Monday, August 4, 2008

ROLE REVERSAL II – A PRETTY HORRIFIC EXPERIENCE


It was almost like a deja vu, but not quite. I started having toothache last Tuesday. It was a dull nagging pain initially, which I tried to ignore (again). Not surprisingly, it got worse the next day & affected my sleep. My cheek on the affected side was a little swollen & I felt feverish. I decided to consult a dentist at my hospital.

I first called up the Dental Clinic. The staff who picked up my call advised me to go to the Staff Clinic, which has an ‘in-house’ dentist. Unfortunately, I was not allowed to register at the Staff Clinic because I’m not their staff (I’m only doing a 6 month attachment at the hospital). Okay fine. The next thing I did was to go back to the Dental Clinic. I was willing to pay as a private patient, but again I was not allowed to do so as I’m actually a staff. What the ****

I was losing my patience already & decided to contact one of the dentists personally. I told her my problem over the phone. She sounded quite alright. Since the toothache was troubling me quite a bit, she advised me to start taking antibiotic (Augmentin) & pain killers first before she attempts to do anything. It would be too sensitive for her to examine or do any procedure at that point in time. That seemed like quite a reasonable approach. I was also advised to do an x-ray of the troubled tooth & its adjacent counterparts.

As a very compliant patient, I did exactly as I was told. The dentist said she would look at the x-ray & let me know later via her dental assistant (DA). She said perhaps she could see me in 2 days time. Meanwhile, I should continue on my antibiotic & analgesics.

The dull nagging pain then became a more severe throbbing pain which not just affected my sleep, but my meals & my work too. Naturally, I tried to get back to the dentist. She was busy, so I spoke to the dental assistant. She said her boss’s appointment list is full for the next 2 weeks & I can only see her after 2 weeks. 2 weeks? The gods must be crazy.


(This is roughly the conversation between me & the dental assistant)

Me: Can you please tell the dentist that the pain is getting worse & it is affecting my work? (I was then put on hold for a while)

DA: Dentist say if you want MC, just come over to Dental Clinic & she will give you MC

Me: Then what about the x-ray? What did the dentist say about my x-ray?

DA: Dentist saw the x-ray. Didin’t say anything

Me: 2 weeks is too long, can’t you give me an earlier appointment? (put on hold again)

DA: Dentist will see you next week, Tuesday, earliest appointment


That night (Thursday), the throbbing pain got worse & I actually went in to the hospital for ‘a shot in the arm’ (intramuscular Tramadol). That was the only parenteral (injection) analgesic available in the ward. The jab was superb, my pain subsided very quickly & there was no more throbbing. But at the same time, I also became drowsy quite fast. This is a side effect of Tramadol, which is an opioid (as mentioned in my original “Role Reversal” post)

I slept on & off till the next morning. Took a cab (was still a bit woozy so decided not to drive) to a private dental clinic. The Dentist was fully booked from morning till evening (which was good & bad). Good because the number of patients usually indicates the doctor’s skill & bad because I might have to come back the next day or find another dentist. But something which I wrote (or declared rather) on the registration form made them offer to slot me in between their pre-booked patients (ie. Occupation: Doctor)

An x-ray was repeated & showed a small abscess at the apical region- not at the same tooth, but the one adjacent to it. I wasn’t surprised or in denial, unlike before. I had sort of expected this when I started having the pain. But of course, I can’t help asking why me?

Like I said in my old post, I’m an obsessive-compulsive teeth brusher, who does it so many times a day. Some people I know brush only once a day & nothing of this sort happen to them. Isn’t that so unfair? My mum said maybe it is because I brush so many times that I get this problem.

I spent the next 1 hour on the dentist’s chair (which sounds nearly as dreadful as the electric chair). LA (local anasthesia) was given to numb my jaw before the dentist did his job in drilling, digging & draining my diseased tooth. I was put on a pair of dark glasses throughout the session so that I didn’t have to see what the dentist & his assistant were doing to my oral cavity. I thought that was a brilliant idea, on the dentist’s part. I burnt a hole in my pocket for the procedure, x-ray & consultation fee, but I left the clinic a satisfied patient.

Back at home, I continued taking my antibiotic & pain killers (namely Paracetamol, Voltaren & Tramadol – but not all at the same time, milder one first & slowly go up the analgesic ladder).

While the dental problem is almost solved (follow-up appointment is in one week’s time), another problem arose. The day after my visit to the dentist, I developed generalised body rash with pruritus (itchiness) which was most likely a delayed allergic reaction. I think I fit snugly into the description of a ‘high risk patient’ (see “Hospital Terminology” post). Fortunately, the symptoms subsided slowly with anti-histamine from my housemate, who was already prepared to send me to the ED (emergency department) if I had started wheezing.

I do not know what caused the the allergic reaction. It couldn’t be Augmentin as I had been taking it for many days. In fact, I had the same antibiotic, on top of Metronidazole (Flagyl) during the first episode. It could be Tramadol but Voltaren is more likely the culprit.

The last time I had an allergic reaction was to a type of alcohol, about 2 years ago when I was still in Kuching. I had pruritic rashes & asthma attack, where I sought treatment at the ED of my old hospital. In New Zealand, where I drank alcohol only on social occasions, I only experienced rashes but no wheezing. After the episode in Kuching, I had stayed away from all types of alcohol. Maybe that’s a good thing.

Anyway, what puzzles me now is that I never had any allergies to medication in the past. I had taken Ponstan before for dysmenorrhoea (period pain) & Voltaren is from the same family. Oh well…I guess life isn’t interesting if there are no events once in a while…

2 comments:

Gasman said...

Dino, I think you brush too much la. Next time ask me to give you nerve block la... Facial N block...

kaybee_dino said...

yes, i think i need that..