WARNING ! HEAVY RANT AND WHINE ZONE. TOTAL EXASPERATION.
YOU DO NOT NEED TO READ THIS BUT I NEEDED TO WRITE IT AND GET IT OUT OF MY SYSTEM !!!!! ;O)
Is it me or are most people in the dental profession incapable of sympathetic, clear and precise communication ?
Those of you who follow this blog will know that my dental saga re. removal of a lower seventh and a wisdom tooth has been going on for over a year. Suffice to say that the extraction process is complicated by the fact that I am not at all keen on having the blighters removed whilst I am conscious but the sedation option now seems to be too difficult because
a) you need to fast beforehand (and the length of time you need to fast varies according to which dentist or oral surgeon I speak to: it is anything between 1 and 8 hours)
and b) the drug of choice is for CS Midazolam which is part of the same family as diazepam to which I have a very nasty reaction.
My dentist referred me to the hospital for the extraction in Feb 2009, having become exasperated by my inability to cope with certain drugs and me having to cancel twice because of my relapse...even after I had told her I had M.E., and explained my 'unreliability' at being able to attend pre-arranged appointments because of the 'nature of The Beast.'
I have now had three pre-op visits to the hospital: each time meeting someone other than the oral surgeon and each time asking about the exact nature of the procedure and the anaesthetics/fasting time they intend to use. I have done so in order to try and secure the best possible outcome for myself as someone with M.E. and with a dental phobia. I have written letters to the surgeon expressing my concerns and asking for a 5 minute conversation over the phone since he has been trying to direct/deflect my questions w through his (very sweet) secretary who reads out his unhelpful response to my letter so that I then I ask another question and she says 'I don't know. I'll get back to you'. It is like playing ping pong with an opponent hiding behind a screen.
In exasperation, two months ago I went back to another dentist ---- a private dentist who was human and treated me as if I had genuine concerns and spoke to me as one intelligent adult to another. I was almost on tears with relief. Here was someone who did not treat me like a freak, a wimp ,a nuisance: yes I could have conscious sedation, yes the fasting time could be as short as 2 hours (do-able for me...just) and it would be fine. I then spoke to their Oral surgeon and all went well until we discussed my bad reaction to midazolam at which point I got referred back to the hospital having been told by the dentist's Oral Surgeon that it was not unreasonable for me to ask for a face to face consultation with the hospital oral surgeon and anaesthetist about alternatives to Midazolam i.e that I wasn't just being a nuisance and unreasonable.
I wrote another letter an yesterday was the big day...I would finally meet the man himself, spend a quality 5 minutes sorting out how they would perform the extraction and the anaesthetic they would use in order to secure a best possible outcome ......and then get on with it. I just want this over and done with.
This is not how the NHS works. I went for the appointment and was about to be directed down the pre-op 'X ray and more blood tests route' again until I said quite emphatically that I'd already done all that and had just come to talk about etc etc.
I wait in a crowded, hot waiting room amongst a group of tired, irritated people who had had a enough of being shoved around (when I did go for the pre-op blood and X-rays last September it took 4 hours !). There were people with tales of being there since 9 a.m. ( this was at nearly 1 p.m.), tales of an elderly woman whose notes had been lost and was distressed and wanted to get back to bed on the ward, tales of people who had an elderly father in day care across the hospital site and a disabled son at home with a respite carer who had to leave by 1.45 and yet his mother had still not been seen by 1.15 p.m....and the hospital knew her situation.
Eventually I am called. At least we can have a proper adult discussion and sort everything out. I want this over as much as anybody. I walk in the room expecting to see the Oral Surgeon ( I know what he looks like). I am met with a very tired, disgruntled woman about 28.
'What was it you wanted then ? Something about anaesthetics ?' ..she asks as if I she is speaking to a piece of sh*t on her shoe.
I explain, again, about my concerns (for it is obvious she has not really read the correspondence and nobody seems to take a few minutes to read your notes before you enter the room)
'Well, you can't have Midazolam because of your reaction to diazepam, they're part of the same family of drugs' (yes I know that ...I told you)
'The only way is to have a local...be a five minute job.'
