Of Infected Teeth and Misplaced Compliance

I’m sitting in the emergency room at my local hospital, the victim of a tooth infection run amuck. While most people might be frustrated at the waiting and scared at the situation, I’m mostly curious.

Curious about how things are run here, what they’re doing right, what they’re not doing right. Here’s the main thing I can report: There really is no privacy in the ER. I can hear everything the staff says, the reports over the radio, and, from the vantage of my room, see everyone coming and going. I know that a 10-year-old girl with nausea and wooziness was brought in a while ago; she’d taken some NyQuil earlier in the day and had a cold. I know that about 45 minutes ago my nurse asked someone else to ask my doctor if I could have pain med (30 minutes after I first asked for the pain meds). Oh, and still no pain meds.

I liked being wheeled in my bed to the CT scan. Felt like a queen. Even kind of enjoyed the warm sensation of the contrast dye. But then, I’m a bit weird.

My husband just texted me. . .”Have you seen the CT scan?” Not yet, I replied. I know why he’s asking; like me, he is a medical nerd, intensely interested in anything medical, even our own tests. So I know that when the doctor comes in with the CT scan I will ask to see it.

What is really getting me about this whole situation is that I don’t think it should have happened. I write about patient empowerment and taking control of your own health all the time, and yet I allowed this tooth thing to get out of control. For one, I didn’t visit the dentist two weeks ago when I first felt twinges of pain. It was the week before vacation and I just didn’t have time. I figured I could handle it with ibuprofen until after vacation.

Then, when it got bad the first couple of days on vacation and I called my dentist and he called in an antibiotic, I committed the second cardinal sin: I blindly accepted his recommendation and didn’t do any research of my own. For most people, that’s probably ok. For me, a medical writer, that’s inexcusable. Four days later, the pain and swelling worse, the dentist switched me to another antibiotic and still I just blindly swallowed the pills.

Not until the third antibiotic was prescribed Saturday did I finally sit down and do the search I should have done a week ago. That’s when I learned that the second antibiotic is never prescribed for dental infections; that the first one is the gold standard but was prescribed at too low a dose for too short a time; and that the third antibiotic, considered second-line, needs nearly a week to demonstrate benefits but that about a third of people are resistant to it.

Wait. It gets better.

I finally saw the dentist yesterday who called in the more experienced dentist in the group for a consult, who decided that, yes, they should do as I asked and send me to the oral surgeon. “You definitely need IV antibiotics,” said young/old dentists. Seems the oral surgeon didn’t quite agree, however.

After shaking his head over the antibiotic flub-up, he put me back on the antibiotic first prescribed, albeit at a higher dose, and told me I wasn’t sick enough to need IV antibiotics yet. Hmmm. I wish he’d told that to my tooth, which woke me at 3 a.m., with horrible pain that required two Vicodin and 800 mg of ibuprofen to finally tame for a few hours. The pain reared its ugliness again at 7 a.m, along with soft tissue swelling into my throat, which is why I’m sitting here in the ER.

Sigh.

I am the perfect example for the book I’m now writing, called “How to Talk Back to Your Doctor: Take Control of Your Own Health.” The book will be a guide to becoming your own advocate (or advocating for your loved ones) within our convoluted, still paternalistic healthcare system. I thought I was writing the book for other people. Now I see that I am other people!

 I’d love to hear about your own stories about your excursions in the healthcare system, particularly those times when you wish you had pushed back against the system to get the care and attention you deserved. More on “Talk Back” later.

Time to find those pain meds!!