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The Letter

  • Thread starter Thread starter vicki
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vicki

vicki

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Oct 24, 2005
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UK
letsconnect said:
One thing that struck me - why not send the letter off to the other recommendation you got as well? That way, you'll have a chance to "compare responses" (if they have the time to respond)...

Good idea 8-) - except that by some strange coincidence, the recommendation is for a practice which is part of the same company as the one I currently go to, so I'm not sure whether they communicate or not :-/. However, if things don't go well, then I will definitely send the letter to them.

Anyway, here's what I've got far (as seems to be usual for me, it's rather long ::)). Any ideas or comments would be greatly appreciated - I'm still struggling with it. Once it's done, if I can't somehow manage to get it there before my next appointment, then I plan to take it with me and try and hand it over ([smiley=frightened.gif] [smiley=hiding.gif]).

Since my last appointment, I've realised that I may come across as a little strange or odd. In other words, one minute I seem to be OK and the next I'm not. There is a reason for this so I'll try and somehow explain. Basically I'm (this is really hard for me to admit) terrified...

When I was younger I had a few really bad experiences (nothing to do with dental treatment) that were very traumatic. I won't go into too much detail except to say that although my fear/panic during these incidents was normal given the circumstances, the reactions of the other people present were not and there were bad consequences for me.

The first incident occurred when I was about two years old and it was not long after this that I was taken for my first visit to the dentist. I had no reason to be scared because I’d never been before and so I didn’t know what would happen. However, once there, it became immediately obvious that the situation was very similar in symbolic/metaphoric terms to the previous incident. As a result I became completely terrified and experienced flashbacks (and still do sometimes). Since then, it has been the same and hasn’t really improved.

The main problem is that because I get so terrified, I sometimes find it very difficult or impossible to speak or move (i.e. the fight/flight/freeze response). So, if I don't answer questions I'm really sorry, I'm not ignoring them, it's just that the words are in my head and that's where they get stuck. This means that I may be unable to tell you if something hurts (I know it sounds crazy) and in the past I have experienced painful treatment as a result of my inability to move or say anything.

You may wonder why I'm telling you this. In the past this fear has caused me to cancel appointments. On one occasion I cancelled an appointment and didn't re-arrange another one for seven years. The only reason that I eventually did was because things were starting to get sore from the acid reflux. After many years of being so scared, I’ve decided to try and sort this out because if I don't, I know that things won't improve (I also don’t like the thought of getting to 70 years old and still being terrified!).

So, in searching for 'the answer', I came across a website which contained a lot of useful information and I finally realised that I'm not alone in some of the fears I have, which was a huge relief. It also made me realise that some of the methods of attempting to deal with this that I've tried in the past aren't actually working, so it's time to try something else.

After a long discussion with someone on a message board on the internet, I've decided to change the way I approach the situation then hopefully things may change for the better. One of the things suggested to me was that I should communicate exactly what my fears are and also some things that may help in order to improve things. I couldn’t do this right now because if I’m nervous I tend to either talk complete rubbish or even worse than that, I develop a stammer (even though I talk completely normally the rest of the time – this is also why I don’t talk much). I really don’t want the embarrassment of that so I thought it would be easier if I typed it instead.

Anyway here goes:

Things I fear:

  • I really don’t like lying on my back with someone behind me.
    (This relates directly to the experiences I had when I was younger).
  • When in a similar situation or position to when these events happened, I find it extremely difficult to trust people and as a result feel trapped which makes me nervous and can sometimes cause me to panic.
  • I’m scared that you won’t stop if I’m in pain or if I ask you to - even though on a rational level I know that you will.
  • I’m also scared of the whole environment and everything/everyone in it – really sorry, no offence meant! (This is a really strange one because I’ve got a couple of other medical conditions apart from the reflux, which mean that I’ve spent far too much time in hospital and had far worse things done than you could ever do).

