Coffee heat rising

Adventures in Pharmaceutical Marketing

Okay, so day has dawned. Accordingly, I leave the house at 8:30 to make the 20-minute drive down to the dentist’s office. Because I know which roads the City has kindly ripped up, blockaded, flooded, exploded, and whatnot, I fly in the door right on time, to the minute: 9 a.m.

A-n-n-n-n-d-d-d-d-d….

Yeah. No dentist.

Whyyy, one might ask?

“Wrong day.”

Waddaya mean, wrong day?

“It’s Monday. Not Friday. Today is Friday.”

Evidently I wrote it down on the wrong day on the calendar. Come to think of it, though, it’s a minor miracle that she’s there, because she’s waiting for her out-of-town relatives to show up and meet her there, whiling away the time fiddling with some new computer software. But she’s getting worried, because she thinks they should’ve gotten there by then.

I say the traffic is its usual bitch-ish self: they’re probably tangled up in whatever mess the city has kindly created along any of the several routes whereby they could have found their way to Dr. D’s office. She says yeah, that’s what she’s thinkin’…but she’s still worried. I ask her if she needs me to do anything for her — pick up some office supplies (there’s an office supply store just down the street), donuts, or any such. She says naaahhh….the truth is, all she really has to do is wait for the relatives to surface.

I’ve already made my way down to her precincts by avoiding Main Drag East, whose blacktop the City has bladed off all the way from Gangbanger’s Way down the entire length of the central city to someplace south of the Doc’s office, mile on mile on catastrophic mile. To accomplish this evasion, I’ve driven way out of my way over to Throughway Drag, a long, dreary strip of asphalt that will take you from way, way south of the river through downtown, through mid-town, through North Central and then the blight that is Sunnyslop, up and up and up till you reach the 101 freeway and from there dumps you into tract-littered desert, a deeply dreary journey, indeed.

Needing a flu shot, I decide to navigate back up Throughway Drag, because it takes you past a Walgreen’s and a Safeway, both of which dispense the flu vaccine. I don’t really need anything else in either store, but both of them are more or less on the way. Sounds propitious, hm?

Hit the Safeway, a right turn off Throughway, easy to access. Not very crowded. Prance to the back of the store, where the pharmacy resides, and find just one (only 1!!) customer ahead of me at the pharmacist’s counter.

She is a very elderly woman, all wrapped up for wintertime (it’s 105 out there now as I write this) and leaning on a walker as she tries to fill out a form the pharmacist has inflicted on her.

No kidding: this thing is PAGES long. And no mere 8.5 x 11 pages: page on page on page of 8.5 x 13-inch paper, covered with lines for her to fill out.

The poor soul is sifting through the goddamn thing, line by line by interminable line, trying to figure out what they want her to fill in and trying — with little success — to dredge the required data out of her memory.

She struggles and she struggles and she struggles and…

I stand and I stand and I stand and I stand…and….

Finally I think OH FUCK IT! It’ll take less time to drive across the intersection to the Walgreen’s, park in their lot, hike to the back of the store,, and get the damn shot there. So I leave her doing battle with Safeway’s paperwork and head across the street.

Yeah.

There it only takes about 10 minutes to get the attention of one of the two clerks. I say I just want a flu shot. She says no problem, and proceeds to give me the Covid Third-Degree. I go no…no…no…no…no…no…no…no…no…no…no…no…no…no…no…no…no…no…no…no…no…no…no…no… to another eight or ten minutes of questions that could easily have been condensed into three or four questions. Fork over my Medigap card and my Medicare ID.

She asks me for my “Blue and Red Card.”

Huh??????

“I’m sorry,” I say. “I have no idea what on earth you’re talking about.”

She says, “You know. Your Blue and Red Card. Your Medicare card.”

“You mean this one?” I give her the photocopy that I’ve been carrying around ever since my original Medicare card was stolen.

She looks more closely at it. “Ohhhh, yeah! That’s it.”

No kidding, kemo sabe?

Now as we proceed, it develops that she cannot figure out how to enter the data to charge up a flu shot on Medigap/Medicare. She asks her coworker how to do it. Coworker, visibly annoyed (because she’s visibly very busy) drops what she’s doing to instruct.

In the process, our heroine remarks that she was off work for eight weeks and so has forgotten how to work the computer.

Uhm. You forgot how the computer works in eight weeks? 

