Tuesday, 9 October 2007

The Big Day

I got to the dentist's and waited 20 minutes or so. It was a pleasant enough interlude for one facing unimaginable unpleasantness. I watched two small boys play with toys at my feet, and that orange antiques man was wittering on in the background (on the telly, not in the surgery). Sounds blended into the usual soup that confuses my brain every time I leave the house.

Then there I was sitting in the chair. The strange yellow goggles (why are they yellow?) were perched stylishly on my nose, the bib for spitting bits and bobs into secured around my neck.
Dr Uncertain says: "I'm just going to take another look at your tooth before..." then he trails off. He has a quick prod, and blows some air on my gum, rather pointlessly I feel.
"I'm juuuust going to go upstairs and have a word with Dr More Experienced Than Me. Won't be a moment." Five minutes later he returns.
"We've decided not to go ahead today."

"Why?" I say in a surprisingly forthright tone. My first thought is: "Thank God I didn't have time to take the stash of pre-op sedation in my bag, having discovered at the eleventh hour that the surgery I'm at doesn't do pre-op sedation." It looks like we're in for a bit of a discussion, and I need what wits I have to be as sharp as they can be.

He gives me the lowdown on what exactly is going on with my wisdom tooth, how risky the extraction is going to be, how I will bleed a lot, it will take more than an hour, my jawbone, the facial nerves, my general health, etc etc oh God here we go again. He tells me that, in accordance with NICE guidelines (The National In - I tell him I know what it stands for, he apologises for being patronising) unless your tooth has been infected three times in a year, it stays put.

I tell him that in preparation for today my son has had to face the upheaval of moving in with his father for two to three weeks. That a social services crisis care team are as we speak on standby because I have no one to look after me, which isn't his fault but that's the way it is at the moment. That I have put myself back ON two waiting lists (for further M.E. therapy and psychotherapy on the NHS, both of which became available this month) to allow for the lengthy recovery from today's extraction. Which now, at the very hour it was supposed to happen, is all of a sudden not going to happen.

He apologises for being 'naive'. He says that generally people leave the surgery and get better and get on with things. He now realises that it's not like that for people with chronic health conditions. He apologises for all the upheaval.

I am shaking. Sadly, my body is still capable of producing nearly as much adrenaline as the anaesthetic I requested not to have in favour of one that wouldn't upset my system. I am angry that they didn't talk this over and phone me to get me in before the Big Day. All the preparation, mental and logistical, has come to nothing. I feel as if he's chickened out, bottled it at the last minute.

I am very angry. My son, uprooted, is uprooted needlessly. I...I...I cooked a huge vat of vegetables and mashed them at midnight in preparation for today. Oh the indignation.

Then quietly inside, I relent. I listen. I don't shout. I don't demand to see Dr More Experienced. He's far too busy upstairs earning £2,000 fitting a dental implant, I presume. Dr Uncertain thinks I should be referred to the Community Dental Service. Sally, you were right. This is what she had to say on my dental situation a while back:

Dentists !
A bit of a practical suggestion ... Every dentist can refer patients to the NHS Community Dental Service - it's for those patients with 'special needs' YEAH, I know. The CDS is usually at a local hospital. If you have medical problems or disabilities that mean getting there is a problem, ask your GP or the Community dental service, to arrange hospital transport - they fetch you and take you back, with an escort if you need it. Or the 'Friends of ... Hospital' volunteer driver service. If they have one.

I think of Sally and smile serenely as Dr Uncertain tells me that the CDS has the expertise for the complex scenario that is nightmare dentistry on a disabled patient (my words, not his). They have defibrillators, oxygen, and what he describes as "a hospital set-up in a calm surgery setting." Should I have requested the referral before today? No, because they wouldn't have listened. They had to experience the cock-up that was today to understand what life with a chronic health condition can be like. And until today, I had confidence in Dr More Experienced, who was the one who was supposed to be doing the extraction. Funny how people are suddenly busy with other things sometimes isn't it?

Actually, having pondered it all awhile on returning home mouth intact but nerves slightly shaken, I am quite glad. Dr Uncertain was right to be so, if he felt that I need more specialist attention than certainly he could provide. Whatever was going on at my surgery today, whether it was "Oh God! Not her from last year," or "On the NHS? Are you kidding?" or "That's a right bastard of an extraction, don't touch her!" Whatever. I am so glad to have NOT had someone plunge into my mouth with a cavalier, devil-may-care attitude. Instead I got a referral to somewhere that sounds really rather good.