It might help if:

  • (1) If/when I have a panic attack, you’ll stay calm and not get irritated or flustered.
  • (2) You understand that I feel seriously humiliated, ashamed and terrified by experiencing panic attacks and anxiety in front of other people.
  • (3) You’ll stop if I ask you to, but sometimes I’m too terrified to speak or move. So we need to figure out a way that you’ll be able to recognise this.
  • (4) You’ll take things at my pace.
  • (5) You’ll explain things before and throughout any treatment, and should I panic, stop and explain what is happening or talk until my anxiety has reduced enough to stop the panic.
  • (6) You are honest about things that might cause discomfort or pain and tell me beforehand, and honestly describe what's involved in any procedures.
  • (7) You take me seriously if I say something hurts.
  • (8) You understand that something I coped well with on previous occasions might cause me to panic at other times, in which case it's back to point (5).

Please understand that I’m not nuts or a complete basket case (not usually anyway!), it’s just unfortunate that you see me the 1% of the time when I’m not exactly my usual self. I hope that this little 'problem' doesn't cause you too much inconvenience.
 
vicki - I think that's a wonderful letter and beautifully written too. [smiley=jumping.gif] [smiley=jumping.gif]
I love the way you've outlined what would help you, as well as your fears. It's a real dialogue with a dental team.
The only suggestion I have is to drop the very last sentance, as your penultimate one is so brilliant, and there's no way this is a 'little' problem. [smiley=notworthy.gif]
 
Thankyou :). I've found it really hard to write and wasn't sure whether I was saying the right things or waffling too much! I also don't want to come across as an emotional wreck (!) :-/.

I can't really take the credit for being able to come up with that list of what might help though - that's down to letsconnect :D.

I see what you mean about the last sentence so I'll take it out (and as the saying goes - 'less is more' ;D). I think I put it in because I really don't want to cause anyone any trouble...
 
There's no way you come across as an emotional wreck - rather someone who's had some real cr*p to deal with from the past, and is making a highly intelligent job of living with the consequences. I think that's why the last sentance isn't needed: you're making at least half the effort to make this work, and you need someone who's good enough to do their part too.
[smiley=notworthy.gif]
 
WOW I think your letter is excellent [smiley=notworthy.gif] What a fantastic idea and as Gumgirl said it's really well written ;D
 
What a fantastic letter :D!

vicki said:
I can't really take the credit for being able to come up with that list of what might help though - that's down to letsconnect :D.

Unless I put words into your mouth - from memory, it was you who came up with the list ;)!

I see what you mean about the last sentence so I'll take it out (and as the saying goes - 'less is more' ;D). I think I put it in because I really don't want to cause anyone any trouble...

Yes, I see what you mean. I suppose what you're trying to say is "well, this is what I'd really like you to do/behave like, but I don't know if that's OK with you and maybe it's too much hassle and/or you may feel uncomfortable/unable to cope with this"?


One thing I'd say is - because the letter is quite detailed, it might be difficult for your dentist to do anything other than skim-read it, especially if he's under time pressure. So he might miss important bits. Because of that, I reckon it might be better if you could pass it on to him beforehand (possibly by snail mail). That way, he'll have some time to read and digest it while not in a mad rush.
 
Thanks for the feedback everyone :). I really wasn't sure that I was saying what needed to be said and in the right way.

letsconnect said:
Unless I put words into your mouth - from memory, it was you who came up with the list  ;)!

Yes it was... sort of (told you I have a memory like swiss cheese :P!), but it was you who asked the right questions to enable me to come up with a list and it was you that put it in some sort of order 8-).

letsconnect said:
Yes, I see what you mean. I suppose what you're trying to say is "well, this is what I'd really like you to do/behave like, but I don't know if that's OK with you and maybe it's too much hassle and/or you may feel uncomfortable/unable to cope with this"?

