Dividends from Unnecessary Surgeries
Last week, I had a root canal. Actually, I had Part 1 of the root canal in September and Part 2 last week. The tooth had a previous root canal and a thin metal rod held the tooth together from root to crown. An unfortunate dental student drew the lottery ticket for re-treatment of this tooth. She drilled away for a couple of hours in late September, excavating pieces of rod until she was exhausted, but she didn’t find a problem. I left with a temporary filling and an appointment to return. Through October, the tooth continued to ache. An upper molar on the right joined the chorus. And then it hit me—the problem wasn’t a tooth.
In the back of my mind, I heard a doctor asking, “How are your teeth?” He was an infectious disease specialist I was seeing about the chronic infections in my eyes. It was August.
“Okay, I guess,” I said. “I have a couple of cavities.” I was seeing an endodontist for re-treatment of a root canal, but I didn’t think it was significant.
“That’s okay,” he said. “That’s not what I was concerned about.”
Awareness began when I saw ENT #10. Dr. D examined the surgery report I’d given him. “Normally,” he said with frustration, “with a Caldwell-Luc, you go in through the cheekbones. But that’s not what he did.” He shook his head. “He went in through the tooth roots under your lip.”
I didn’t grasp it. My cheekbones have sunk since the surgery, especially on the right, so I know that bone was removed from them. I can see the post-op collapse of my maxillary sinuses on CT scans. I’ve read about the obsolete surgery Dr. S performed, the Caldwell-Luc. I know that holes are drilled through the cheekbones in order to access the sinuses. Of course, that’s what he did—but wait—
Finally, in October, as I lay in bed reading to the throb-throb of my upper molars, a neural pathway formed connecting the facts. I got out the surgery report and read: “a Caldwell-Luc approach with trocar obturator under the lip with careful preservation of tooth roots and infraorbital nerve was done.”
When I returned for the finish of the root canal, I took the surgery report. “Maybe it’s not the tooth,” I said. The dental student finished the tooth and didn’t find a problem. She filled the gigantic hole she’d made. She took an x-ray and showed me the result. “A future dentist might wonder why your tooth looks like this,” she said. It was the Guinness Book of Records root canal. Barely any tooth remained. “You know why it looks like this,” she added, referring to the excavation.
My brain was busy with a recalculation of damages.
“If the pain becomes unmanageable and it’s coming from nerves and not the teeth, we would refer you to a neurologist for pain management,” she said.
“I don’t want to be on a lot of drugs,” I said. “I had to go on Klonopin after the surgery so that I could sleep. I’m weaning myself off now.” In fact, I had been crying every day for two weeks since cutting my pills in half. Going off a diazepene is a painful process.
Coming off this drug, I am rediscovering pain that I thought had healed such as throbbing in the bridge of my nose, which was cut and narrowed—to the mystification of every doctor I’ve seen.
I’m wondering how I stifled so much awareness. How did I keep from knowing, for two years, that my teeth were at risk? I’ve read this article many times: http://www.urmc.rochester.edu/smd/RAD/neurocases/Neurocase238.htm . In part, it states, “The main complications associated with the Caldwell-Luc procedure include oroantral fistula (breakdown of the gum incision with communication between the mouth and sinus), rare osteomyelitis, infraorbital nerve injury with associated hypesthesia, injury to the tooth roots and tooth discoloration.”
And how did I keep from knowing that I was medicating pain with the pills I was taking for sleep?
Maybe we protect ourselves from too much awareness.
It has taken two years for the pain in my teeth to commence. I guess I can count on new dividends from these unnecessary surgeries for life. I went to an ENT with a case of tinnitus, and now I’ve got tinnitus, facial and nasal pain, nasal dryness and dysfunction, breathlessness, a deviated septum, collapsed nasal valves, rhinitis, a Klonopin addiction, tooth pain, dry eyes, cosmetic facial issues, osteoporosis, osteoarthritis, and worsened sleep and fatigue. Those are some impressive returns.