Definitely not the brightest rhinestone on the pharmacist’s lab coat.

It takes her another eight or ten minutes to figure out this two-minute process, during which another elderly woman hoves up to the drive-through window in her Cadillac, whence she asks for something that was supposed to be ready. She is given a nice runaround.

I think If I’d stayed behind the Safeway crone I’d be on my way home by now. Matter’o’fact, I’d probably be in the house by now.

The paperwork filled out and the stabber in hand, I ask if they could please send a notice over to the Mayo to let them know (as the doc there requested) that I received this inoculation.

Now…get this: She says “Where’s that?”

No kidding. Another sentence or two, and it becomes startlingly clear that this little lady has NEVER HEARD OF THE MAYO CLINIC. Not only does she have no clue where it is, she doesn’t know what it is.

I think…I’ll bet you were in one of my 300-level “professional” writing courses, weren’t you? Probably one of the classmates who never heard of the Civil War or never imagined it happened during the 19th century. Whenever that was…

Holy shit. Next time I’ll drive out to the Mayo to get a shot.

Adventures in Dental Science

One fiasco after another. Old age is definitely no land for the young…

For quite some time, I’ve had a broken tooth, one of the forward molars. We haven’t been able to tell which one, because of the several crowns back there and because it was cracked, not actually busted. The dentist X-rayed that side of the mouth several times and could not find the crack. And I could not tell which of the two surviving upper molars emitted an electric shock of pain when I bit down just right…on just about anything.

Finally, however, the thing split apart. That hurt quite a bit. But interestingly, when the chip fell out a day or two later, the pain stopped altogether. Who’d’ve thunk it?

At any rate, all this meant the tooth had to be pulled. Dentist sent me to an endodontist, who proposed to dig it out, implant a “post” (which far as I can tell is basically a titanium screw).

However, when I told the endodontist about the supposed MRSA infection, he flew into a panic and said he couldn’t do the procedure.

What was I supposed to do about the broken tooth? He shrugged. Finally he suggested that I get a second nasal swab, and said if it was clear he would proceed.

Sooo…I had to trek out to the Mayo — halfway to Payson from my house — to get someone to stick a Q-tip up my nose. Again.

Astonishingly, the Mayo sent word that the MRSA test was negative. So the endodontist relented and scheduled a procedure for last Friday.

Naturally, I came down with a cold on Sunday. Never, EVER fails!

The cold is rather mild and the tooth situation was rather urgent, so we decided to go ahead with it. This meant I got to spend something over an hour on my back in the dentist’s chair, gagging on goop oozing down the back of my throat.

Ugh!!!!!

While it was uncomfortable — mostly because of the cold — the procedure was not painful. It was actually pretty interesting. His office has equipment that allows them to make 3-D X-rays of your teeth, which is amazing. And the amount of work and skill required to perform the trick of extracting a tooth in several pieces really is amazing.

So at any rate, the tooth is out. He insisted that I take a week-long course of clindamycin by way of fending off any potential infection. He remained concerned about the potential for MRSA, but resistant bugs or not, apparently dosing you with antibiotics is S.O.P.

Yes. Well. Unfortunately these days I’m allergic to just about every drug out there. And if a drug has a weird side effect that afflicts one in a million users, invariably I am number 1,000,000. At the risk of repeating myself: Never fails.

Clindamycin has a number of dire side effects. One of them is a skin thing that is incurable and causes your hide to fall off. Another is C. difficile overgrowth.

Right.

SDXB’s former wife died of a C. difficile infection. She died laying on her living room floor, where she was found by a neighbor about two days later.

Naturally, while I was at the endodontist’s having my gum sliced apart and the tooth wrenched out, the Mayo’s clinician Mona called on the phone asking me to call back to talk about that MRSA test. Naturally, by the time I got home it was after 5 p.m. and they were closed. So naturally, I get to worry about that all weekend.

Cripes. Let’s just hope all she wanted to say was that “negative” in your chart means “negative.”

Believing I would surely be in terrible pain, the endodontist handed me a prescription for oxycodone.

Besides the fact that I don’t take addictive drugs on principal, when I get it home I find it’s mixed with acetaminophen. I’m allergic to acetaminophen. It’s an NSAID. Interestingly, I’m allergic to all NSAIDS.

