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Don't understand why I'm not jumping for joy right now...

Pianimo

Pianimo

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So, I had my first sedation appointment today. And it went ok! Went well, even. My dentist (D3, for those who've been keeping up!) came to walk me through, introduced me to the nurse and sedation nurse, then patiently answered my A4 page-long list of anxiety-fuelled questions. I cried a bit at this point, but the nurse (N) gave me a tissue, and I managed to hold it together. I also have severe IBS-D, made worse be anxiety, and she knew I'd had a bad morning, so she asked me a few times during the prep stages if I needed to *ahem* 'go' :redface:, and said I could ask at any point during the treatment, and they'd help me there and back (I didn't need to, thankfully!)

She had some bother with the IV - she tried twice on one arm, and got it in but apparently the vein was too close to the skin to manouevre it properly (I didn't know you could be too slim for an IV to work...all that time on Weight Watchers for nothing! :rolleyes:). So she then tried the other arm, and that was ok. I don't mind needles, but this all hurt a bit, especially when she was trying make it work in the first arm. The sedation nurse (SD) held my hand and talked to me all this time, and D3 explained what has happening, and that it wasn't my fault - I was physically shaking from when I sat in the chair, and quite badly at this point, so I was worried it was me.

Once the sedation kicked in, I thought I was still aware of everything, but there was definitely a time lapse - one of the next things I remember doing is saying I was cold (they'd told me to tell them), and they went and fetched my coat from my Dad to put over me, and he said that was well over an hour after I went in! I'm not sure whether I was 'in and out' or out for ages then back, but I don't remember the LA injections at all, and SN says I went to sleep for quite a while (my hand went limp). She was holding my hand/sometimes stroking my hair all the way through, and I really felt safe and looked after. In fact, all this care was just done as if it was completely normal, so I never felt silly or burdensome for being so nervous or needing the support.

I remember bit of drilling and washing and other feelings; each time D3 told me what I was going to feel and taste etc before it happened. I also remember gagging a little once, and asking to swallow, which they let me. SD said afterwards that D3 gave me lots of breaks, and also quickly worked out she could help me gag-wise by stopping whenever she could to let me swallow, so she did. I felt no pain whatsoever at any point, and they were attentive to every groan/mumble I uttered. I'd brought my mp3 player with me, and they taped the earphones on so they woudn't fall out, and even pressed play for me, as the sedation obviously kicked in before I got a chance!

...Actually, I'm really glad I've come to write this, as it's reminded me how amazing today has been! The thing is, after being sooo nervous beforehand, I kind of expected to feel really amazing afterwards...and I don't. :( It's not physical pain (I've had an ibuprofen for a bit of soreness, from the LA I think, plus my 'wrong' arm hurts a bit, but that's all). Obviosuly I am tired, but I didn't anticipate still feeling so down in the dumps! I think it's mostly two things:

1. Unfortunately, my other two MAJOR worry sources still exist (the uncertainty regarding my university extension application, and the absolutely dreaded hosptial procedure on Monday...just been in tears over this again!)

2. I'd been told by D1 (first dentist I saw, a different practice) that all my teeth were saveable. D2 confirmed this. PM gave me my treatment plan, echoing what had D2 said to me, stating I need 1 root canal, 5 fillings, and gum treatment. Today's appointment was supposed to be for the root canal, and two fillings on the same side, if time. However, when I got there, D3 said she wasn't sure she was going to be able to do a successful root canal on that tooth. I'm not sure what can have changed, as I've had no new x-rays, and no-one has looked in my mouth since I saw D2. After she'd finished today she said she got most of the dirt and nerve out (or something like that, I was still woozy!), and has put a filling in, but it's temporary. I need to come back and discuss, possibly with their endodontic specialist, whether to do a root canal or just have the tooth replaced. This came as a complete shock to me, and feels like a setback - today was supposed to be the hardest but, with 'easier' appointments from hereon in. Now I may be facing an extraction...and I'm also back to not knowing quite what's going on again. I'm sure she's told me the truth, which I need to know, so it's not her fault, but I suppose I thought I'd already dealt with all the truth I was going to have to face!

