to go back to the oral surgeon to have him check it.

I was right that the expander might open up the palate. But the surgeon said there would have to be another procedure to close it again. The important thing was to make room for the additional teeth that were coming down now and to stabilize the front teeth.

While my father was speaking with the surgeon, he handed him the check for his fee from #nited. My dad had the last laugh that day, the surgeon could not believe they actually paid the claim in full.

Today I get my braces and I get to pick what color I want.

Had them now for six months.I couldn't decide on any one color. Dr Galkin says it will be a long road ahead now. Maybe up to four years of metal in my mouth, and another ten with a retainer.

Dad says when I am an adult the final surgery will be a nose job. They will try and fix the left side of my nostril by cutting and bringing it down to make even with the right side.

Now we get the real braces. The stabilizing braces are removed with the expander and the real upper and lower will be installed.

The goal here is to shift some teeth around. Stella still has a couple of baby teeth that are slowly coming out. She also has to adult teeth coming down that need a home.

The expander breached the palate. Stella says she cant feel liquid go up her nose This will have to wait to be corrected.

Her lip scar is completely faded now.

Doc had X-Rays taken and he found a loner tooth floating around inside her palate. The tooth needs a home and a space to live.

With this X-ray you cannot see the tooth.

The top arrow shows a mutant tooth living in the palate. It will have to be surgically removed. The next arrow shows a tooth with no place to go. It will have to be chained and towed to home port.

The hard palate will be exposed. The tooth will actually have a chain on it and will be pulled down by her braces into place.

Long brutal winter left her pale and white.

This is the scar left behind after the bone graft back in 2012. Almost faded away.

The springs are to make space for the tooth that will be pulled down. When the orthodontist says he has enough room the oral surgeon will perform the chain procedure.

I discovered half my daughters braces are missing on the right side. She has no idea where they could of gone off too....

There all getting nicely aligned.