Moby Tooth and the interconnectedness of all things great and small.

Well, six months post transplant and nothing transplant related to report. And the opportunities to get out in the world and have some post transplant fun has yet to begin. A major milestone and life is about as boring as it can be... who would want anything more from a life post transplant? I am officially done with two of my meds, so there's something.

So I could stop here and it would be the shortest, most boring post into this journal to date. Or I could tell you a little story, would you like that?      You would?     Well okay then... a story... mostly true... but probably exaggerated for effect. A story about a guy, let's call him Bil. A story that meanders in and out of a single plot line but somehow all seems connected. Shall we begin? Okay then, I give you a story about a guy named Bil and his aching tooth. Told in first person narrative of course.

I was watching a video this week describing the timeline in the Marvel Cinematic Universe leading up the release of the Avengers Infinity War, which of course I will see and I've seen every one of those movies leading up to this point. As I watched those movies I was often aware of an eventual culmination of  these myriad story lines in a bigger movie, but I had no idea about how many smaller details really filled in gaps for other movies until I watched this video. The key point here though is that dominoes that were put into place beginning with Iron Man in 2008 and up to the more recent Black Panther movie in 2018 are all going to spill all over the place as this movie ends one phase of the MCU and begins another. And life is like this too. An incident barely worth mentioning on a particular day can have repercussions for years to come.

Call me Bil. Some years ago—19 years precisely—having an infant on his way into this world, I stood around a hospital room for hours awaiting his arrival and feeling a bit peckish. Always prepared for such occasions I reached into a box of crackers and nibbled on one. Most crackers are of a type that are brittle and crumble when engaged by ones grin chiclets, but these were a more dense wheat cracker that crushed under the pressure of the clickers. On this such occasion the crushing met its maximum capacity and stopped my jaw from clenching my teeth any tighter and in that same moment something in a tooth on the lower left side of my mouth cracked. A tooth with a filling gave way a bit on the back side. There wasn't any pain, just an awareness of the tooth giving out and the filling being exposed.

From that day forward the tooth slowly eroded over a number of years and approximately six years later I found myself in the chair of a dentist having the crumbly remains of the tooth, sans filling, cut from my gum. I had spent the prior two years pulling bits of it out with my own pair of pliers, but it had reached a point where I could no longer do anything unless I intended to start cutting into my gum with a scalpel. Now free of the tooth, the dentist recommended I have a false tooth added in but I didn't have insurance and just having the tooth removed was more than I could afford so no false tooth was ever added. I've had an open space ever since.

Four years later I was diagnosed with kidney disease and four years after that I was on dialysis and put on the list for an organ transplant. Having kidney disease and being on the list to receive a transplant meant following certain rules like getting my flu shot annually, having all kinds of other shots related to the potential for infectious diseases and of course seeing the dentist twice a year. All things I did to maintain a level of health satisfactory enough to continue to be on the list. Four and half years later I had my transplant.

Unless you coincidentally have a dentist appointment about two to three weeks before an unexpected kidney transplant, there's almost no way you can be on a schedule of twice a year appointments with the dentist and have a dentist appointment scheduled for greater than six months after you've had a transplant. Such was true in my case. My transplant was in October and my next dentist appointment was in January.

In November following my transplant I started having weird little heart flutters. After having this looked into it was decided that I had a mild case of AFib and a process called a cardioversion was scheduled in late December. Before I could have a cardioversion I had to be on eliquis for a week and then needed to continue for a month or two following the procedure. My followup visit to the cardiologist proved well and I was allowed to discontinue the eliquis once I finished the 30 day prescription I was on.  Which by the way ended about five days before my scheduled dental appointment.

In the final days of being on eliquis I happened to catch one of those medication commercials that's more like a short film and this one was about eliquis. At the end they often have about thirty seconds of disclaimers, you've all seen these and know what I'm talking about. This particular disclaimer suggested mentioning to your dentist if you're on eliquis. So when I arrived at the dentist that day I made sure to let them know that I just came off eliquis within the last week, in case it mattered. It didn't concern them, but the fact that I had a transplant only three months earlier did. For some reason after my transplant, when getting ready to leave the hospital no one thought to mention to me as I was being educated on what I can and can't do over the next several months, that I shouldn't see the dentist for at least six months. So they rescheduled me for early May.

In the meantime an issue was developing on my upper left side of my mouth. At first it was a familiar feeling whenever I get a cold. I don't know if anyone else experiences this, but when I have a cold I often feel like my teeth are about to fall out of my head, especially as I go down stairs. Is that unusual? I think probably not. And since I had a cold around this time I attributed this sensation to the cold. But as time went on the cold symptoms mostly went away but I still continue to have a bit of a constantly runny nose and my teeth have gone through a few other sensations since then. There was a tenderness that wasn't annoying enough to make me concerned. Then there was the occasional bite down on certain foods that sent a brief signal to my brain of discomfort. Then about a week ago my teeth above the area of the missing tooth started to feel like they were under pressure and also like they were itchy. Did you ever have itchy teeth? bizarre sensation.

