Coffee heat rising

MRSA

Adventures in Dental Science

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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!

Chewing Up the Tax Refund

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Ohhhh man…has a lot transpired between the time I jotted in that post title this morning and the time I staggered back to the computer this evening!

So bright but not too early this morning, the endodontist and I were scheduled to meet at his office, so he could pull out the busted tooth and screw in a post on which, at some as-yet-unscheduled date, to attach a fake replacement tooth. This project would cost about $3,000 — almost all of this year’s tax refund.

When I arrived at his office and was placed in his massaging (!) chair, I mentioned to his assistant that they probably should know I was diagnosed, some months ago, with a MRSA infection. This, I noted, was supposedly treated but I’ve never had a follow-up culture to confirm that.

Well. That bit of intelligence set the man’s hair to standing on end. Long story short: the guy announced that my dermatologists didn’t know what they were talking about, that they could not possibly have treated the colonization properly, and he would not perform the scheduled work. He said his concern was not only that the surgical wound could get infected with antibiotic-resistant staphylococci, but that he and his assistant would be exposed to it.

I suggested that I could go either to the Mayo or back to the dermatologist to get a second nasal swab cultured. He said he preferred the Mayo, so now I have an appointment tomorrow to traipse out to the far east side for that — a two-hour round trip.

So I was passing pissed, because the tooth had been hurting quite a bit. Couple days ago, it actually fractured all the way through. and was now falling apart, a slab of the thing trying to work its way loose from the base. While I’m not pleased at yet another surgical procedure, I surely was anxious to get it over with.

When I reported to the Mayo’s PA that the dentist had remarked he figured I would infect him and his sidekicks with the dread pathogen, she said “not if he was following the standard rules” for surgery. And we might add, she sounded mighty sarcastic. Hmmm….

Well. Some hours pass, during which I wonder how I would cope with the pain of the exposed nerve getting jolted at every turn. Along about the middle of the afternoon, I serve up a bowl of soup.

While I’m eating that, plink! The broken sliver falls out!

Oh…shit! think I. This is going to make things many orders of magnitude worse. If that exposed nerve hurt every time I bit down on the tooth while it was fully sheathed in enamel (albeit cracked enamel), what will it do now that it’s sitting there stark naked?

Yes. Well. The answer to that is… Nothing.

As soon as that loose piece of enamel lifted itself away, the freaking pain stopped!

The sharp electrical jolts ceased altogether. It feels like there’s a hollow space on the grinding surface of the molar and a razor-sharp edge along the backside. There appears to be no decay. The front surface, the part that’s visible when you smile, looks undamaged and normal. The part that’s broken away does not go below the gumline.

Y’know what I think?

I think the tooth could be filled or possibly crowned, and that would fix the problem.

The repair would cost several hundreds of dollars…but it wouldn’t absorb my entire effing tax return.

So I have a call in to the dentist — naturally this deconstruction event happened right at 5 p.m. And…if he doesn’t agree that the tooth can be fixed, I’m getting a second opinion.

Why, for godsake, have I become sooo cynical about the avatars of the medical profession in this country? I’ll tellya why: it’s because about half the time I’m right. These people have to make a living. And to do it — and pay their employees and their office rent and their utilities and whatnot — they blow up every minor ailment into a case of the Black Plague. And often as not, they downplay conditions that show any sign of being expensively time-consuming matters. There’s a sweet spot in there where a nice profit is to be made…and that’s where they exploit you.

That’s unkind. Of course. Possibly a more generous view of the matter is that these folks are only human. And what they do involves a lot of informed (more or less) judgment and a little outright guesswork. So of course they make mistakes. Nevertheless, dentistry is becoming notorious for overtreatment — yea verily, here’s an article that claims if 50% of a broken tooth remains, it can be fixed with bonded restoration. I think if the good Dr. D doesn’t agree with that, we’ll be getting a second opinion…