' Are you sure ?' (Really incurring wrath now.....questioning the expert !) ' Only my dentist extracted the lower 7th of the other side and it took about 20 minutes (of torture....but I didn't say that last bit).
'No it'll be easy....it's all I do all the time. ( no wonder she looks so bloody grim ) We'll just pop them out.'
(I didn't tell her that the oral surgeon at the private dentist said, when I asked him if I might just as well go for a local and tough it out, 'Oh God know...I wouldn't want it out with a local...there'll be stitches and everything and it'll be nasty.)
I was flummoxed. I didn't know what to say. I was tired and exhausted and thinking about the 30 minute drive home.
'That do you then ?' she says.
'Yes, I suppose so...' I find myself answering.
So that's it...out with a local.
Why is it then in such situations I always come to a point, no matter how much I rehearse my attitude and responses, where I feel like I'm at school and must do as I'm told: that I'm standing the in my nice grammar school uniform waiting to have whatever someone else thinks is good for me, done to or metered out to me ? I hate that feeling and hate myself for having that feeling 36 years after I have left school.
What makes me really angry is that all I've ever asked for from the original dentist and the hospital is a a very little time and a proper reading and addressing of my questions,. When I sent similar letters to the original dentist her response was
'Well, none of my other patients make this much fuss....but then...we've got a receptionist with M.E...she's never here. Always depressed...she's gone down that route' (make you own minds up about her attitude to PWME...anyone hear a little voice saying 'waste of space, wimps, malingerers ???)
Yesterday was hell anyway with builders banging constantly, daughter's birthday coming up, cake to be made, presents to be wrapped, son also at same hospital for another appointment. It took all I had to get to the hospital yesterday and our conversation could have been held over the phone: no journey for me, no waiting, no taking up valuable time of surgeons, secretaries, getting in the way of patients who also had busy lives but who really needed to see a dentist in person.
Why will nobody listen to me ? Is it too much to ask ? and what do I do with this latest fobbing off about having a lower seventh and a wisdom tooth out with only a local ?
Rant over ....well nearly....
* Having said all that I recognise that there is something else going on here and it probably has something to do with my whole attitude to authority and, in particular, to the medical profession.
Don't get me wrong: without the NHS my son would probably not be alive and even if he was he would be in much worse health than he is. In a crisis and where children are involved, the NHS works miracles.
On the other hand, I have seen other relatives go through hell, placed inappropriately, doctors playing God, expecting to be treated like God, being unreasonable (when my mother had terminal cancer she fell and had suspected fractured hip and the A&E doctor wanted to send her home. It was only because my partner and myself physically stood on front of him and told him if he sent her home we'd report him that she stayed in hospital...and even then she ended up on the wrong sort of ward, where all her drugs were messed up , she was not fed or changed and she stayed there until I begged the local hospice to provide a bed.) and at the same time I have worked in the NHS and seen the disorder and waste first hand. I know for a fact that yesterday's oral surgery clinic (every Tuesday 9- about 1.30) had 29 people to see and that is a 'light' day...usually it is around 37. How in God's name can anybody --even the grumpy 28 year old..be expected to process 29, let alone 37 people in about 4+ hours ? The whole system needs an overhaul with patients and staff treated like human beings who need and deserve proper (not begrudged) respect.
Can you tell I'm very angry ? ;o)
YOU DO NOT NEED TO READ THIS BUT I NEEDED TO WRITE IT AND GET IT OUT OF MY SYSTEM !!!!! ;O)
Is it me or are most people in the dental profession incapable of sympathetic, clear and precise communication ?
Those of you who follow this blog will know that my dental saga re. removal of a lower seventh and a wisdom tooth has been going on for over a year. Suffice to say that the extraction process is complicated by the fact that I am not at all keen on having the blighters removed whilst I am conscious but the sedation option now seems to be too difficult because
a) you need to fast beforehand (and the length of time you need to fast varies according to which dentist or oral surgeon I speak to: it is anything between 1 and 8 hours)
and b) the drug of choice is for CS Midazolam which is part of the same family as diazepam to which I have a very nasty reaction.
