Recovery

A less disgusting, but boring entry about my healing mouth. Because my brain is a defective sieve, incapable of holding any of the items I want to write about and I have nothing else right now but a whine about my brother's cancelled bachelor party, which ruined my plans to have the house to myself for the weekend and a second whine about the Penguins, as they continue their painful slide into last place.

Monday
The stitches and stent came out, after a quick examination by the periodontist and the application of more topical Novocaine. There was another brief moment of panic when I accidentally scraped away some of the graft tissue, thinking it was excess packing. A brief tour of the internets reassured me that I had not done any damage and that the graft would be alright.

I turn down the offer to put the stent back in.

Tuesday
I met my hockey buddy for lunch at Pamela's. I have breakfast for lunch, crepe style pancakes stuffed with strawberries covered with brown sugar and sour cream. D orders a sandwich and fries. I'm still on the softer variety of foods to protect my sore palate and gums.

During our conversation I learn that D had the same procedure done on his two front teeth, sans packing or stent or prescription drugs to ease post-operative pain.

D ends up losing his ATM card and gets a parking ticket. I don't think he will be meeting me for lunch in my neighborhood anytime soon.

Weekend
Call off work on Friday to see if I can recover some of the sleep I've lost in the past several days. Lounge in bed and think about ways to get myself out of the house and interacting with people again. Decide to sign up for a four week class at the Pittsburgh Glass Center. The class meets on Sundays. I will be learning how to transfer photograhic images to glass.

How I Spent the New Year

AKA – How to survive a subepithelial connective tissue graft with apologies if the details are too gory...

The day I had been dreading since last February arrived Monday. At 2:40 in the afternoon I entered the periodontist's office for a dental procedure called a subepithelial connective tissue graft. This is a very technical term for the barbaric necessity of having gum tissue removed from the roof of my mouth and grafted over gum recessed and root-exposed teeth in another part of my mouth.

The procedure is a preventative measure, to prevent infection, loss of tooth and/or bone and to avoid an even more painfully barbaric procedure called scaling and root planing, in which the periodontist removes bacterial plaque from below the gumline with a serious of instruments that would not be considered out of place in a medieval torture chamber. My mother was forced to have this procedure done and swore that she would let her teeth fall out before going through it again.

As I had to have a graft done on both sides of my mouth (lower right and upper left), I was given the option of splitting the procedure over two visits. I elected to get it over with all at once, afraid that the experience would be so bad the first time that I would not want to come back again.

The first step in the graft was the administration of 7.5 milligrams of Valium to ease my very quiet, but very real panic and the taking of an impression of the roof of my mouth to create a wax stent. As I waited for the Valium to take effect, the dental assistant talked me through the rest of the process, sent J out to get the prescriptions I would need and compared notes with me on migraines.

After twenty minutes, she carefully guided me to a second room and handed me over to a second assistant. Assistant number 2, covered my eyes with protective glasses, my body with protective paper and numbed the hell of ¾ of my mouth with a topical Novocaine solution, so the injections would not hurt as much. She waited five minutes, then numbed the surface of my gums again.

After an additional five minutes, the periodontist, an oddly charming and cheerful old Jewish man named Dr. Baumhammer began injecting Novocaine into my lower right and upper left gumline and midway between the hard and soft palate on the roof of my mouth.

(This particular injection, into the palate, is something I experienced at the age of twelve when I had four molars removed and stands out as one of the singularly most painful experiences of my life. I clearly recall, as heavily sedated as I was then, the oral surgeon saying “This will hurt and you will remember this one for the rest of your life”. Correct on both accounts).

After the first round of injections, Dr. Baumhammer stopped for five minutes. He explained that it takes approximately five minutes for Novocaine to reach its full effectiveness and he would be administer a second round of shots. Based on my reaction to the second round he would either start the procedure or wait longer and give me a third round of injections. At any point, if I felt the slightest bit of discomfort, I was supposed to signal him to stop by raising my left arm.

Aside from the injections, the procedure was close to painless. The only sensation I felt was of the surgical thread running against my lip as he stitched the grafted tissue into place and the donor site closed. The upper tooth was more difficult and he had to stop multiple times to give me more Novocaine (I lost track after the sixth shot), as I could feel the scalpel blade (no pain, just the blade) against my gum.

