Monday, April 27, 2009

Saga of Pain

About the same time that I was worrying about the threat of deportation (or worse) my lower left back molar started to bug me. When I crunched down on it in just the wrong way it would twinge up. Still, it was no big deal; it only hurt when I chewed on it, and then only certain foods. Just the same, I made an appointment to see my dentist.

One look and she told me the tooth was cracked; but, after reducing the crack out of it, she said it looked okay to put a crown over it, which she did in short order over the next few days. But, within a week of getting the new crown, part 2 of my “saga of pain” began. Now, it was a general ache that seemed to come from the newly crowned tooth, or I assumed so, thinking that the crack must have gone deeper than the dentist could see and was now infected.

Back in the dentist chair, I asked her to go ahead and remove the week-old crown and do a root canal on the underlying suspect molar. She used what I call a sliding slamma-bamma hammer to remove the freshly glued on crown. It took a lot of bashing with the hooked device to get the thing off. It was a very uncomfortable experience to say the least, but eventually it came loose, after which she commenced to drill its supposedly infected root out.

Later that afternoon, back home, I waited for the anesthesia to wear off so I could eat dinner without biting my cheek; but once the numbness went away, it marked the beginning of some six weeks of hell, and part 3 of my pain saga. From twinge on chewing, to dull ache, now it had developed into a continuous agonizing throb enveloping the entire lower left side of my jaw.

For the next few weeks I obsessed over how I might get my hands on more potent pain meds. Everything I tried hardly helped at all, although I finally settled on some yellow pills called Diclofenac Sodium, a nonsteroidal anti-inflammatory that would take the edge off for maybe 4 to 6 hours at a time. Altogether, I ended up taking a couple hundred of them. I worried about that though, since I have cystic kidneys. I was afraid all the pain medication might seriously affect them, especially considering how many in a day I was forced to take. My choice was to take the pills or pay someone to kill me, so I probably did the right thing.

The next morning, with the pain growing worse, my dentist agreed to see me short notice on the following day, a Saturday morning, two days after she had bashed off the crown. Her tiny office x-ray showed no evidence of infection in any of the teeth in my lower left jaw. By this time I thought the pain might actually be coming from the tooth next to the last molar, but she said the x-ray showed that that tooth had already had its root removed. There was no swelling in the jaw or in the lymph nodes of my neck. By now, to me, she seemed at a loss; I could tell she had no clue. Her final remark was if the pain was from nerves damaged when she had hammered off the crown, that maybe it would resolve with some time. I left her office feeling uncertainty and alarm. She wouldn’t even write me a prescription for anything stronger than Tylenol.

"Now what?' I thought, forlornly desperate.

(That was one of the things I learned from this little adventure in pain, that doctors here are averse to writing prescriptions for the most effective pain killers considered narcotic. Hint: if you must live here, try to bring “a stash.” Meds like percosets and morphine sulphate are incredibly expensive, if you can find them at all.)

First thing Monday I went to the hospital to see an MD. The doctor examined me, also noticed no obvious evidence of infection and decided that the pain must therefore be neuropathic. He showed Divine how to massage areas in my neck and jaw explaining that it should help the damaged nerves. A good thing was that he wrote the RX for the Diclofenac Sodium, which was the ONLY thing that allowed me not to jump out of my skin, or my "mortal coil," in Shakespear-speak. I was supposed to take only one every 8 hours, but by the end of "my ordeal" I was down to one every 3 to 4 hours.

Other than the one Tuesday after that Monday, I didn’t even try to go to the office for the next work week; I figured there was little I could do anyway with my brain hardly functioning on a thinking level.

But, after a week of suffering at home I went back in anyway, mostly out of guilt. I figured pain was no excuse when I had people depending on me. Thing is, although I was able to conduct interviews, provide advice and fill out forms, dang, I was not a happy camper. When dealing with my clients I struggled trying not to be abrupt to the point of rudeness, which is how I kind of am anyway. My “normal” personal style is blunt directness, but with nagging throbbing pain added to the mix, I became one part curmudgeon and two parts snapping turtle.

My precious yellow pain pills gave me brief stints of semi-relief, but for some reason gave me hardly any relief at all at night when the pain caused me to moan and writhe in spite of myself. Divine was wonderful. We discovered that hot compresses, one after the other, along with the pain meds, relieved the throbbing enough for sleep to take over after a couple hours. She went back and forth from bedroom to kitchen scores of times every night for days until she found a heating pad at the mall that did the same trick.

A month of that and thoughts of suicide began to leak into my mind. Eventually, my jaw locked so that going to the office was out of the question; if I couldn’t speak there was no reason to go in at all. That’s when I asked Divine to find a TMJ specialist. Her friend recommended one, and with a little hope rekindled anew in my heart, we made it to the appointment a full half hour early.

The specialist dentist took a look at my teeth and saw nothing remarkable. He sent us down the street to get wrap-around x-rays done of my entire lower face. Just over an hour later, after spending about $35 for an envelope full of toothy jawbone images, we returned and handed them over. Telling us to have a seat in the waiting room the TMJ dentist disappeared into his office.

‘Please see SOMETHING…!’ I pleadingly prayed.

Then, “Mr Spear, I have bad news for you and good news!” he called out.

My prayer was answered. Upon hearing his jovial remark, immediately I felt enormous relief, for I KNEW he SAW a problem, FINALLY! Now we had something we could FIX!

I answered him excitedly, “Doc, if you can actually SEE something, then it’s ALL the news is good!”

