Dear Dr. P,
I hope this letter finds you well. I am writing to you with deep concern about my current health status and the complications I have been experiencing since my surgery on July 6, XXX, to shave the tip of the protrusion in my upper palate.
As you may recall, I came to you on May 2, XXX, with complaints of degenerative TMJ joints and a sharp, painful bony protrusion in the upper palate. After our consultation, it was decided that an exploratory surgery would be performed to shave the tip of the protrusion to give me relief. During our initial consultation on May 2, XXX you had expressed uncertainty about the precise nature of the bony protrusion in my upper palate. You had referred to it as XXX and assured me that it was a straightforward surgical procedure that any surgeon in my area could perform. However, the actual outcome of the surgery was not what I had expected.
When I woke up from surgery, it felt like a chunk of the skull-base was missing. My nose was numb and painful, and walking around, my skull felt unbalanced, as if no remaining bone was holding up the left side of the palate and its muscle connections, in contrast to the right side. It felt severely abnormal.
Firstly, I have received conflicting accounts about what was done during the surgery. You initially informed me that only the “tip” of the Hamulus was shaved and its connections were not affected, as it was superficial. However, Dr. Siew (resident) told me that “We did not go back to the Hamulus. We went to the posterior edge of the hard palate. We did not remove it.” Upon reviewing the post-surgery CT scans of the procedure, outside providers have said that the entire hook of the Hamulus was removed, which is rarely ever done, and that its connections likely would not reattach since the hook is gone. This is causing me great concern as we did not discuss removing the hook of the Hamulus or the repercussions of this.
Secondly, the asymmetry of the palate bones is causing trouble with functionality and an imbalance when upright. The left side has collapsed down and back, and it feels like the muscle connections are detached. I am experiencing constant pain in my palate and nose, making it progressively harder to talk and function.
Thirdly, there is a thick band of stretched scar tissue running from the upper palate to the base of the throat, which is pulling all day long, causing me pain when talking due to tendinous tissue pulling down on the palate and nerves. Moreover, I am experiencing breathing difficulties due to structural collapse of jaws/nose and narrowing of the throat. Speech is impeded due to the formation of scar tissue that is stretched from the upper palate to the base of the tongue/throat, and I am having trouble hearing in my left ear.
I have researched the Hamulus bone and learned that it is a crucial pivot “connecting the palatopharyngeus, superior constrictor, and tensor veli palatini” and that fracture “may have detrimental effects on the muscles around the pterygoid hamulus, which play essential roles in the velopharyngeal function and middle ear ventilation.” This is causing me a great deal of concern regarding the attachments that latch through it.
Dr. P, I am reaching out to you to gain clarity on exactly what was removed during July’s surgery and to find solutions to get my life back. I would appreciate your clarification regarding the following questions:
- Why was it unclear going into the surgery that the pointy bone was not an aberrant bone, but the Pterygoid Hamulus? You said you weren’t sure what it was… finish tis version of the document
- Did you not review my CT scan prior to surgery? If not, why?
- What was the specific surgical procedure performed during the surgery, and what exactly was removed?
- What are the potential long-term effects of the removal of the entire hook of the Hamulus, and why were these not discussed prior to surgery?
- What is the plan to address the asymmetry and collapse of the left side of my palate, as well as the scar tissue formation and breathing difficulties?
- What options are available to address the pain and functional limitations I am experiencing, and what is the timeline for addressing these issues?
I understand that surgery can be unpredictable, and there may be unexpected complications. However, I feel that there was a lack of communication and transparency regarding the specifics of the procedure and the potential risks involved. I trusted your expertise and expected you to inform me of any potential risks or complications associated with the procedure.
Dr. P, I appreciate your attention to this matter and look forward to your prompt response. I am hopeful that we can work together to find solutions to these issues and restore my health and well-being.
Sincerely,
[Your Name]
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