Finally he finished stitching up my poor mouth, covered the grafts with surgical packing and the donor site with the hard wax stent. I discovered that 7.5 milligrams of Valium was not enough to keep the tension out of my body, as I had to physically force my legs to relax. The assistant helped me sit up in the chair and sent J ahead to get the car.

While we waited, she prepared a small brown paper bag, into which she dropped after care instructions, an envelope with a prescription for an antibiotic, some gauze pads to staunch bleeding and some ibuprofen for pain relief. She escorted me down the elevator to the alley behind the building and handed me off to J.

I spent Tuesday and Wednesday “working” from home. Between Monday and today my face swelled up, I learned that Vicodin is an excellent painkiller, ibuprofen is equally excellent, baby food is absolutely disgusting and being restricted to soft foods only gets old quickly. My diet has consisted primarily of applesauce, chocolate milkshake, eggs (scrambled and poached), whipped potatoes and cream soups.

I also have an enormous blue bruise on the lower left side of my check and a small purple bruise under my left eye. I looked like I was punched. Hard. The bruises are the relic of the six plus shots of Novocaine into the upper left gumline. It has been interesting to see how people react when they see my face. More than one woman has winced and looked at me with pity and J says a couple of men gave him rather unfriendly looks.

The stitches come out on Monday.

David Byrne as Minor Deity and the Cat Came Back

I say upfront that my ability to form coherent, interesting sentences seems to have taken a holiday with the last round of viruses. I hope for the return of my full facilities soon, as this odd feeling of dullness is becoming an irritant in my life. I can not seem to create or comprehend the world around me.

J and I went to see David Byrne at the Carnegie Music Hall in Oakland on Friday night. We stopped to have a drink at the Panther Hollow Inn, half a sandwich at Camille's and a short stroll through the neighborhood before the show.

Stopping at PHI was a bad idea. As the majority of PHI's sales are in the form of stiff drinks and beer, smoking is not only permitted (due to an exception in the law), it is actively encouraged. Unfortunately this last round of virus', which started with a case of food poisoning and evolved into step throat + a massive sinus infection with a finish of bronchitis have lowered my tolerance for cigarette smoke to z.e.r.o. As I have spent the better part of the last four weeks at home, forgoing the gym, outings with friends and hockey games, I'm not very keen (what a quaint word, "keen") to be sick again anytime soon. My list of tolerable venues grows ever shorter as an increasing number of bars and restaurants in the Pittsburgh area apply for an exception to the smoking ban.

Bah.

We wandered briefly around Oakland. It was warm and the streets were crowded with students and fellow concert goers. The city is celebrating it's 250 Anniversary with a Festival of Lights and some prominent Oakland buildings were lit with abstract designs and film of wild animals in hotel rooms. On our way to the hall a couple asked us for directions and I resisted the impulse to send them to the Carnegie Music Hall in Homestead instead. Submitting to my better angel did little to aid the large number of attendees who confused the two venues and arrived after the show was well underway. Late enough for Byrne, to note their arrival in between songs.

David Byrne as minor deity, attired in white shirt, white pants and white shoes to match his toned down (but still slightly flamboyant) white pompadour hair. The band, backup singers and dancers were also dressed completely in white, which lent an on-vacation-resort-wear vibe to the evening.

Oakland's Carnegie Music Hall is a tiny, high, tight venue used mostly for lectures. The music reverberated through the hall, filling it with sound without feeling too loud. The temperature rose quickly, from the heat of so many bodies packed so close together and I could see how uncomfortable the band was by the end of the show.

My favorite part was the end, watching the expressions of pleasure and disbelief cross his face as he listened to the applause from the audience, completely in the moment.

As for poor kitty, she is back at home, perfectly healthy (in better health than myself actually) and pain-free after a through cleaning and extraction of her lower left canine tooth, which had a lesion large enough to expose the nerve.

Remedies

Remedy 1:

The waning days of this campaign have been tiresome. As Pennsylvania slips in and out of battleground status, the McCain ads have become increasingly negative and the rhetoric I am hearing has made me almost glad that my current battle with a massive sinus infection has stuffed my ears to the point that I barely hear myself speak, much less anyone else.

But I have found a remedy to the rhetoric. Every time I hear or read something completely asinine, I give money to the Obama campaign. I've only been doing this since October 10 and I have only made three donations, yet I feel as if I am doing something to combat the assholeness swirling around me.

