Wednesday, December 9, 2020

A World Of Hurt

Remember when I said my body was all healthy and raring to go for another embryo transfer? Yeah, I spoke too soon. (Which is part of the problem with blogging – I suspect it invites calamity to keep things interesting.)

See, there’s this tooth. No. 19 for those in the know. I had a root canal on it in my teens, a crown put on it in my 20s, and for the past few years, it had been bothering me for a day or so every few months – just a mild, achy sensation that I couldn’t exactly pinpoint. I didn’t think too much of it because I’d had a root canal, after all – how could I possibly have any sensation left in a tooth with no nerves?

Clearly, I didn’t understand dentistry well enough. (Though as I’m learning, neither do the so-called dentists.) Finally, one night in November, this troublesome tooth woke me up, throbbing. I popped a couple of Advil and decided that was it, I was going to take care of it. With the transfer looming in December, I didn’t want any future dental surprises while pregnant.

Cue insane circus of trying to get a referral to – and an appointment with – an endodontist. When my efforts proved fruitless, I called a dentistry chain that advertised itself as affordable, offering a free exam and X-rays for new patients. This was attractive to me because I haven’t had dental insurance in at least a decade. They could see me right away, so I went. After an unnecessarily long and involved appointment, the dentist there, who we’ll call Dr. DeVille (for reasons that will soon be clear) said that it looked like there might still be some nerve left on my tooth and that I should see an endodontist to have the root canal redone. (Bangs head against wall.) I asked if I shouldn’t just have the tooth extracted instead and she said no, that wasn’t necessary. Oh, and by the way, I had a cavity. (My second one this year. WTF?!)

The endodontist Dr. DeVille referred to was available to see me the next day, so I went. The office was so fancy – white leather seating, massive flat-screen TV, fireplace, silver statues of animals – that I didn’t even feel like I could afford to sit in the waiting room.

The endodontist was nice, but he seemed young and inexperienced and after reviewing even more X-rays of my tooth, he said he could certainly redo my root canal, but he wasn’t confident it would be successful. And if it wasn’t, then I’d be looking at nerve surgery and a type of filling I’d never heard before (something about from the bottom up). The cost for these procedures? $2K. Each. Ouch.

I asked the endodontist what would happen if I did nothing. “It’s just a matter of time until it flares up again,” he said. “Then your face will swell and it will be very painful. But you could do nothing, for now. I don’t think it will give you a heart attack.”

At first, I thought he was joking. As in: it won’t stress you out. But then I went home and Googled. Holy shit. An infected tooth – even a latent, painless one – can cause a heart attack!

Given my Familial Hypercholesterolemia diagnosis, I knew I had to do something. Was it worth $4K to potentially save my tooth? Or should I just have it extracted, for a measly $338 at Dr. DeVille’s office? My husband had recently had two teeth pulled (at a different clinic), and after about a week of narcotics and soft foods, he was back to normal, running and chomping away on all his favorite crunchy snacks. It didn’t seem like that big of a deal. He was in favor of extraction.

Given how much we’d just dropped on our upcoming embryo transfer and the future costs of another baby, it seemed like a no-brainer. I’d get the tooth pulled.

Oh, but can anything in (my) life be that fucking simple and easy? Of course not.

I cried every day leading up to my extraction appointment. I had been hoping that someone along the way would say, "You're too young to lose a tooth!" But no one did. I really didn’t want to say goodbye to my tooth – especially since it had stopped hurting – but I also knew that I didn’t want to risk a dental emergency after getting pregnant – or even after the next baby would be born. There is no such thing as “taking it easy” when you have little kids. 

The extraction was traumatic. I was completely numb, so I felt no pain during the procedure, but it was as medieval as dentistry gets. At one point, the dentist (not Dr. DeVille; a colleague of hers) wrapped her arm around my head, pulled me into her bosom, and then used some kind of terrible tool to tug my tooth back and forth, back and forth. Halfway through the procedure, I thought about jumping up and saying, “Never mind! I want my tooth! Put it back! I’ll pay anything!” But I knew it was too late to change my mind. It will forever be one of the worst decisions I ever made.