Erm... sort of... in a nutshell. I suppose it's harder because I've already seen the  current dentist 3 times - so for me to suddenly present a sort of 'wish list' could well be met with :o, :-?, :-/, [smiley=confused.gif], [smiley=hiding.gif] or even worse: >:(. Whereas if I emailed/posted it to someone new, they haven't got any preconceptions of me and the worst that would happen is that I'd either receive no reply or an unhelpful letter/email in return. Alternatively it could turn out OK so the only way I'll find out is if I'm able to say something (which is fairly unlikely) or able to send this letter.

letsconnect said:
One thing I'd say is - because the letter is quite detailed, it might be difficult for your dentist to do anything other than skim-read it, especially if he's under time pressure. So he might miss important bits. Because of that, I reckon it might be better if you could pass it on to him beforehand (possibly by snail mail). That way, he'll have some time to read and digest it while not in a mad rush.

True. Although I think if I send it via snail mail, it probably won't get there until quite a while after christmas now. So, either I'm going to have to bite the bullet and send it to their general email address and live with other people reading it, or I could try going in there again and handing it in at reception ([smiley=frightened.gif]). If I went on a saturday, there's less chance of a repeat performance of my toothpaste trip as they only see private patients on saturdays and I think there's only one or two of the dentists there.

Sending it before my appointment will definitely make the pre-visit panic about 100 times worse (if that's possible), but I know I've got to do something otherwise things won't change.
 
vicki said:
Erm... sort of... in a nutshell. I suppose it's harder because I've already seen the current dentist 3 times - so for me to suddenly present a sort of 'wish list' could well be met with :o, :-?, :-/, [smiley=confused.gif], [smiley=hiding.gif] or even worse: >:(.

The thing is - you don't know how he might react. He might be grateful for this information, because at last he'll know how he can help you, or he might get a bit scared or feel unable to deal with the situation. And let's face it, not everyone is cut out for that type of thing or has the experience required, even if they're the nicest person in the world. On the other hand, he might welcome the opportunity to help you. But at the end of the day, no matter what happens, you always have a Plan B to fall back on.
The worst thing that could possibly happen is that he reacts with >:( - but how likely is that, based on your experience with him?
If you're worried about "causing trouble", you could end the letter with something like "I don't know if you would feel comfortable with this and understand if this is too much trouble", or sth along those lines.

True. Although I think if I send it via snail mail, it probably won't get there until quite a while after christmas now. So, either I'm going to have to bite the bullet and send it to their general email address and live with other people reading it, or I could try going in there again and handing it in at reception ([smiley=frightened.gif]). If I went on a saturday, there's less chance of a repeat performance of my toothpaste trip as they only see private patients on saturdays and I think there's only one or two of the dentists there.

Do they have a letter box? It might be easier to drop the letter into the letter box on a Sunday, rather than hand it in at reception.
 
Vicki-One other option came into my mind -that might work . would it be possible for you to set up an appt to discuss the contents of the letter -after clinic hours are over for the day??I also think you should personally hand him /her the letter,as well .By doing it that way, Vicky ..you know he/she received it...YOUR needs /issues can be addressed at a time when its not impinging on other pts treatment slots . ...or your own treatment .You wont be able to obtain the treatment you neeed by not communicating your needs /issues to the dentist . By not doing so - the practicioner is at a decided DISADVANTAGE when it comes to your care...and you are paying that practicioner for his/her time as well as their services .Take this one small step at a time , Vicky ......you can do this . I know how tough this can be , Vicky -all it took for me was one inadvertent/insensitive comment by my dentist about my own needle phobia to damm near blow a years worth of focused effort to keep me in that practice .The office manager of the practice involved risked her own employment status to negotiate /intervene on my behalf .... the resulting mayhem that ensued ........almost told her to *&*& off ....... which took a full two months to partially resolve ......which is now an ongoing communications process. You can do this, Vicky -one -or maybe two- smallsteps at a time .The letter-overall...was quite well written . Keith2
 
Actually - I like Keith 2's idea :D (I did the same thing myself - get the last appointment of the day). I sort of got sidetracked b/c of the NHS issue, and for some odd reason it never entered the picture before. But it might be worth a try and see if you could change it?
 
