Wednesday, February 27, 2019

Dental Dystopia

The people that usually get to hear my bitching and moaning are out of the PST zone this week so you my lovely social media friends get to slog through it with me.
I have decided that this writing style is called data dump.  A kind of DIY. You get to mix and match the paragraphs yourself to maximize the entertainment value.
I'll try to interject some of my trademark dry wit, but with the recent rains even that got damp.

Really feeling the po'folk vibe this week. This part of the saga started over a year ago. I had gone to Oildale Dental for years. They took MediCal and DentiCal. When another tooth needed root canal and crown they stalled me. They put me and my missing tooth off for months. DentiCal had just expanded what they cover which should have made it easier. It didn't so they never bothered to submit my tooth repair to Sacramento. I complained until the staff gave me a list of other providers that they recommend and circled the one they recommend the most.  That is where it all started to go wrong me thinks.

I won't give the name of the place right now while I'm still going there. Have to see how it all works out. I may feel the need to warn others and will update this accordingly.

The first procedure was a couple weeks after my first visit on March 9 of 2018. It took 6 weeks to get that one. The young Dr whose name is no where in the office started to drill out the roots of #10 & #11. Front tooth top [my left] and the one left of that. #11 the lefter of the two didn't want to be drilled so he put some kind of dental 'liquid Wrench' down in it with a syringe. A week later he said it was unrootcanalable. I know from my many previous dental misadventures that a periodontist could have done the root canal but a cheap office like that one doesn't send work out. Not to mention the 4 to 8 weeks DentiCal approval takes and the yearly cap on those benefits. I said "Go ahead, pull it".

The upper dental plate I had been using for 4 years was now 1 tooth short leaving a 2 tooth gap in my smile. This was about the time tooth #6 the upper right canine broke off. I blame diabetes or maybe the other medications I take to save my life. Don't know if it's factually true but it's a working theory. At any rate the upper plate now moves around so much I have to use dental super glue to keep it in place. After the new crowns are approved and installed they will add a tooth to the upper. They lied and said the plate was not covered and I'd have $200 out of pocket for the upgrade.
Last time I posted about this on facebook a guy I know complained about what it costs him for his competently done in a timely manner and where they don't cheap out by using budget Novocain dental work. Really dude? I paid into Social Security for 40 years so I'd get looked after if I ever got disabled. Hundreds a month under the poverty level to live on is not looking after me. Other programs like Medicaid (medi/denti/cal) are all I can afford. $200 for a fixed dental plate literally means nothing but rice and beans for another month. Oh my, you can only afford 8 weekend holidays out of town this year. Cry me a river.

Months pass and I don't hear from them. I call and the office manager assured me that she'd submit my x-rays for approval again. In September I get the call to come in for that front crown. Yay. It takes 1 visit plus one for the install. Feels kind of big in my mouth but I'm not trusting this guy to file it down enough without breaking it. The new upper plate will stop that slight touch where lower tooth hits it. "Yeah, feels good doc". He admonished me to always wear the dental plate when eating so it doesn't get stressed.

Come January 2019 approval for root canal of #6 is in. Young doctor and his even younger assistant are doing what young guys do. Showing off. The assistant did the x-rays holding the little photosensitive panel in his hand during the flash of x-rays. At least a dozen x-rays. I asked him if this wasn't risky for him. "Not at all" he told me and pointed to a Gov't flyer that said 604 exposures a year were just fine. I did some math in my head but kept my tongue. A co worker of his over heard the exchange and gasped. That should ripple through the office.

That was on a Thursday. The next day #6 hurt even more than it did after the budget Novocain first wore off. Upper dental plate no longer fits due to swelling. Saturday was pretty much lost to pain. My little KitchenAid mini chopper did chewing for me as it did a couple of years ago.