My dentist referred me to the hospital for the extraction in Feb 2009, having become exasperated by my inability to cope with certain drugs and me having to cancel twice because of my relapse...even after I had told her I had M.E., and explained my 'unreliability' at being able to attend pre-arranged appointments because of the 'nature of The Beast.'
I have now had three pre-op visits to the hospital: each time meeting someone other than the oral surgeon and each time asking about the exact nature of the procedure and the anaesthetics/fasting time they intend to use. I have done so in order to try and secure the best possible outcome for myself as someone with M.E. and with a dental phobia. I have written letters to the surgeon expressing my concerns and asking for a 5 minute conversation over the phone since he has been trying to direct/deflect my questions w through his (very sweet) secretary who reads out his unhelpful response to my letter so that I then I ask another question and she says 'I don't know. I'll get back to you'. It is like playing ping pong with an opponent hiding behind a screen.
In exasperation, two months ago I went back to another dentist ---- a private dentist who was human and treated me as if I had genuine concerns and spoke to me as one intelligent adult to another. I was almost on tears with relief. Here was someone who did not treat me like a freak, a wimp ,a nuisance: yes I could have conscious sedation, yes the fasting time could be as short as 2 hours (do-able for me...just) and it would be fine. I then spoke to their Oral surgeon and all went well until we discussed my bad reaction to midazolam at which point I got referred back to the hospital having been told by the dentist's Oral Surgeon that it was not unreasonable for me to ask for a face to face consultation with the hospital oral surgeon and anaesthetist about alternatives to Midazolam i.e that I wasn't just being a nuisance and unreasonable.
I wrote another letter an yesterday was the big day...I would finally meet the man himself, spend a quality 5 minutes sorting out how they would perform the extraction and the anaesthetic they would use in order to secure a best possible outcome ......and then get on with it. I just want this over and done with.
This is not how the NHS works. I went for the appointment and was about to be directed down the pre-op 'X ray and more blood tests route' again until I said quite emphatically that I'd already done all that and had just come to talk about etc etc.
I wait in a crowded, hot waiting room amongst a group of tired, irritated people who had had a enough of being shoved around (when I did go for the pre-op blood and X-rays last September it took 4 hours !). There were people with tales of being there since 9 a.m. ( this was at nearly 1 p.m.), tales of an elderly woman whose notes had been lost and was distressed and wanted to get back to bed on the ward, tales of people who had an elderly father in day care across the hospital site and a disabled son at home with a respite carer who had to leave by 1.45 and yet his mother had still not been seen by 1.15 p.m....and the hospital knew her situation.
Eventually I am called. At least we can have a proper adult discussion and sort everything out. I want this over as much as anybody. I walk in the room expecting to see the Oral Surgeon ( I know what he looks like). I am met with a very tired, disgruntled woman about 28.
'What was it you wanted then ? Something about anaesthetics ?' ..she asks as if I she is speaking to a piece of sh*t on her shoe.
I explain, again, about my concerns (for it is obvious she has not really read the correspondence and nobody seems to take a few minutes to read your notes before you enter the room)
'Well, you can't have Midazolam because of your reaction to diazepam, they're part of the same family of drugs' (yes I know that ...I told you)
'The only way is to have a local...be a five minute job.'
' Are you sure ?' (Really incurring wrath now.....questioning the expert !) ' Only my dentist extracted the lower 7th of the other side and it took about 20 minutes (of torture....but I didn't say that last bit).
'No it'll be easy....it's all I do all the time. ( no wonder she looks so bloody grim ) We'll just pop them out.'
(I didn't tell her that the oral surgeon at the private dentist said, when I asked him if I might just as well go for a local and tough it out, 'Oh God know...I wouldn't want it out with a local...there'll be stitches and everything and it'll be nasty.)
I was flummoxed. I didn't know what to say. I was tired and exhausted and thinking about the 30 minute drive home.
'That do you then ?' she says.
'Yes, I suppose so...' I find myself answering.
So that's it...out with a local.