Luckily, I apparently don’t register pain the way normal people do. Probably because my menses were so excruciating, other pain seems negligible by comparison and tends not to bother me. Although the site where he’d extracted the tooth was sore, it certainly wasn’t enough to send me flying off the North Rim of the Grand Canyon. Got to sleep with no problem (so exhausted a jackhammer could have been going in the backyard and it wouldn’t have kept me awake).

Next morning I gaze into the mirror and find my face is swollen, which was not surprising. Then I developed a black-and-blue spot that makes me look like someone socked me in the face. Loveleeee. Both of these are normal, as it develops. But I sure could do without them.

Last night a member of the choir committee called to ask where the heck I’ve been and was I coming back. Of course, I’ve missed several times: last Sunday, and then again Wednesday evening. And yesterday morning: we have a concert this afternoon, which I’m also going to miss because I’m not rehearsed. I’ll be surprised, really, if he lets me sing this morning, since I wasn’t at rehearsal for today’s service.

And in fact, I’m still feeling pretty wrung out, so think I will just go over, drop off my choir folder & hymnal, grab my robes to bring them home to launder and store over the summer, and call it a day.

Or not. We have the annual end-of-season choir party tonight. My friend urged me to come to it. We shall see: by evening I am just wrung out, and by 5:30 p.m. I surely will not be the life of anything like a party. So that’s depressing. But I’ve just been too sick to think about it.

And so away, off to swallow another horsepill and toss some food in the blender. Whee!

Hold the Phone, Here…

Waaaaitaminit! A few belated second thoughts about the pending dental adventure are occurring.

I’m driving down the road headed back from campus to the Funny Farm and thinking, “Good grief! Three thousand dollars is more than a fourth of the savings I’ve earmarked to supplement Social Security for the next year.  That ‘supplement’ represents half my month-to-month living allowance. So we’re talking about disappearing three months’ worth of money for living expenses.”

Furthermore, think I, the prospect of sitting in a dentist’s chair while the guy bangs away at my mouth for two hours sounds…well, counterproductive. As in a very, very bad idea.

Then it occurs to me to wonder whether two crowns are really necessary. Dr. Davis, he of the pricey parking lot, once opined that though the chipped crown on the bottom molar is unaesthetic, a) no one can see it unless I open my mouth in public and yawn like a hippopotamus, and b) it’s perfectly functional. As for the broken tooth on top, the new dentist polished the surface smooth, so that it doesn’t irritate my tongue (in fact, it irritates a lot less than it did after he filled the first break in it). It also seems to be perfectly functional. It doesn’t hurt, and since my teeth are already so dull I can’t chew up a normal bite-sized piece of meat, there’s no change in my ability to chew or eat. hmmm….

The light dawns...

INSIGHT!

If you can get a second opinion for a doctor’s diagnosis and you can get a second opinion for a veterinarian’s diagnosis, why the heck can’t you get a second opinion for a dentist’s recommendation?

If this tooth were so badly damaged it needed to be crowned, wouldn’t it hurt? Not very much of it broke off…certainly not a big chunk, as this guy described it. I would have noticed if a fourth of a large molar had fallen into the mouthful of rice and canned beans I was eating at the time. It says here that the stuff underneath the white enamel of your teeth is called dentin, that it’s yellow, and that if it’s exposed, what you get is sensitivity. I’ve been guzzling iced tea, bourbon on the rocks, and hot coffee for the past two days, with nary a twinge.

Bounce out of the car and into the house, grab the phone, and call Old Doc Davis’s office. Ask if he’ll see me. The receptionist whose head I nearly bit off the last time I was there is polite, if you can imagine. She arranges an appointment on Monday.

Grab a mirror and a flashlight. Take a real close look at that busted tooth. It’s white all over, just the way it looked in the digital image New Doc made of it. That is to say, it’s the same color and consistency of all the other teeth in my head. Pretty clearly, this guy doesn’t think there’s any urgency to crown it; otherwise, he wouldn’t have let his office assistant make an appointment at the end of May.

Maybe, just maybe, it doesn’t need to be crowned at all. Or, if it does, maybe there’s no reason to remove the old crown on the bottom tooth and change that out. And even if that is necessary, maybe it doesn’t have to be done in one long torture session.

And if I really do need two crowns, maybe Davis will do them cheaper.

We shall see.

Image: Chicago Skyline at Dawn. Joe M500Creative Commons Attribution 2.0 Generic license.