January 6th, 2006
A long while ago, I had some dental issues that could only be resolved by having my wisdom teeth removed. I had a draft of it forever, here it is, for better or incoherent.
I realized something was wrong in my mouth on a Tuesday. I was having persistent pain. It was not particularly sharp, but it was present in a way I’m not used to.
I have never taken particularly good care of my teeth. I brush, more or less. But I didn’t floss except before a date or if maybe I had eaten some celery and had obvious crud between my teeth. I didn’t take to flossing. Is it a character flaw to not floss? Maybe not, but not considering the long-term of an action was certainly a flaw of mine for a long time. I have to work to consider the future carefully.
The pain was in the lower part of my mouth, right hand side, rear. I thought it was simply some stray food particles lodged under my gums. I brushed, using the Braun electric that had served me well for several months. But this didn’t really help much. I used Peroxyl, a hydrogen peroxide based mouthwash, and vigorously gargled. I also used my generic brand green mouthwash.
I even went to the extent to purchase a dental irrigator. The WaterPik was I think the first device of this kind. It simulates the action of a toothpick, but with a jet of water. My grandparents had one when I was a kid, and I always liked them – such a neat action.
The irrigator didn’t help either.
The next thing I realized was when I developed a funny taste in my mouth. Like metal. Aluminum maybe. Again I tried to attribute this to “food particles” – perhaps an errant bite of mexican food or Tiger’s Milk Bar that went astray and got stuck.
No such luck. The taste remained even after purging my mouth of every bit of anything that could possibly be in there.
I brushed, and gargled with water, the alcohol-based mouthwash, the Peroxyl, more brushing, some irrigating, and yes, the taste went away.
Then it came back.
To my horror, I realized something very wrong was happening in my mouth. It is simply not normal to have a taste get cleansed from your mouth, then, 15 minutes later, for it to come back. I had something malicious happening in my mouth. Something oozing. Something was making an “exudate” – a word I remembered from my days practicing Respiratory. I had to see a dentist. Fast.
I know enough about disease processes to know that something that is making pus at that kind of rate is not my friend. My mouth was rotting, and needed addressing. The thing I’ve always been cognizant of about teeth problems is that they have a way, untreated, of affecting the rest of the body greatly. I think of the endocarditis and mitral valve problems that people can get. The mouth has lots of exposure to the outside world – and if your gums are bleeding, it’s a potential conduit to the bloodstream for all kinds of microbiological nasties.
I was scared. Very.
I looked up dental abscess online and indeed, it sounded like what I had. An abscess is “A localized collection of pus in part of the body, formed by tissue disintegration and surrounded by an inflamed area.” And this is definitely what I had. In my mouth.
So I did what I always do when there’s a crisis, I reached out online, asking, via email and mailing lists, for local (San Diego) dentists.
In a few hours I’d collected some good data, and I found one from my friend Steve E, and called immediately for an appointment. I was immediately put at ease by his scheduler, who asked how I was feeling, and to describe my symptoms. Her alert level went up a notch as I described what I relayed above. She said it did sound like an abscess.
She scheduled me for an appointment in a week, and I said that was fine. She also said she would try to get me an appointment soon, because she knew that what I had happening was serious business. I am every so thankful to her for that.
When I got home from work that night there was a message on my machine asking if I could come in for an appointment the next day, Friday. I called back immediately, and said a hearty YES!
I was in. The problem was being addressed. I sort of imagined pilots in their ready rooms running out to the bombers and fighters staging a counteroffensive. Troops were rallied. Action was happening. Go Joe!
Yes it would cost money. But it was going to get taken care of. I still had the taste, and the pain, but I felt that good feeling of “progress. ”
One thing: When the Dentist looks at your wisdom tooth, and says “Oh Wow,” how can you not be scared? I was scared but was okay with it, come what may.
My Dentist told me that the kind of decay I had was rare. It happens in two groups typically. Children, and the elderly. I am 33 years old. He said that the aged get it because their oral chemistry gets weaker. Kids get it because they tend to eat continuously throughout the day.
This second scenario, “eating like a kid” ,is precisely how I have lost weight in the past year. I eat what I want when I want.
The irony of the thing is that apparently the diet that lost me 90 pounds in 9 months is the same diet that accelerated my tooth decay. Had I brushed in line with my eating, I probably would have been fine.
Then came the day of Surgery.
I checked in at 7:40am and at 7:45 they took me in. There are photos of this intake procedure in my photos area.