Finally, the tooth came out. The dentist showed it to me. It had a little gummy gurgle of blood at the bottom of the root. “That’s the infection,” she said. “It’s out now.”

I thought the worst was behind me. (Ha!) Though I’d asked about antibiotics and prescription pain killers, the dentist swore I didn’t need either. (Huh.) She sent me home with instructions on how to “stack” Advil and Tylenol, which she swore was just as effective as an opioid. (Hahahahahahaha. No.)

For two days, I blended and drank all my food and popped the Advil and Tylenol on schedule. But the pain was starting to assert itself. I called the clinic and Dr. DeVille said that as long as my pain was constant, not increasing, I didn’t need to come in. She sent in a prescription for Tylenol with Codeine – but because of insurance issues, the pharmacy wouldn’t release it to me. Thanks to the opioid addicts of the world, there were a gazillion restrictions on pain meds and I had to wait a whole other day for Dr. DeVille to resend it to a different pharmacy, where I paid for it in cash.

I’ll try to spare you the minutiae of what turned into the second-worst weekend of my life (after my hospitalization for endometritis earlier this year). Suffice to say that the clinic’s 24-hour “emergency line” was bullshit. If I did get a call back (often, Dr. DeVille would text me instead, clearly as an avoidance strategy), she would just say that I should take more meds, that I would feel better soon, and that if I didn’t, I should go to Urgent Care (which I didn’t want to do because what do MDs know about teeth?). I asked multiple times for her to meet me at the clinic for evaluation, but she refused. I sent Dr. DeVille a picture of my extraction site, worried that I had developed a condition called dry socket (where a blood clot fails to form, or forms and falls out, leaving the bone exposed) and she blew off my concerns. I didn’t want anything to be wrong but I couldn’t ignore my instincts, either.

By Saturday night, I was in so much pain I couldn’t stop crying. I left the sleeping baby in my husband's arms and went to Urgent Care – where a doctor immediately diagnosed me with dry socket. (Thanks for nothing, Dr. DeVille.) I asked for a Percocet prescription, but of course the doctor, like everyone else, was a pussy when it came to prescribing narcotics. He wanted to try all his other options first. He shot me up four times with the weakest form of numbing agent I’ve ever had. It was no match for the throbbing in my gums. He filled the socket with paste. That did nothing. Finally, he printed off a Percocet prescription (because doctors can’t call these fucking things into the pharmacy anymore; thanks again, addicts) and I hauled ass to the only pharmacy within a 30-mile radius that was still open that late at night.

I arrived home at almost midnight, exhausted and in excruciating pain. I took the Percocet and some penicillin and got into bed with my baby, hoping I wouldn’t roll over on her in my drug-induced slumber. Yeah, well, no worries about that because I could barely sleep.

By Sunday morning, my mouth was not only still throbbing, my face was flushed red and swelling. The whole point of pulling the tooth was to avoid a dental emergency, yet here I was, toothless and having a dental emergency. I paged and texted Dr. DeVille and when she didn’t respond, I left her a tearful voicemail begging for an appointment. Apparently, she had had enough of me. She texted me saying that she was “referring” me to her boss, who was just as insensitive and who also refused to call me or meet me at the clinic. All he was willing to do was make sure I got an appointment on Monday. (Gee, thanks.)

Unable to stand the pain anymore, I found the only emergency dental clinic in my area that was open and took the first appointment available.

“They treat dry socket at Urgent Care?” the emergency dentist asked.

“Not very well,” I said.

“Huh. Did you hear that?” he asked his assistant. “Maybe I should start treating bladder infections here.”