Anyway, I'm sorry for such a looong post (congratulations to anyone who's made it down to here!!) It's been a help to me to write it as it brings home to me that I really have achieved something massive today, even if emotionally I don't feel it! Because, I really have achieved something...haven't I?! (Tentative :party:)
 
Pianimo

Pianimo

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Ok, I spoke too soon about the lack of pain...got awful toothache today. :( It 'wandered around' a bit, but I'm now pretty sure is coming from the root canal/not tooth. So I'm assuming that's a bad sign for the tooth??
 
Dr. Daniel

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Hey Pianimo

It is great that the post was helpful. You are treating your teeth and that is the right direction. I do hope that in the future you will be able to cope with the dentist also without sedation.
You wrote that your feeling is not so positive as you expected. Is it possible that the reason for that is simply physical tiredness? Sedation is considered a real effort for the body, and it takes time to recover, in addition also the anticipation and the waiting before the dental appointment is not easy, not to mention the stress you are experiencing regarding other fields in your life.
All these factors together could influence your general feeling.
 
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letsconnect

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Congratulations :jump:!!! Great to hear things went so well for you, and that your dentist managed to find a way to handle the gag response :thumbsup:. I think it's quite normal for there to be some dull pain and/or pain upon biting down - this is a recognised side effect of root treatment and usually disappears within about 48 hours or so. An anti-inflammatory over-the-counter painkiller like ibuprofen should take the edge of it :). Gordon once explained the reason why:

"Basically when you stick instruments up the root canals, a little bit of the infected material will be pushed out of the end of the canal into the wee space between the tooth and the socket. This sets up a small area of local inflammation and can cause pain upon biting down and a dull pain.”

If you have the chance to see an endodontist, do it - the equipment they have a available (esp. the microscope) really does make a huge difference in success rate and I wouldn't worry too much - it is very likely that the tooth can be saved.

Re. not feeling as elated as you may have hoped - I don't think that's a huge surprise with the other two things still hanging over your head :( - but maybe you'll feel in a mood for celebrating on Monday night :D - if so, have one on me :sleepyjuice:!!

Well done you :respect:
 
Pianimo

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Well...today was an ordeal. Had the dreaded hospital procedure, and the whole experience was seriously traumatic. :cry: But at least it's over.

Thanks very much for your replies, Dr. Daniel and letsconnect. :) I know you're both right - given all I'm dealing with at the minute, and my constant anxiety/exhaustion (I'm not sleeping well), let alone the effects of the sedation, it's no wonder I wasn't feeling as happy as I'd expected. I am proud of myself for having started my treatment, and really grateful for how well I was treated and how well it went (and my experience today has really brought home the last two points.....).

In fact, life's been so overwhelming that I've encountered the ulimate irony: when I was at my lowest point on Saturday - crying and sick with worry about today, whilst trying to deal with a problem with my extension application, and in a lot of pain with my tooth - I sat there thinking, "I'm sick of feeling like this - I can't remember the last time I felt safe/relaxed...oh yes, I can - in the dentist's chair!!!!! Can't quite get my head around that one!!!

I have also had some positives since my last post - firstly, the bad, constant pain in the tooth only lasted a day, and now it's just a bit achey now and then (I was given antibiotics in case I had ongoing pain, but I haven't needed them). Secondly, I emailed D3 to say thank you, and she replied saying I was a "delight to treat"!! - me, with my weird mouth-aversion and pages of questions and crying and shaking and gagging!!! I felt like I'd just received a good school report! :D She also said she's going to arrange a chance to talk to me herself about the options for the root canal tooth, which I'm glad about - if I do go down that route (ha, no pun intended!! :giggle:) then I'll see the endodontic specialist, but I'd rather have things explained to me first by someone I already trust.