Why is it then in such situations I always come to a point, no matter how much I rehearse my attitude and responses, where I feel like I'm at school and must do as I'm told: that I'm standing the in my nice grammar school uniform waiting to have whatever someone else thinks is good for me, done to or metered out to me ? I hate that feeling and hate myself for having that feeling 36 years after I have left school.
What makes me really angry is that all I've ever asked for from the original dentist and the hospital is a a very little time and a proper reading and addressing of my questions,. When I sent similar letters to the original dentist her response was
'Well, none of my other patients make this much fuss....but then...we've got a receptionist with M.E...she's never here. Always depressed...she's gone down that route' (make you own minds up about her attitude to PWME...anyone hear a little voice saying 'waste of space, wimps, malingerers ???)
Yesterday was hell anyway with builders banging constantly, daughter's birthday coming up, cake to be made, presents to be wrapped, son also at same hospital for another appointment. It took all I had to get to the hospital yesterday and our conversation could have been held over the phone: no journey for me, no waiting, no taking up valuable time of surgeons, secretaries, getting in the way of patients who also had busy lives but who really needed to see a dentist in person.
Why will nobody listen to me ? Is it too much to ask ? and what do I do with this latest fobbing off about having a lower seventh and a wisdom tooth out with only a local ?
Rant over ....well nearly....
* Having said all that I recognise that there is something else going on here and it probably has something to do with my whole attitude to authority and, in particular, to the medical profession.
Don't get me wrong: without the NHS my son would probably not be alive and even if he was he would be in much worse health than he is. In a crisis and where children are involved, the NHS works miracles.
On the other hand, I have seen other relatives go through hell, placed inappropriately, doctors playing God, expecting to be treated like God, being unreasonable (when my mother had terminal cancer she fell and had suspected fractured hip and the A&E doctor wanted to send her home. It was only because my partner and myself physically stood on front of him and told him if he sent her home we'd report him that she stayed in hospital...and even then she ended up on the wrong sort of ward, where all her drugs were messed up , she was not fed or changed and she stayed there until I begged the local hospice to provide a bed.) and at the same time I have worked in the NHS and seen the disorder and waste first hand. I know for a fact that yesterday's oral surgery clinic (every Tuesday 9- about 1.30) had 29 people to see and that is a 'light' day...usually it is around 37. How in God's name can anybody --even the grumpy 28 year old..be expected to process 29, let alone 37 people in about 4+ hours ? The whole system needs an overhaul with patients and staff treated like human beings who need and deserve proper (not begrudged) respect.
Can you tell I'm very angry ? ;o)
8 comments:
I can't believe this nightmare. Well, I do, but you know what I mean. And doctors! Hmph! HOW VERY DARE THEY? The ones that talk to you as if they are God and you are sh*t are sooooooooooooooo infuriating! You can only hope they have to experience the same one day, and suddenly have a flash of insight into what they've been doing to people.
Sorry! No words of encouragement here really - just lots of sympathy and fingers crossed for a good outcome soon. Hugs. xox
Lots of sympathy from me as well. Don't worry this isn't only happening within the NHS - it happens here in the US also.
My mother is on disability for a laundry list of mental health illnesses and anxiety is a HUGE issue with her. Her psych doc only provides her with one xanax per day - I constantly hear her voice shaking, her freaking out over minimal events (overblown is an understatement) and have told her repeately that her anxiety is not controlled. But yet, when she goes today for her appt. she will take the one a day script and not argue because she wants to be "compliant". She also has issues with authority.
My son's friend has a horrible gastro illness which resulted in him losing 30 pounds in 9 days - he was never admitted to the hospital because he had no insurance.
I don't know what the answer is, I know that the entire system (universally) is overwhelmed and I do emphasize, however it doesn't give doctor's a license to ignore the oath "do no harm".
I'm hopeful you can find a better solution without having the tooth yanked out - that does sound horrible to be honest.
Dental things are a complete nightmare - because of this kind of thing I've paid literally thousands for private treatment, but even that doesn't guarantee intelligent and informed approach. I had a wisdom tooth out with local and it was actually far more straightforward than other "easier" teeth. But the probs go on.
Empathy is all I can offer (and virtual Rescue Remedy).