I went back early on Monday. The assistant talked to me first. Not much English is spoken in that office so he does a little pre-interview. Then tells the doctor what I said so when he comes in we are kind of on the same page. The doctor speaks English, just not often enough that he is overly confident. He gives me the jazz about how this might happen. You have to let doctors, even dentists, feel like they figure things out for you. This time I just said "It's infected, just, just, give me some antibiotics". He asked about pain and I said ibuprofen was taking the edge off. Something stronger might have had more entertainment value or let-me-sleep value but I let him decide. Throw him a bone cuz I still need him to finish this project.

• I had been limping because the arthritis in my left hip has gone rogue and attacks me on the regular.
• Valentine's day was the next week, I hadn't asked a woman out in forever so I kind of did. That rarely went well when I had some practice so of course; no go. Later at home things went a little sideways. Was the universe rebelling because I was trying to expand my part of it. I'm not all that dialed in on magical thinking, but maybe I should be*.  It might have been one of the other comedians earlier that night, who while telling a story back stage about Nazis yelled an incantation, "Hit 'em in the ACL, Hit 'em in the ACL!". Later as I sat down to a late dinner my right knee kind of snapped. Such a shock of pain. WTF? Felt like a blow to my Anterior Cruciate Ligament. Hopping around looking for my cane.
• 2nd Saturday in a row all about pain.
• 2nd Monday in a row with a doctor. This time it's an urgent care doctor telling me it's just a sprain. He said my old neoprene knee brace will just do fine. He gave me some smelly topical analgesic because he doesn't believe in ibuprofen. (Sigh) doctors.
• Between the knee brace, walking with a cane, and shock of pain every time I stand up the left hip is attacking me even more and the right one is not happy.
The following Saturday was relatively pain free. I am used to a certain amount of pain but extra pain that sharp stabs every so often is exhausting. You can't help but to get all pissy and grouchy on days like that, people stop talking to you like you have control over what feeling like shit does to you.
I went to a store in my part of town that was having a sale. They were giving out free hamburgers. As I got home and was finishing my free burger the front tooth crown #10 fell off.
• 3rd Monday in a row with a doctor.

I called the dentist's office again. They said to come in at 1:30 so I could be first after they got back from lunch.

My gal pal, let's call her Gina, is in Paris with friends staying in a historic apartment like you see in the movies. We are texting each other through WhatsApp while I am waiting in the waiting room. She, of course, has a more horrendous story of dental misadventure that happened just days before. WhatsApp's speech to text is the best but kept wanting her to be speaking in British english. Here is the gist of what she WhatsApp-ed to me:

Everybody is so civil here and not like anything we can relate to [back in the states].

One of my molars shattered. So I go see this guy a few doors down operating out of a similar flat to the one where I'm staying. He's turned one of the rooms into a waiting room. Another room has a dental chair and an assistant. Office/flat is very common in Paris. It's sort of under the table but in a very fancy way. No paperwork. The guy knew my name only because I told him.

He is an older man, mature, seems very professional. He throws me in this chair.

He works ferociously fast then tells me he thinks he can probably save the tooth but it will need a root canal. His English is very broken. I tell him if it can't be saved I don't want to pay to have him just work on it. He's rushing like crazy. Tells me "got to do the root canal" then he'll put in some temporary cement in. Next week I can come back for permanent cement, that way I can go to the States and get a crown. So I say "ok great what's the cost" and he says "well, €150 cash today for the root canal and the temporary cement.

[This is where it gets interesting]
I say ok. Then he said open your mouth and he starts doing the friggin root canal.

No warning. No numbing whatsoever. No topical numbing. No injection. He just told me to not talk and keep my mouth open. It made me wonder; perhaps it doesn't really hurt to get a root canal because I don't think he would neglect to give me anesthesia. So I thought to myself; ok go for it. He is working so fast and then says "if you feel some extreme pain just raise your hand". He's going down four different routes because this molar has four roots. Of course there were couple times when he hit the nerves. They each hurt to different degrees but overall no big deal.

So he does a frigging four root root canal without any anesthesia whatsoever.

He slaps the cement in and then "You're done". He didn't suction out or clean out my mouth or give me anything to rinse my mouth out so I've got pieces of cement in my mouth. I had to take a sip of water and spit it out on the street.