My first donation came in the guise of a $15.00, long sleeved, Obama 08 campaign t-shirt. This purchase was precipitated by my accidental involvement in an email thread wherein the originator of the thread sent a link to a pro-Obama article, but forgot to BCC the recipients. As I was disinterested in a flame war, I sat back and practiced deep breathing in an attempt to lower my rising blood pressure. Yes, I should have hit the delete button, but I could not bring myself to look away from the train wreck.

It was the last message of the thread that provoked me to walk across the street to the Squirrel Hill Obama campaign office and purchase the t-shirt, as the sender stated “he looks good when he stands next to McCain on TV, and plenty of women will vote for him”.

Nice to know that a complete stranger has such a low opinion of women. The ritual of purchasing the t-shirt and chatting with the staff was soothing. “I know you are a Democrat” one staffers remarked as I waited behind a couple of middle aged women purchasing yard signs. “Because Democrats are patient, and you have that patient look about you”.

Fifteen dollars to Obama.

My second purchase was yesterday. Sick of the negative ads and given an opportunity to do a good deed, I trundled across the street to the campaign office, purchased $20.00 worth of swag in the form of a t-shirt, rally sign and buttons (including a “Steelers fan for Obama” pin) and mailed the entire bundle to a child in Canada.

Donation three came tonight, on the heels of one of my coworkers commenting that a vote for Obama was a vote for communism. Or was it socialism? The conversation began innocently enough, with him asking us if we were as ready for the election to be over as he was. Then it veered into crazy territory.

Presumably I will receive a special edition car magnet and possibly a t-shirt for my donation. When I suggested that I affix the magnet to a hidden spot on my right wing conservative B-I-L's car, as some sort of reverse voodoo curse, J rolled his eyes.

My only regret is that I did not do this sooner. I could have picked up a sterling silver Obama charm. Unfortunately, the website is sold out.

Remedy 2:

In addition to campaign fatigue, I have a sinus infection. Not just a little infection, but a full blown, head stuffing, ear clogging, sore throat, slowly losing my voice and developing a cough infection. So massive that I broke down and started taking full doses of day and night time cold medicines in the hope of mitigating some of the symptoms. I'm drinking so much water and herbal tea that I'm only sleeping three hours maximum at a stretch because that is the longest I can go without needing to use the bathroom. And I worry that one night I will not be able to wake up on time.

And none of it is working all that well. The cold medicine takes almost an hour to kick in and the effects last far less than the four hour claim on the box and makes me sick to my stomach. I'm having a little more success dealing with the sore throat with periodical doses of ibuprofen, but worry about how much damage I'm doing to my liver. The anesthetic throat drops are not all that numbing.

So tonight, in a last effort to bring myself some relief, I elected to experiment with a home remedy known as “irrigating the sinuses”. In other words, I shot warm saltwater up my nose.

I would not call it the most unpleasant experience, but the feel and taste of warm saltwater dripping down my throat into my mouth does not rank as the end all/be all of fun times. It did nothing to ease the pressure in my left ear, but did leave a pleasant tingling sensation and an urge to sneeze.

Burned Out?

I took a sick day today, a necessary measure to preserve my mental health as my stress and anxiety levels have been going up in increasing increments over the past several weeks. I've made multiple mistakes this week that indicate that unless I take a day off very soon, I am going to be suffering significant burn out.

When I woke up and decided to stay home, I used the awesome powers of the Internet to verify that I had no work waiting for me. That pleasant, confident feeling that I could take a day to get my head in order guilt free lasted until approximately nine A.M., when I called my manager to let him know I would be out.

Now it is nearly two hours later and I'm still near tears and my frustration and anxiety have increased even more. Suffice to say, it was not the most pleasant conversation. I found myself being called accountable for issues I thought I had resolved and communicated, including one item that wasn't my responsibility to begin with, but that I set up and taught the item's owner (as I was running out of time and had to leave by 4:00 PM yesterday) how to do, so he could do his job. And communicated to the project manager what I had done. And he (the task owner) did not do it. And I am to blame. Even though my manager told me “don't worry about it, I'll take care of it”.