Thank you all for your comments and support. I don't really see why anyone should have to read my moaning but I am SO exasperated and infuriated by the whole thing.
Now, what makes it worse really, is that it is apparent that my experience is not rare. Gott in Himmel, even comments from USA and Australia verify my frustration ! Are ALL medical systems like this all over the blessed world ? What the hell is the matter with people who go into caring professions ? I was in caring professions and have seen some stuff in my time (and reported it) but what I'm talking about here is not abuse, not malpractice as such..it's attitudinal and that's much more difficult to address.
And then we come to the question of fee-paying or NHS. I can only agree with Signs, for I too have spent a fortune on private dental treatment and it has made little difference save for the fact that the atmosphere is nicer and people speak to you more pleasantly and more respectfully: in a sense they have to because you are paying them hard cash to do so.
I really do not know what the answer is.
My dentist in town told me that dental students who like talking to people and enjoy the relationship with patients become 'High Street' dentists --- though she's the one with the dubiosu attitude to PWME! She said the dental students who are interested in teeth and not people become the oral surgeons because their patients are often knocked out and so no converstaion has to be 'endured.'
Think she's got that wrong too because so far the only dentist who has spoken to me as a real human being and an individual is the private oral surgeon who I would gladly have kissed or clung to his ankles and begged to remove the teeth if only he could have found a way to use Midazolam. He is the only one so far who I felt I could trust.
Oh Hell and Dammnation !
It sounds like the 'system' is the same all over the world .... total crap here too!
If it's any help at all I believ it is standard proceedure here to only use a local when removing teeth. I was actually booked in to get 4 wisdom teeth pulled when I got sick and it was going to be with a local and apparently would be 'quick and easy' ... it never happened because I was ill, but I guess at some stage I will return for the trauma/drama hahaha.
It's shit that things you know should be achievable and simple, such as having a 5 minute discussion with a Dr are in reality a nightmare and impossible.
Chin up, it will be over and done with sooner or later!!! (that's what I constantly tell myself about EVERYTHING haha)
Awful, just awful.
My last partner had terrible teeth and a heart problem to boot. Got referred to a 'hospital' dentist in Kent somewhere. Same thing, packed waiting room. I actually heard the nurse say something about 'playing catchup'. They were not waiting for anaesthetics to take effect and they actually put a bag over my partner's head. He was there because he was phobic. When I asked them about his heart, they said 'what heart problem' and panicked a bit. Not read the notes see. He was a wreck, weeping and sobbing. I was furious. But we don't do anything about it do we, because the problem seems too big.
I'm so sorry you've had this experience.
Bloody hell this is awful! You're not being unreasonable at all.
Ok first off - you could try approaching your GP for a sedative to take prior to the procedure. I know someone who has a sedative off her GP (but not in UK) in order to get anything with a needle done. No reason the GP couldn't prescribe a one off sedative to help keep you calm during the proceedure. I also remember taking a flight with a woman who had been given tranquilisers by her GP. She was compliant and calm.
Second - the first extraction of wisdom teeth I had done was apparently awful (I was fortunate to be sedated). I needed stitches, it was a struggle to get the teeth out and I was battered and bruised for a couple of weeks. BUT the second extraction was easy peasy and took 5 minutes (I was sedated but not as heavily as before).
The dental surgeon could see instantly from my xray and examination that it would be an easy extraction because the teeth were pointing in a pluck them out sort of position. The ones before were growing at a different angle.
So - just because the first extraction was awful doesn't follow this one will be. I mean it might be awful but then again it might not.
Thirdly - if sedation is something you still want for treatment (which I know I would even if was a 5 minute job being phobic myself and anxiety causing worsening of my ME) how about contacting your local NHS PALS?
Seems to me this is exactly the kind of situation they are set up to deal with
http://www.pals.nhs.uk/cmsContentView.aspx?ItemID=938
you seem perfectly reasonable to me, no need to explain why you may have issues from past experience; your issues now are valid. Hope it is all over soon and not as bad as you fear. I hope at the last minute you get some good doctor who will treat you right and make it easier on the day.
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