First a young woman took me to the just for x-rays room and took a shot of where #10 was not. She even ducked behind the door way to snap so she wouldn't get a dose of X-rays. Again I talked to the assistant first then my young dentist doctor. He tried to tell me that he said to always cut my food with a knife. WTF? I have had 6 or 8 crowns in the past. If the doctor knows what he/she is doing they work like natural teeth. I told him what he did say. "Always wear the dental plate when eating and no crunchy food". He didn't seem to know what crunchy is. Skating over the fact that with #10 missing from the plate and me not being able to wear the thing for several days meant that crown #11 went unsupported. I didn't get a chance the mention my mini chopper doing the grunt work of chewing by making everything into slaw.

I said "How is a burger so tough that it broke the crown off?" He shrugged then showed me the x-ray where the broken off post is placed deep into the root of #10. Then we look at the crown, where it broke off. A single thin wire to handle the stress of thousands of bites. A more durable post to anchor the crown to, takes more time and materials I have to assume.  "What can be done to fix this doctor?"

A few moments later a roundish 30s-ish Latina with hypnotic green eyes comes in to give me the scoop. She informs me that adding 2 teeth to my upper dental plate is a covered benefit (Hmm it didn't used to be). She is speaking haltingly in a thick accent and only giving me flashes of eye contact. Could be a cultural thing but I'm doubtful. Then she says the plan is for me to come in the next day early so they can make impressions of my mouth. I tell her: "Okay but I thought we had been waiting (a year) for the crown on #6 so the plate will be snug the right way." She doesn't really respond to that just tells me that when the updated plate come it they will extract the root of #10. That way the plate will some how help it heal faster?
I think I should be expecting the bum's rush after they do that.

The following Friday 10 minutes before they closed for the weekend I get a call that the altered dental plate is ready. I get 10 to 15 calls a week and maybe 1 is actually a call I need to take. My phone's ringer is never on. At 5:14 pm I see that I had a call. I left a message that I got their call and would like to schedule the install/extraction "please call me at . . .".
Monday comes and I tend to other things in the morning assuming they would call me. At 11 I call them. The phone answering person thought it was weird that I would have an extraction the same day. Appointment set for Tuesday at noon.
At first it took 6 weeks to get an appointment. At least 4 weeks to get an appointment after DentiCal approved each procedure. The the last 4 appointments were next day or same day. I wonder if the doctor whose name is on the door even works there any more.

Tuesday arrives. I didn't get much sleep and learn why I don't do arm's length selfies. No jowls, more than double chins.  Yikes, what's with those whiskers? Am I even human?

I did wash the blood off my teeth when I got home.

I am led to the dentist's chair by a new assistant. I make a point of looking at young Doctor's name tag.  Carlos (something I can't spell) DDS. He puts the modified upper plate in; it is a bit tight but has promise. This time he uses novocaine that lasts longer that 15 minutes.  There is nothing above the gum line. I figure that he will have to do the thing where he drills a hole then screws into it so he can leverage the root out.  So of course he tries 5 different approaches first.  Drill-in-pull doesn't get all of it so then he chips away at it with needle nose pliers for a while.
Finally the plate goes in and fits really well. He grinds on it here and there a little. Tells me I'm done.
I am told to keep the plate in to stop the bleeding and so it will heal faster.

A decent outcome despite too much pain and having to wait and come back and back.

For the first procedures DentiCal sent me duplicates of the approvals. I have not gotten anything since before the crown on #10. Will the crown for #6 ever be approved? What about fillings for front teeth #9, #8, & #7?  It would be nice if they all were the same length. I had asked them about it when the crown went in. They acted like they had never heard of such a thing. I'll give approval of #6 a month then back to Oildale Dental I guess, I know they do fillings.

* One thing I haven't mentioned has to do with if I should feel superstition about the dentist's office itself. Does the place have bad juju? My mother took me to that same office when I was 9. At that time it was inhabited by a diet doctor. He molested me during an anal exam. WFT? Why would a diet doctor need to probe around in my juvenile butthole with the lights off?
After this last set of experiences; I don't know what to think.