The next step now is my first appointment with the hygienist, a week today. (I'm having these in between my treatment appointments with D3.) I haven't met her yet, but PM picked her as their most phobic-friendly hygienist! I've no sedation for my appointments with her, so let's hope so! (They offered me Nucalm again but, although I'm still tempted to try it out of curiosity, I can't bring myself to pay for it! Besides, I'd rather stay in communication with her.) Any idea what I should expect in the first appointment? I know she's going to treat my gums and do some cleaning etc, plus intruct me on how best to care for my teeth etc, over four appointments, but I'm not really sure exactly what that all entails. Any guesses?
 
Dr. Daniel

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Hey
How nice to read your post. I think your post is can be a real inspiration for many other readers because it reflects the difficulties that you experienced and coping with them. :D Many readers need these kind of examples and stories to improve their own coping ability with the fear.
Regarding the hygienist, I do not know what is your situation but it seems like you are heading for a thorough cleaning. If so, not only will you be cleaning your gums but actually you will reduce the amount of bacteria all over your body (the gums is the biggest source of germs). You might see bleeding from the gums, but that is a good sign (a sign of inflammation being removed).
Deep cleaning might be unpleasant and even painful. I suggest you first share your fear and concerns with the hygienist.
The hygienist might offer giving a bit of local anesthesia (if the gums are to inflamed), but if you r have a problem with getting the anesthesia, if the hygienist works slowly and gently, you will not have any problem. :thumbsup:
 
brit

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Pianimo

If you find it too uncomfortable, get numbed up either with gel for the gums or local for the teeth and the gums.

Gentleness is everything with unanaethetised dental hygiene but I am sure your practice will have no issue providing numbing if you want this.

More info here:

:grouphug:
 
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C

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Don't let anyone make you feel guilty for having sedation. If that's how you get through an appointment, fine. The important thing is that you did it, made it, and survived. Some people will try to make you feel like you shouldn't use sedation, but use it if you need it. If you get to the point where it seems unnecessary, fine, don't use it.
 
letsconnect

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I'm sorry to hear that the medical procedure was such a horror :shame: - glad to hear you made it through it though!!

If the last time you felt safe and relaxed was in the dentist's chair, that's really saying something :D. It's great that they're taking such good care of you :).

Can't really add anything regarding the hygienist - the links to the pages which brit posted explain it all. Keeping my finger crossed for you that she's a keeper and just as concerned about your comfort as your dentist :grouphug: (it sounds as if she is :))
 
Pianimo

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Brit - thanks for the links. I guess I'll have to wait and see whether I'll be having anything done that might hurt, but I'll certainly ask for something if I need it.

Having read the descriptions of what my appointments might entail, I've a new worry, in that I really hate the feeling of rough surfaces against my teeth...or nails, or rubbed against each other! Probably sounds odd...I think it's like a nails down the blackboard thing (which, incidentally, doesn't bother me at all!) I can't use nail files, and eating a fruit pastille is a delicate operation! :giggle:

But I think my biggest issue is likely to be the gagging - physically, especially if she has to work in the back of my mouth, then worse from the nerves and my mouth phobia, which means I feel sick when I can see/hear/feel things happening in my mouth. But I want a healthy mouth, so we'll just have to find a way!

Clem - thanks. :) I've only had sedation once, but it definitely was the right choice for me. I was treated wonderfully, which was a huge factor too, but I still feel the sedation was crucial to me getting the work done. I'm going to be sedated for the rest of the treatment I need, but I can't afford it for the lesser stuff - not to mention they can't really 'educate' me if I'm all dopey! - so I'm going to have to brave the hygienist without.

letsconnect - I know, I can't believe it either! I think they began earning my trust by how they treated me before I was sedated, and then proved they deserved it by how they treated me while I was - e.g. in the bits I was awake for, I remember D3 stopping to explain exactly what I was about to feel before she did anything, just as she'd promised she would; she didn't not bother because i was sedated, but took as much care over me as if I'd been fully aware. So, between them and the sedation, I felt completely at ease. Incredible!!! :jump: (See, I've managed a brief jumping for joy moment just now!)

