Monday, September 12, 2016

Health Update – the dental saga continues

My next transplant appointment is in roughly two weeks. I had hoped I’d be listable by then, but it’s not going to happen. The dental saga continues.

Honestly, I’m a little frustrated.

I need a root canal before I can get dental clearance. After much back and forth (that I won’t get into here) the doctor that was going to do the procedure now cannot do it. The problem is that my cough is so bad; I can’t promise that I can not cough during the procedure. 

If you’ve seen my cough, you know it isn’t a dainty little cough. It is a violent cough. It can go on and on and on sometimes. So, the plan was to use sedation. The only way to stop the coughing, however, was to do general anesthesia. My pulmonologist (rightly so I think) nixed doing it at an outpatient dental anesthesia center. I was very worried all along that this plan wasn’t the best one, but everyone seemed to think I was overacting – so instead of checking this out first, plans went on and only came to a halt days before this was supposed to happen.

I know root canals are not bloody procedures. After my experience last February, however, it isn’t the expected bleeding I was worried about. It was the ability to handle unexpected bleeding. I met with my hematologist (who I LOVE!) and he put my mind greatly at ease about that issue.

The other concern I had was how I would bounce back after the anesthesia. Before I was on oxygen and had procedures done my oxygen levels would never require oxygen afterwards, but they would drop to the low 90s when they were always 98 to 100 percent before. I don’t have much reserve these days. If I do need oxygen after a procedure, it might be more than the average person coming out of the fog. I was very worried about this being adequately managed in an out-of-the-hospital setting. My pulmonologist agreed.

So, the good news is that if I have this done, it will be at the hospital. I expect that if it goes smoothly, they’d just send me home afterwards. But, if my lungs are a little sluggish afterwards, they have the option of giving me high flow oxygen and keeping me for observation. That goes a long way to helping with my anxiety about this.

The bad news is this will mean seeing and getting evaluated by dentist number four – one with hospital privileges. That could take some time to set up, and I’ve been working on this since my six-month exam in June! If I’m close to being listed, my feelings are (excuse my language) but screw it – pull the xxxxxx tooth! When it comes down to teeth or lungs, I’m going for those lungs baby!

Because I am already missing a back tooth on that side of my mouth, I wanted to avoid pulling it. I suspect that pulling it will mean some other work long term.

So, now my plan is to see where the transplant team is at in regards to their thoughts about me at my next appointment. If this is the one thing holding me back, then I know I can get it pulled relatively quickly. If, on the other hand, they want to see me again in a few months before doing anything, then maybe I have time to save the tooth.

I’ve always had anxiety about being listed. Who wouldn’t. But, now I’m feeling more anxious. In the pre-op for the anesthesia, I saw a copy of my CT report that was to be given to me at the next transplant appointment. (Not that it is a secret – I just didn’t see the point of worrying about it until the next appointment.) The report says there has been some progression. This doesn’t surprise me. I know my normal oxygen for casual walking has gone up a liter. To walk fast, I need more than the little concentrator can generate. I have to check myself and remember to walk slower, which is hard to do sometimes.

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