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Doctors, Doctors Everywhere

Posted Aug 21 2009 12:39pm
. . . and not a drop to drink?

Well, actually, scratch that, because I think I might actually need a drink after the fiasco I just endured over on Madison Avenue. And to be totally honest, you might want to grab a drink too, awesome readers, because this is a heartbreaking saga of sheer ridiculousness -- you know, the kind of ridiculous that only I can seem to really pull off for some reason. And, like all truly epic stories, it begins in a dentist's office.

Okay, not really, because it truly began in midtown Manhattan traffic, which is, I assure you, probably the only place on earth I would LESS like to be than in the dentist's office. And this particular cab ride up Madison Avenue was made all the more pleasant by the 90-some-odd degree, incredibly humid day outside our dirty and grafitti -laden cab windows. And yet, I felt oddly calm, like a woman with purpose, a woman on a mission . . . in other words, like a woman who is listed for double-lung transplant and needs a root canal.

Yeah, that kind of woman.

As a root-canal virgin, I wasn't entirely sure what to expect, so I brought along my mother for moral support. This was frustrating for both of us, because I've been really trying to attend more of my transplant center's "lung group" educational/support meetings lately, and unfortunately the only time available for the crucial root canal also happened to overlap with a particularly interesting looking group meeting on post-transplant meds. I had hoped to at least send my mother up to take notes, but kinda chickened out at the last minute and decided I needed/wanted her to be with me (you know, in the waiting room doing nothing, where she'd be most useful in my warped perspective). So here we both were, in the cab, on our way to what we knew wouldn't be the most pleasant of experiences, and silently kicking ourselves for missing something educational and informative up at the hospital. Oh yeah, AND we were hot, did I mention that? Because it was really , really hot .

Anyway, we arrived at the dentist and I gave my name and quickly got called back to go sit in the dreaded root-canal chair, which I'm convinced is somewhat on display so you can serve as a cautionary tale to other patrons and especially young children ("look, little Timmy, see that woman over there squirming in pain and trying not to cough? That's what happens when you don't floss every night!"). So I sit. And I sit. And I wait. I sit. I wait. I look around at all the posters of radiant smiles and wonder how they really get their teeth that white in just two simple treatments. And I wait.

Finally a nice young dental hygienist comes in and says that, due to my medical record and the drugs I'm on (admittedly a scary number of antibiotics for anyone whose calling card doesn't read "professional drug tester"), the dentist cannot treat me without prior medical clearance. Which, of course, had never been mentioned to me before because, after all, I'm just the patient and the only link between my doctors and my dentist. So you know, why bother telling me this?

In other words, the situation as it was explained to me is pretty simple: Because I'm listed for transplant, I need prior MEDICAL clearance in order to get a dental procedure that I need to get in order to get DENTAL clearance for the transplant listing.

Yep, makes sense to me.

It made even more sense when I learned that the medical clearance has to come from my prescribing doctor (i.e., my CF doctor - NOT my transplant team) and then the dental clearance needs to go to the transplant team (NOT my CF doctor). So doctor A must give clearance to dentist B to work on my teeth so that he can give further clearance to doctor C, so that doctor C's partner, surgeon D, can eventually remove my old, nasty CF lungs (cared for by doctor A) and replace them with new, pretty, healthy lungs to be cared for exclusively by doctor C.

Okay, fine. I get it, huge hospital medical bureaucracy, you're just trying to prove a point. Show off a little. Well, bring it, because I was not to be defeated. Instead I promptly insisted that despite my inability to get a root canal (and I resisted calling the dentist a "wimp" for being too afraid to work on a CFer ), I wanted to see the dentist anyway and get him to give me a full mouth exam. In other words, confirm that the root canal is in fact all that needs to be done. And once he had done that, I gave his lovely hygienist the number for my transplant coordinator and instructed her to tell them that I had been fully examined and that I had rescheduled my root canal for the following week because of a need for medical clearance. Finally, I called my transplant team myself to confirm that this information from my dentist would be enough to serve as "dental clearance." Thankfully, it was.

So in other words, I need medical clearance sometime before next week and then I can get my tooth fixed and life will go on as normal. My transplant team, in the meantime, is satisfied, and I feel like I actually turned a bad situation around at least a little to get a somewhat okay result. As for the medical clearance, in all fairness this wasn't something that was on my CF doctor's radar at all, since I never told her I was going to the dentist (although I did tell the transplant team, multiple times). And since I hadn't been told at all by anyone that I needed such a clearance, I guess I really can't blame any one particular doctor for this mess either. To be honest, everyone was really nice about it all, if a little confusing.

The saddest part of the tale is that I still missed my transplant meeting, but I guess it was worth it just for the minor victory of getting the dental clearance through to my coordinator. Then again, on the bright side, now I have a whole new week to be excited about the root canal all over again.

Thank goodness for happy endings, right?
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