Sunday, October 17, 2010

Oral Health Update

Not quite the holiday snap I was expecting to be uploading as we approach the end of the first quarter of our stay in the US. This was taken last Wednesday in the fast track emergency department  at Massachusetts General Hospital in Boston. I don't really know whether 'fast track' really means that they thought I needed treatment faster than the average emergency patient or whether it's just a label they use to make the patient feel that they're being taken seriously. I wondered whether it's the Premium Economy of hospital care.

Anyway, after feeling much better on Tuesday night after the first operation I was rather disappointed to wake up on Wednesday morning feeling unbelievably awful. I phoned Dr Ok and outlined my symptoms; feverish, cold sweat, shaky, nauseous, run down and he suggested that I come down to see him at the Harvard Dental School. I explained that there was no way I was going to get there on my own. I was finding it difficult to get out of bed and even on the previous day when I thought I was quite well I had missed my stop twice on the subway. He then consulted with his colleague and recommended that I should go straight to emergency at MGH.

I waited for Peta to come home, she called a cab and we started the extensive triage process that they have to assess the extent of the problem. The last man I saw wanted me to choose a number between 1 and 10 to describe the level of pain I was in. This was the closest I came to breaking down as I tried to explain that I wasn't in any specific pain, I just felt awful. Understandably he wanted me to evaluate the level of this awfulness for his form but eventually saw my distress and gave up muttering, Fast Track, to one of his colleagues.

Dr Merrl saw me next and recommended a cat scan and blood test to see what was happening with the pockets of pus in my face. When the nurse came to see me I was quite surprised when rather than just taking a blood sample she inserted a cannula into my arm and left it there for the saline drip she attached soon after.

This set alarm bells ringing. This was the opposite of the delight I felt on the previous day when the doctor used the words, 'life threatening', 'acute' and 'immediate emergency operation' in one sentence. I felt validated, I was sick, I'm not a malingerer. To see a saline drip being utilised made me think that I wasn't ill at all, that I'd just not been eating and drinking properly which was true. I felt the pendulum of public opinion swing away from one of  pity to one of disgust and I wished again for some more visceral outward sign of the pain and discomfort I had been feeling over the past week or so, more blood, a gaping wound, bandages, just something more than the Don Corleone type swelling under my chin and on the left side of my face.

And worse was to come. I started to feel great, the saline drip had worked and I was now being wheeled on a trolley down to the CAT scan room. 1. I never needed a CAT scan I needed a drink of water and a banana. 2. How much does a bloody CAT scan cost?

But once you're on a hospital trolley it's hard to get off both literally and otherwise so I decided that I'd stick it out and try to learn something from the experience. Luckily the porter was not waiting for me when the scan had finished and the machine operator was very happy to educate me. Computerised Tomography apparently, 'tomos' being the Greek for cut, it takes pictures of you in slices. It also whirs and clunks just like in the movies.

The porter turned up and took me back to emergency where my bed had been taken by someone who had been in a car accident and who claimed on the phone to her employer that her foot was as big as her head. It wasn't, it was a big as her other foot but she didn't want to go to work after writing off her (boyfriends) car and that was fair enough.

Eventually nice Dr Tagoni and his yarmulke wearing assistant came to prepare me for my operation which mostly consisted of explaining the dangers (temporary or permanent loss of tongue sensation was the most interesting one) and getting me to sign waiver after waiver. What he didn't explain was that it would hurt quite a bit but I suppose that's the doctors prerogative and, to be fair, he did give inject quite a bit of local anaesthetic with that horrible big silver plunger thing they have.

So, 100ml of pus later we saying our thank-you's and goodbyes and Peta and I returned home at about 10.00pm, roughly seven hours after we were fast tracked.

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