With an appointment schedule in a few weeks I decided to just wait until then to have it looked at. But Thursday of this week came with some serious pain and its only become worse since then. Too busy at work to exit for an emergency dental appointment I continued to put it off. Yesterday I was so on edge that I couldn't take it any longer. I called my dentist even though they were closed. They had an emergency number you could call so I did. I left a message and they called me back less than thirty minutes later. My dentist called in a prescription for penicillin and said she'd get me scheduled for an appointment on Monday.

So I've been on the penicillin for almost twenty four hours to no avail and also taking tylenol. While I find eating difficult I notice that eating seems to calm down the pain a bit. And tea seems to calm it down even more. So toast and tea are being consumed regularly. I also keep switching between ice packs to help sooth the area. Naps, music and television help to take my mind off of it. But this has yet to truly subside.

Of course I assume that not having that open space in my teeth filled with a false tooth has probably attributed to this problem. I also assume that my tooth pain is somehow related to the runny nose, though maybe I'm wrong. The rest of this story still needs to be written, but that will be sometime after tomorrow's appointment.

So here I sit and ponder the interconnectedness of individual moments over twenty years of time and how things can culminate into a story that ultimately needed to be told even though the smaller components on their own may have seemed disconnected at the time. Much the way the MCU has spent the last ten years telling us myriad stories that were all actually one big story.

And for those of you who took notice... yes the first line of the third paragraph is a rip off from the opening line to Moby Dick, a book I've never read but probably should.


04/29/18

UPDATE:

So, after last week's post I saw my dentist on Monday morning. She couldn't figure out what the problem was, though she could see something was going on. So she sent me to a specialist. I saw the specialist the next morning and he couldn't figure out. He decided to send me down to his Peabody office where they had a 3D scanner, which he hoped could get a clearer and more instructive view of the problematic area. Unfortunately he wouldn't see those results until the following morning. We should come back to this later.

The following morning he called to let me know that he found the problem and unfortunately the tooth had to come out. In the picture of my teeth above I point out a tooth that I call Moby. Turns out that wasn't the problematic tooth after all... it was the next tooth forward and not really seen it that photo. Apparently it was rotting away from the inside out and so a root can wasn't an option. Shame too, because the tooth appeared to be in such great shape, hence the reason they were having trouble finding the problem.

An hour or so after the phone call from the specialist, I was sitting in the chair of the surgeon who was about to pull the tooth. She turned to me and said, "So you wanted it pulled? No root canal?" To which I was rather surprised and said, well my understanding is that a root canal isn't an option and that this tooth needed to be pulled. She mentioned that she couldn't see any reason why it would need to be pulled and I said, well didn't they send you the pictures from the 3D scan? "No. Just this xray" she said. And I had two simultaneous thoughts. One being "why didn't they send the surgeon a picture of the problem?" The other was... "Well the 3D scan & the Doctor who ordered it are both literally  across the hall in this same building, why doesn't she just walk over and see why it needs to be pulled?" She had me hooked up to the blood pressure cuff, She had the little heart beat monitor on my finger, they were about to have me sign a consent form and administer the Novocaine shots when I said: "is there any reason we don't just walk across the hall and get a copy of the 3D scan to see that in fact this tooth needs to be pulled before we pull it. "Well that's what I would want to do if I were in your shoes" she said. Once again I'm thinking then why don't you just cross the hall and ask for a copy of it?

She asked if I'd like to see if I can go get a copy of it. And so I did. The other office then told me that they sent a copy already and that they'll now follow up by having the specialist come over to consult with the surgeon. Which of course should have happened already.

Anyway, the surgeon sees the scan and says, "oh, now I see why we're pulling it." Back on the cuff and heart monitor I sign away my life, or at least a tooth and received the Novocaine shots, which are always the worst part of any dental procedure. About 20 minutes later my tooth was out and but for some localized pain and some swelling it's been mostly better since.

I could continue now with how this whole story ties back to an earlier post regarding how things are proceeding at work lately, but I think I'll just let it go and go take my nap... it Sunday afternoon and I do enjoy a good Sunday afternoon nap.

Oh... Also I saw Avengers Infinity War yesterday. It's been a great ten years of watching Marvel's movies and I look forward to what the next year or two delivers as precursors to the second part and how things go following that. Hopefully nothing mentioned right there is a spoiler for anyone.