Dr. Daniel - Thanks for the information. It would be great if my experience could be a help to anyone - reading other people's positive expereinces was such an encouragement for me before my appointment, and I'd love to be be able to do the same for someone else. :)

Can I also say a big thank you for something you said in a completely different thread - "Pain is a subjective feeling. If the patient says it is painful, than it is painful." Nothing to do with the dentist, but when I was having my procedure on Monday I had to ask them to stop before they were finished, as I couldn't stand the pain. I felt so pathetic and ashamed because they'd said it would just be uncomfortable, and people should be able to get through it. Reading what you said was an enormous help to me, to stop feeling guilty - the fact is, for me, it HURT! And I don't need to apologise for that. Thank you!
 
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brit

brit

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Can I also say a big thank you for something you said in a completely different thread - "Pain is a subjective feeling. If the patient says it is painful, than it is painful." Nothing to do with the dentist, but when I was having my procedure on Monday I had to ask them to stop before they were finished, as I couldn't stand the pain. I felt so pathetic and ashamed because they'd said it would just be uncomfortable, and people should be able to get through it. Reading what you said was an enormous help to me, to stop feeling guilty - the fact is, for me, it HURT! And I don't feel need to apologise for that. Thank you!
No idea what your procedure was but there are lots of medical things where you can be easily sedated but don't necessarily have to be e.g. endoscopy. It should be your choice not the doctor's. Have never had an issue with medics re pain control they always seem to head off pain in UK...there's always 'gas and air' around as well???
They are the ones who need to apologise for underestimating the pain of a procedure. Again them stopping when you say stop, makes you feel in control.
 
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Pianimo

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Brit - from what I can gather, it's a procedure which some (NHS) hosptials offer sedation for, but some don't (mine didn't), and none I've come across mention pain relief; the general concensus seems to be that neither should be needed, as it's supposed to be pretty uncomfortable, but not really painful. The person doing mine did say beforehand that she'd stop if I asked her to, but also that if I found it hard I should try to get through it, as if they couldn't finish I may have to have it done again! So when it started really (REALLY!) hurting, I tried to let them keep going, but in the end I just couldn't bear it any more. :( She did keep her word, and stopped, although she then asked if she could try again to finish, and we did a couple of times, but I still couldn't manage it. The thing is, when you're told you "should" be able to handle something (and seemingly 'everyone else' can), and you can't, it does make you feel like a failure. :shame: But, as Dr. Daniel said, only I know how much pain I felt. That's why it was such a help to read his comment - it allowed me to think that even if they thought I was pathetic, and I feel it, it doesn't mean I am!
 
brit

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Thanks for the 'heads up' - you need to ask to be referred to the nearest hospital that will sedate you for it.
Did you get a customer satisfaction questionnaire? Fill it in appropriately negatively and also write a letter of complaint to the hospital and PCT....they are wasting their resources even more when they do a procedure and it fails because a patient feels pain.
 
Pianimo

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Well, I saw my GP today, and she says they got far enough through that I won't need to have it done again. :) She also said that what happened to me wasn't actually too uncommon. Unfortunately the rest of the appointment wasn't so cheering, but at least that's one fewer worry! Thanks for your support.
 
Pianimo

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So, I love my dentist! :D (Who'da thought?!) Had a (free) consultation today about the root canal tooth - supposedly 10 minutes, but she happily let me stay for about half an hour, so she could answer all my questions etc.

In the last few years I've seen so many different health professionals - doctors, nurses, psychiatrist, consultant (and a few more!), and now dentists and other dental people - and she stands out as being what all the others should be. That's not to say the rest have all been awful, some have been brilliant...while other, less so! But it just particularly struck me today that THIS is what going to the dentist/doctor/hospital should be like. I know I've not been seeing her for long, but mostly I think it's as basic as that she constantly treats me like a person, not (just) a patient. She's earnt my trust because everything she says and does leads me to believe she actually cares, and wants to do her best for me. Seriously, why can't they all be like this?!

For those who want dental details...basically the problem is it was a very big cavity, so I can have a root filling, but it probably won't last too long (though of course you never know for certain). The other option is obviously an extraction, then either a denture, a bridge, an implant, or a gap! The temporary filling is doing its job for now, so I don't need to decide straight away (gives me chance to hopefully get though some of the major stress in my life first!). I know what my current leaning is, but I'm curious what others would recommend?