He struck me as kind of a frat-boy type, though his music of choice was the kind of country that’s desperately trying to be cool. But I forgave him, because he knew his shit and took care of me. He told me that my nerves were going wild, like phantom pain. He got me completely numb, then scraped out the dry socket, put a medicated “pack” in, and sent me on my way. Though I couldn’t feel half my face for the rest of the day, I also couldn’t feel the throbbing.

Monday morning came and I was feeling somewhat better – by which I mean, I didn’t want to die. (I haven’t mentioned, but should, that in addition to reducing my diet to liquids and purees, the extraction also meant I couldn’t exercise. At all. So all my eating disorder triggers were being pushed at this point, too.) I had few coping mechanisms left. When I prayed, all I could manage to get out was, "Help me. Heal me. Please. I beg of you." When I meditated, I imagined my body being remade by God in heaven as the Bible promises it will be. Weightless, painless, free to move about as I pleased – and all my teeth in-tact.

On Monday afternoon, the dentist that pulled my tooth saw me again and said my healing was within normal range. I would be back to myself in, oh, about two weeks. 

“Two weeks?!” I thought. “Where was the warning?”

Another memo I didn't get: dry socket is more common in lower extractions. It's also more common in women taking hormonal birth control pills, which I was. Thanks for the heads-up! 

Had I known how awful this experience was going to be, I gladly would’ve forked over $4K to avoid it. I would still pay $4K now if there were any way to put my (mildly and rarely painful, if infected) tooth back in my skull. 

Why am I telling you all this? Well, for catharsis, first of all. (My therapist isn't available until next week.) But this really isn’t about my tooth. Or rather, it isn't only about my tooth. It’s about how much one person can take.

One of the things I hated about this ordeal was that I felt like I was trapped in a cage of pain and I couldn't interact with the outside world, where everyone else was going about their business as usual. I couldn’t be present for my baby. There were many moments when I would just sit on the floor with her in my lap, but I was too preoccupied by my pain to read to her or sing to her or even smile at her. I just couldn’t be there for her in any meaningful way. The pain demanded my complete attention. I was a zombie mommy.

Normally, being in my body feels like riding a brand-new Ducati – smooth, sleek, fast (sometimes too fast). OK, it doesn’t feel that great all the time, but right now, my body feels like a rusty tricycle with a crooked wheel – slow, awkward, in need of repair. And I can’t trust it.

Rather than being in a joyful state of preparation for the embryo transfer, I am freaking out (a recurring theme). And because one freak-out begets another, I can’t help but wonder: If one little tooth could take me down this hard, why am I thinking about having another baby? 

I’m worried about how long my mouth is going to take to heal. I’m worried about the amount of drugs currently in my system. I’m worried about traveling amid coronavirus, especially if my immune system isn't strong. I am worried that I can’t handle any future health problems that might arise if I have two little ones depending on me. I’m worried that I should be prioritizing the restoration of my own health over trying to build another human being.

If pain is a message, what is mine trying to tell me? (Other than the government needs to lift restrictions on Percocet just for me, please and thank you.) Is this tooth saga a sign that I should not proceed with the embryo transfer? Should I delay it? Cancel it? Trust that in a matter of weeks I’ll feel better and this will all seem like a foggy, distant nightmare?

My husband keeps saying, “This too shall pass.” Of course it will. But will I come out of it all right? I keep telling myself, "Tomorrow will be better," but I don't fully believe it. I've been in a near-constant state of pain for a week now.

I wish I had a panel of infertility warriors, medical specialists, and competent dentists to consult. I wish I could trust my decisions. I wish I knew how to be patient – with my body, with other people, with adversity. I wish I didn’t have to blog these things to feel some relief. (How do you people who don’t write everything down do it?!)

Do you know the poem "The Guest House" by Rumi? It goes, "This being human is a guest house. Every morning a new arrival." Well, the guests in my house right now – pain, anger, anxiety, regret – are assholes and they need to get the fuck out. I have to tidy this place up and prepare it for a guest who actually deserves to be here. Because I should move forward with the transfer, right? Right?

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