My son is coming home tomorrow. I think I will make a cake. And hey everyone. I've got Autumn back :-)


Elizabeth McClung said...

I am astounded at your positive attitude - as such things seem to happen almost weekly and I just get the anger (later followed by crying...and more anger...and depression).

Thank you for the vivid description of the anger and the caprious whim of whomever is there as all the steps you have taken run through your head. I am sorry, I am glad, I am whatever you want me to feel.

I should say I read your blog line by line over the phone to my partner who said during the entire thing "See, you're not the only one!" (Because I assume there is something wrong with me, that they must not believe me ergo think I a liar or such when I tell them in advance what they finally decide - or just walk away from)

Mary said...

oh god... you did well to not explode at anyone in tears/rage/laughter/whatever.

But you are absolutely right, it is better that the dentist didn't start trying to do something to you that he wasn't sure he had the time/equipment/know-how/backup to do safely. And yay Autumn. Probably.

Sally said...

Oh excellent outcome Seahorse - but OH OH the pain and worry beforehand (and complex arrangements for you and your son) - yes the relief tempers the anger, so we don't attack the Dentist on the spot, but what is unacceptable is that THEY have the control in this situation - your needs have not been well managed by the dental practice - so, now hopefully the CDS will look after you and put your needs first.

Demand what you need - that is what they are paid for.

Your area's NHS Primary Care Trust (who contract the dentists and pay them to look after you) should have a something like Dorset's PALS - Patient Advice and Liaison Service - by whatever name. If you have any problems contact them - more work for you I know, but the government want all PCTs to listen to their patients (I will get round to blogging the latest developments soon).

The only problem I have with the CDS is that they are under-funded - what a surprise ! Once they have sorted out your current dental problems, they should continue to see you on a regular check up basis (so you never have to go to a 'high street' dentist again) but they will only do necessary work, not preventative or 'pretty smile' work. Hey ho.

It is your determination to not only survive - but eventually thrive - that will see you, and your son, through these situations.

Three Cheers for Seahorse !!!

Cusp said...

Well, in a funny kinda way I would say 'Result!'.

You've had to go about it all in the most preposterous and nerve wracking way but it seems you may finally be getting dental treatment that caters to your needs.

Having a disbaled child I know already about the CDS. In fact I took him yesterday (only to be told all appointments had been cancelled because the nurse was sick --- must have been that kind of day in the 'Dental Planets'). They have been marvellous with him since his condition means he has a very narrow pallette --- problems with room for teeth and cysts.

Now what I want is also to see the Community Dentist. I am like you in that I simply cannot cope with extractions at an ordinary dentist but my GP just will not have it ---or my dentist --- both just make me feel like a wimp and hysterical.

I'm really glad things have turned out as they have(bar the trauma and upset you and your son have had to endure). Sometimes things do work out in a funny way.

Go and bake cakes and enjoy the sunny weather with your little boy, let the dentists do the worrying and next time you have to cope with this rigamorole it should be easier.

Hug x

seahorse said...

Elizabeth: I get a sense of much frustration reading what you have to say, which I totally understand. My latest trick is to imagine each medic I see is one of the medics I know as a personal friend, and I know a few. That way, they become more human. We are all human. Yes they can be rubbish, careless etc but I feel Dr Uncertain was neither. Just uncertain. It's Dr More Experienced I have my doubts about. He didn't bother to come downstairs and they didn't communicate properly as a practice. But I'm out of there. And I need someone good. It is a bugger of a tooth.

Mary: Yes I'm so glad he didn't make a start. I think he is too.

Sally: I have to thank you for the knowledge you bring to my sometimes tricky situations. I feel I have a team of 'those who know better' backing me up as I wade through all this crap. And your encouragement is always heartening.

Cusp: My son is cool. We had fish and chips for tea, watched Top Gear and discussed ideas for his school newspaper. It's like nothing happened :-)

The Goldfish said...

I read this earlier in the week but was too fogged to comment - glad you got autumn back and well done for handling this so well. How is your tooth now?

I do hope you realise that all this concern about your wisdom tooth has reminded my skeleton that I haven't got all mine yet and I got a new one pop through yesterday.

seahorse said...

Goldfish, if I write a post entitled Head Fell Off please don't read it.

My tooth is fine now. The sod. I do hope yours come up as sparkling as snowdrops and straight as the poker I would dearly love to sho...no, calm, breathe.