I also asked today how long my first appointment with the hygienist (on Monday) is going to be, and they said 1 hour, but there'll be talking as well as treating in that time. So, new survival plan: keep her talking as long as possible! :innocent:
 
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Pianimo

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Another visit to the dentist, another positive experience. :D I can't believe it! Saw the hygienist today, and she was lovely. She'd planned everything so she could do it without showing me pictures etc, and she was really gentle, constantly checking I was ok both anxiety and pain-wise. She used the gel before taking all the measurements etc, and nothing really hurt. She's happy to go slowly with me, and said at the beginning that she'd like to clean at least a few of my teeth today (with the air thingy etc), but it was ok if i couldn't manage it. In the end she did my bottom front six...so I now have six nice teeth! :D

She made me feel at ease, didn't go into the back of my mouth etc too much, and let me swallow whenever I needed as well as using the suction thing - the combined result of which was she said I actually gagged less than some of her 'normal' patients!! I can't believe how much of my problem has been so easily solved by just nice dentist/hygienist + lots of swallowing! Also, like with D3, I felt safe. So I was able to control my anxiety - the only real giveaway was a rather wrangled tissue in my hands at the end! I never felt judged or criticised, and all her advice was tailored specifically to me (my teeth, my gums, my issues etc).

We both think the back teeth will be more difficult gag-wise, so D3's going to clean them while I'm already sedated (for more fillings). Then I'll see the hygienist again, for my top front teeth. And I'm ok with that!!!

Actually, I've just realised one thing that I think helped today, which i hadn't thought about at the time - there was just her and me in there. She'd normally have a nurse, but they didn't have enough to go round this afternoon. But I think I was less nervous/embarassed for not having an 'audience'. Do you think it's ok to ask for the same to happen again next time??
 
letsconnect

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"Three's a crowd" :D - having said that, a dental nurse can come in very handy when there's water involved and you want someone to help with the suction thingy (no, I'm not talking about any filthy games here :p - just meant things like the water that squirts out from ultrasonic scaler and the like, honest!) ... If you prefer "no audience", just ask your hygienist if it would inconvenience her if the nurse wasn't present :).

Great to hear that your hygienist is such a sweetheart :cloud9: - that's fantastic news :jump:!!
 
Pianimo

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Hmm yes - maybe asking to make it "just me and her" wouldn't go down quite so well if I were a bloke!!! :redface: :giggle:

Incidentally, I didn't mind having the nurses in with D3; actually, SN was so good with me that I've asked if they can try to have her in for all my treatment (she's not from the practice). So maybe I'm just awkward!

I am so happy/amazed I've found people like this, that I've been able to trust, so quickly! I never would've thought it possible. So, now the only issue is whether I can afford to stay with them! I'm technically on referral, and supposed to go back to D1 when my treatment is finished (though that won't be for a while yet). She is closer and cheaper, and she was nice to me. But I want to stay... :(
 
letsconnect

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I suppose it all boils down to money, but it's pretty good going if even the "cheap option" is someone you actually really like :D!

Having said that, check-ups and routine maintenance usually don't cost the earth and if you can afford it, it would be best to go with the dentist you liked the best :) (and..... I have no idea who that might be - they all sounded wonderful :D)
 
Pianimo

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I suppose it all boils down to money, but it's pretty good going if even the "cheap option" is someone you actually really like :D!
Yes, I know! :D To be honest, liking my dentist or feeling I could trust them was so unthinkable that as soon as any of them were actually at all polite and kind I thought they must be wonderful! lol But while with D1 and D2 I thought "Wow, they're being nice to me, maybe I could actually trust this person one day!", with D3 I'm actually already starting to trust her! Which is not only amazing, but also ironic really, given I had the worst start with her - the whole missing notes/'singeing' consent form debacle! But like I said a few posts ago, from all my medical experience I know how hard it is to find someone you can actually achieve that kind of relationship with, so I'd really like to hang on to it, if i can!
 
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