I urinate. Then I go into an “on-deck” room where they lay me down on a stretcher. They put a blood pressure cuff on me. It’s predictably too small for my arm so the Nurse (is she a Nurse? I have no idea) gets a larger one.
Lynn, the nurse is looking for an IV puts nasal mask (nondisposable) on me “laughing gas” she calls it. Nitrous and Oxygen probably. Very calming. They put two ECG (did you know we refer to EKGs as EKG because “EEG” and “ECG” sound too much alike? — at least that’s what I was taught) electrodes on my chest. They put another electrode on my left arm. She sticks me antecubitally for a vein. (bigger always better) but she misses. I feel the stick, and it hurts. But it feels like it’s hurting on the other side of the room — I am lucid, but the sensation is of a disconnect between what happens in the room and my self. She tries the top of my right hand. She hits, but can’t get the sheath in. I’m lucid enough to say “Third time’s a charm” when she jokes apologetically about turning me into a pin cushion. I say it’s fine.
Something in me prevents me from mentioning how many times I’ve stuck people for blood – ABG’s – Respiratory Therapists draw bllod from arteries.
Third time *is* a charm and she hits me on the radial side of my wrist.
I feel a splash of cold on my hand. She tells me it’s just saline. It could be blood for all I care, as long as she doesn’t allow it to drain out of me. That would be… bad.
I overhear two people (Nurses?) (Surgical Techs?) talking about radial notches and the ulna and I say “somebody’s taking A&P.” I mean, if you’re working in a Dentist’s office and you’re talking about the ulna, you must be taking an Anatomy and Physiology class. At least semi-drugged, I came to that conclusion.
So I see the Doc — the Oral Surgeon. He says “Hello, how we doing?” I say okay.
The nurse at this point says “we’re giving you the drugs to make you go to sleep now.” I tell her okay. I have a clamp in my mouth.
I don’t remember falling under the influence of the Versed, but I must have. It might be nice to see the operative record. If only so I can see the chronology. Having been under the influence of powerful narcotics, I’m scarcely a trustworthy witness!
When I wake up, I am back in the holding area. Everything feels like a dream. An overhead lamp suddenly, in the hazy eyes I have, becomes a little silent puppet show. I am lying flat. Two white hospital blankets covering me to my neck. I’m watching and listening.
Watching and listening like always.
I close my eyes.
In and out.
I move a hand up and feel my face.
Upper lip – no feeling. maybe some pressure. But I really can’t feel it much.
Lower lip – nothing. it feels like a nylon stocking filled with a nerf football. I press it but cannot feel it.
Lower jaw – likewise. This is probably good.
Oh, the glory of local anesthesia.
There is cotton gauze in my mouth. Big hunks of it. Covering the stumps of where my four wisdom teeth were.
I make a sound. Not much. A slight gurgle cough. Then a glugging giggle at the silliness. Increduility at how I can’t really make a sound.
I often feel that incredulity. I’m always amazed at simply existing, and how bizarre things are.
Eventually they bring me out. To Leah.
Leah drives me back to her place.
I think I’m awake and alert, but I sleep most of the way.
Things written on clipboard when I could not talk. These were “said” to Leah.
“lip no feeling”
“would like to take pen. & vicodin. fear cannot swallow though”
“can feel the pain coming.”
“like the outskirts of town.”
“good got drugs down.”
“T.Y. (you said to stop writing thank you)”
*The Leah-Takes-Care-Of-Me Post-Op Phase*
I changed the gauze packs every hour – they were gunky, bloody, and awful. It was nice to see the progression of the gauze from totally wet with bright red blood, to merely damp with brown and black.
The instructions said to NOT rinse frequently or vigorously in the first 24 hours. I respected that. I was scared to death of “Dry Socket,” which had afflicted both my sister and father when they had had tooth extractions.
Vicodin: loved it, though it gave me constipation.
Tried to drink juice sometimes, though water was best.
Leah made me pudding. Lots of pudding. It’s a strong memory of having something I could actually eat. Leah was wonderful to me.
And mostly, I slept.
Here’s an email I sent to my sister:
– chocolate pudding – just right
– mashed up bananas – just right
– little pieces of pear – a bit too much yet
– 7up – the old favorite, GREAT!
I’ve stopped bleeding from the stumps/holes/caves
slept a lot yesterday
my mouth was VERY numb (like, useless) all day yesterday
but now I can talk
and move my mouth, and it all works well
though now my jaw is muscle achey
And that’s the end of the wisdom tooth saga. I laughed, I cried.