He called us in and explained as he pointed to the x-rays of my lower left jaw, “You see there under that tooth? Its completely infected. The entire tooth is now being acted on as if it’s a foreign object. Your body wants it out. You see here? There’s almost no bone left around it; its all been dissolved away by the infection. You say you were able to actually work like that? From the looks of that x-ray you have been in horrible pain. How were you able to do anything? You’re a pretty tough guy. Were you a Navy SEAL or something?” he joked.

“Doc, for the last month, I haven’t felt in the least bit like a tough guy at all. I have been a total ass to just about all my clients, and everyone else for that matter. But oh man, right now, I’m SO happy knowing that it’s almost over. I really had lost all hope. You’re a Godsend Doc. Thank you! Thank you! Thank you!”

He just grinned, basking in my gratification.

I looked again at the dark area on the x-ray that signified infection under and around the root of the bad tooth, and suddenly realized the tooth in question was indeed the tooth NEXT to the one the other dentist had crowned.

Shaking my head I declared ruefully, "And to think I could have had that darned thing pulled over a month ago and been spared all this. Well, you definitely have earned MY business Doc!"

So, after 6 days on antibiotics to knock the infection down enough to remove the tooth he yanked that bad boy out. Before doing so, he injected anesthesia and epinephrine directly into the root area; to numb the tooth and to reduce bleeding he said. He took a strong grip with some hefty forceps, twisted it in, then to the outside, and out it popped—easy squeezy.

Ten days after the extraction and I had a new bridge glued in to cover the missing molar. I’m writing this now looking at the offending tooth sitting on my desk next to this computer. Seeing it reminds me that it’s such a relief to be agony free. Mental depression can be a real life-souring thing, but it doesn’t compare to what that little sucker did to me. I kept it to remind me of that.

(Oh, in case you’re wondering; the cost of the extraction and the bridge was about $210. Best money I ever spent!)


KA said...

that seems like a greater ordeal than my knee surgery!

Ed said...

Reading this makes me queasy.

Amadeo said...


So that was how your absence in the net was spent. So sorry to hear about your bouts of pain.

But the silver lining is that you found resolution and as you gushed, at a reasonably cheap price. Compared to US prices, of course.

I too had to take several trips back to the old homeland for teeth problem. The biggest one was for a complete "overhaul" of the entire system. After which, I was no poorer than a little over $500. In one trip alone I had over 20 sessions with her spread over about a month. Now that would be a miracle in the US, since I would have had to spend at least 6 months to get that schedule.

Of course, your "neighbor problem" is a downside, which is all too common in some parts of the country.

PhilippinesPhil said...

"gushed?" I prefer "crowed."

What kept me away wasn't just my pain problem, that was only part of it. Most of what took out my stuffings was the altercation with the meaner side of life here, going up against someone with some "authority." Too dangerous for me to say more.

And yes, as you intimate, I'm hoping that I can find a more foreiger-friendly part of the country to nest in. I've about had it with this part. I need to find a place with plenty like you buddy.

Anonymous said...

You have an incredible site here. I love it and have been reading it for hours today. I love your open and honest approach to not only your topics but your personal struggles. Thank you, J.C.

PhilippinesPhil said...

I appreciate the kindly comments JC. Thanks for reading...

Anonymous said...

Hey Phil, just wanted to add something. I too have struggled on and off for years with some of the same mind numbing pain you have experienced and expressed in your extrememly thoughtful writing style. I am off work now due to the snow here in Tennessee and just found myself deeply affected by some of your articles. It was so comforting to see someone with intelligence and strength admit that there was something very humbling and gut wrenching going on with their life. It is something I have never felt real comfortable talking with people about, so thanks again for helping me to process some of these issues that have plagued me for most of my life. I am 46 yrs. old and learning to live with this dark cloud that blocks the sun on many a day. God Bless, J.C.

PhilippinesPhil said...

Hey JC. Ah yes, the depression thing; the more I know about it, the longer I live with it, the more I observe it in others, the more I realize that it exists in ALL of us to one degree or other. Take some comfort knowing that this condition more than any other is what makes us human. Perhaps it's because WE are the only creatures that KNOW we must die some day. In a nutshell, life is a series of tragedies ended by death. I'm convinced that That stark truth is why mankind developed religion, to give us at least some hope of a reason for all "this." To stave off complete debilitating anger and sadness, to keep my mind off the "ME," my creed has been this: protect the weak and the small and be kind to them; find your happiness when and where you can; love your family and friends and show respect and tolerance to all others, even those that may not exactly deserve it. Its a bit lofty, but it's something to strive for, and helps to keep away from the edge of "the black pit of despair." Oh, one more thing, I laugh as often as I can, and TRY not to take anything too serious or else "the dying thing" begins to creep back into the peripheral vision (and i'm not talking about MY death, I'm referring to those I love). Back dark thoughts! Back I say! chuckle

Anonymous said...

Ah yes my friend. Good values to live by and I must say they have been a core belief system for me since childhood too. As I have become older a habit of mine is to try to watch something outrageously funny or rediculous for that matter at bedtime. A good laugh is medicine. In reflection most of my deepest despair comes for me in the winter time for obvious reasons. The rest of the year it is much less of a debilitating struggle, only sporadic. I do think all humans deal with this to some degree, but I think the fact that I am a very sensitive, caring person causes me to carry to much burden for people sometimes. I tend to focus on the injustices. To learn that we cannot fix everything or anybody does alleviate some pain haha. There is a chemical factor in all this I am convinced of, but not scientific enough to understand all that. Anyway, love your site and look forward to conversing from time to time. Joe (J.C.)