I cried a little, because as much as I like to think I am some tough feminist woman, I am such a girl. I pulled up my resume and reactivated one of my job search accounts. I edited and refined and threw it out into the wild to see if I could trap an unsuspecting employer into granting me an interview.

But the tape in my head, the one that likes to turn on in such times, tells me that I am wasting my time. That no one is interested in hiring an almost 35 year old woman with such a spotty and inconsistent resume. That for all my varied skills and education, I am not valuable enough of an employee for anyone. Because I prize having some type of a life above ambition, I have basically killed any opportunity to move forward into something interesting.

So, yes, I am burned out. And I'm not sure what to do about it. Advice (seriously) appreciated.

End of the Saga

I am hoping that this is the last post on the state of my health. I can't seem to find a way of framing what is happening to me in a manner that takes in the broader issues of class and income. It seems petty to whine about the time, the expense, the stupid lectures when there are so many people in the United States without access to decent health insurance and/or reliable doctors.

Except I could not turn off the interior monologue, which became louder when the forms to appeal company X's refusal to approve a chest CT scan arrived in the mail. Seeing the phrase “suspected malignancy” in print is demoralizing. Waiting for information on procedures is demoralizing.

The arguments with Insurance Company X over which procedures are medically necessary, the trips for consults, MRI's and CT scans, the lecture from my mother over refusing contrast, all of this is making me weary. In between I've also had annual visits to the dentist and the optometrist and a consult with a periodontist. I have spent more time in medical offices in the past six weeks then I have in the last ten years.

It is not over quite yet, but it is close. My scans are normal. My blood work is normal. My x-rays are normal. I have orders for physical therapy on my left shoulder, to strengthen the tendon. I have an estimate for two gum grafts, to fix the recession on two of my teeth. And I have a GP who thinks that I have been through enough – and that I am normal.

Another Reason for Healthcare Reform

My GP has admission privileges to multiple hospitals in the Pittsburgh area.
She retired from one of those hospitals recently. She still retains privileges at several other hospitals and is still practicing.
The hospital [thoughtfully] notified all insurance providers in the area that she had retired.
The insurance companies, in turn, removed from the preferred/approved provider lists.
Because she is no longer on the lists (even though she is still practicing), my insurance will not authorize the CT scans she ordered.

Her office assures me that they are working diligently to have the situation rectified.

Gods forbid this happen to someone with serious medical issues.

Health - the Sequel

Today I had my shoulder examined by an orthopedic surgeon at UPMC Sports Medicine. According to the scheduler I spoke with last week, my doctor is an authority on shoulders, that is almost all he does and he is very good at it. According to several of his biographies, this particular doctor is also an assistant professor at the University of Pittsburgh Medical School and one of the Penguins' team physicians. According to one of our friends, who works as a sales representative for a company that produces joint replacement parts (seriously), he is highly respected and has his interns do a lot of the work.

I liked him. He was very clinical and extremely professional, almost to the point of coldness. Yet he managed to come across as a nice man, possibly due to the fact that he had to tie the back of my gown closed.* Which he did, in a very professional, business-like manner and surprisingly gentle manner.

He had an intern with him, also a man, whose primary function seem to be to observe and neatly print out the doctor's scripts.** I found the interaction between the two highly entertaining, as I sensed that the intern was restraining a large part of his personality in deference to the authority in the room.

The diagnosis was a torn rotator cuff, severity to be determined upon the completion of the MRI. Fraying will mean physical therapy, a hole or significant tearing will surgery. I was instructed to call and leave a message with his secretary after I had the MRI, as he suspected that the damage was minor and would only require physical therapy, which meant I would not have to see him again.

The MRI is scheduled for tomorrow afternoon.

And insurance continues to be a headache. As my first round of blood tests was (tragically) normal, my GP has decided to send me for a set of CT scans, just to be thorough. My attempt to schedule the scans was thwarted when I was informed that my insurance required pre-authorization. No magic number, no appointment.

*Moment Number One: I was instructed before the exam to tie the gown halter style around my neck, so my shoulders would remain bare. Somewhere between the telling and my brain's translation, the idea that I also needed to tie the back of the gown was lost.
**Moment Number Two: The script for my MRI was made out to my GP. I politely pointed out to the intern that my GP would probably disagree with the need to have an MRI and perhaps he could correct the name. Which he, highly embarrassed, did immediately.