Saturday, January 18, 2014

Adventures with Health: Dental E-patient! Gum Grafts!

The freakin' mess that's
the right side of my mouth.
On Thursday, I'll start another round of gum grafts, starting with my upper and lower right quadrants.

I guess I shouldn't bitch about this too much because, hey, what's a little major periodontal surgery on an average of every 12.3 years? Actually, it's about $4,200 out of pocket if the dental insurance coverage doesn't totally suck.

At least some of the technology has changed, so it shouldn't be as horrible as it was the previous two times. Welcome to my pathetic fantasy life.

This time, the periodontist might be able to use AlloDerm® instead of slicing strips of skin from the roof of my mouth. And even if he must attack my pallet, he assures me that he can remove a layer of connective tissue from underneath the surface tissue.

I ask if this is a new technique, since previous surgeries left gaping wounds that made me long for the comfort of slamming a hot slice of pizza onto the roof of my mouth. Nope, not new, but thanks to rivalries between New York City-based dental schools, the periodontists who performed my previous surgeries hadn't been trained in this less brutal technique.

Next, I ask about anesthesia options and discover a wider range of choices have emerged since the mid-1990s. #Yay

Back in 1977, I had precious little pain-killing anything, which wasn't a problem because I was still drinking. A lot. Nearly 20 years later, when I had surgery to replace the grafts on all four quadrants, I opted for nitrous oxide. By then, a few years into sober living resulted in me absolutely hating how I felt on nitrous. I'd wanted it to be fun. It wasn't. Everything still hurt, but just took much longer to moan about.

Informed consent!
This time I have the option of choosing "light" intravenous sedation. I figure this is ultimately safer than squirming around in the chair anticipating every awful moment, especially since bone will have to be shaved from the lower right quadrant.

My periodontist makes a big deal of letting me know that they have "reversal agents" onsite in case anything funky happens. I make a big deal of letting him know that I don't have time to get "DNR" inked on my forehead.

Our conversation takes almost 30 minutes, but only because I feel compelled to tell him about the former colleague who ended up in an irreversible coma during a routine dental procedure. Please don't worry if you inadvertently kill me, I say.

I find out and communicate all this stuff because I am what healthcare cognoscenti call an "e-patient" (i.e., educated, engaged, equipped, expressive).

After (too) many years of medical adventures, I find out and communicate everything and anything I possibly can about everything and anything having to do with my care. Dental crap is just my latest upcoming adventure with health and healing.**

*Have a good laugh: spell check wants to correct "gingiva" to "vagina."
** You can look forward to more posts from me in 2014 about Adventures with Health and Healing.