I'll try phoning them tomorrow - might take a while though. It usually starts with picking up the phone and putting it down again for ages and ages, then I move on to actually dialling the number and then hanging up when it starts ringing.

It's a good job I'm off work tomorrow - looks like this might take a while :-/.

I can't believe how fast time is going - it's 3 weeks today [smiley=frightened.gif] [smiley=hiding.gif].
 
After what seemed like all morning, I managed to make the call. I got so nervous about it that I ended up writing down what I needed to say and reading it out over the phone.

I started off by asking if I could change my appointment to the end of the day rather than first thing in the morning as it is at the moment (9am 17th January) and I was told that the earliest they could do a late appointment is in April :-/. So then I asked if it was possible to make an appointment just for a chat either last appointment or outside of hours and the answer was no. I even offered to pay for a private appointment but the answer was still no - unless I needed treatment. I guess the festive spirit isn't upon everyone :-/.

I suppose I should have realised. When I had to go for 3 monthly checkups instead of every 6 months, every time I went to reception to make a next appointment after I'd had my turn in the chair, the receptionists always said that I couldn't have a check up in 3 months because of NHS guidelines (?). Apparently, the only appointment I could have before 6 months was for a scale and polish with the hygienist (as if I would *choose* to do that! [smiley=frightened.gif]). When they checked with the dentist, obviously he said it was to be 3 months (there's no way I'd be going back sooner than absolutely necessary!), but I guess some people are just 'jobsworth's' :-/.

Anyway, it looks like I'm back to square one. Somehow I have to get that letter through the door before the 17th.
 
So sorry you didn't have any luck Vicki. Sometimes I wonder who runs the office, the dentist or the receptionists. I hate to have to call my dentists office and have to deal with the receptionists, I always seem to have trouble :( Best of luck with the letter 8-)
 
Vicki-A couple of questions : First -is this dentist NHS or private ? Second - who is paying - You -or NHS ? Third ....As traumatic as it might seem -or be -you need to challenge -firmly-the answers you just got ...I,m startting to wonder if theyre giving you the runaround ./BS . This is YOUR dental care thats at issue - not the mouthpiece/ at reception . It may come down to you switching yet again -or if this dentist has any decency in his/her body ...he/she WILL take the time to address the issues .that need to be dealt with in order to facillitate treatment . If they refuse -then I would suspect that the dental care will be shoddy -or worse ......You DO have the right as a patient to have those needs addressed . Exercise that right, Vicki.Finally - it is NOW mandatory- that if you stay in this practice -the attending dentist needs to be handed -personally-a copy of that letter from YOUR hand- no one else - before the 17th . if you are refused, turned down ........dont make a scene over it - just leave . And then ditch that practice ......ASAP!!!!!Notify the practice on your terms where to send your file .I realize i,m coming across as being harsh- but YOU, Vicki - cant afford the potential ramifications / implications implied here......the LAST thing you need is more trauma/ abuse from a dentist ..or insensitive staff . protect yourself against that...Keith
 
Well done for making that call [smiley=cheers.gif]!!

My gut feeling at this stage is that this is a wild goose chase (sorry to be so negative :-/...). It might be more productive to ditch Plan A altogether and go straight for Plan B? Not just because of the time issues, but more importantly because it sounds like you'll need to find someone who will able to carry out the actual treatment (and the NHS may not be *it*)... (even assuming he turns out empathetic and able to deal with this on a psychological level, where does this leave you when it comes down to the nitty-gritty?).
 
Hi vicki - well done you for making what must have been a difficult call. [smiley=jumping.gif] I'm a bit apalled at the response you got. While I can understand not being able to shift your appointment, it seems awful that you couldn't either get a short appointment to talk about what you need or even a chance to have a brief chat to the dentist on the phone. :-? Maybe I'm becoming a bit spoilt by being with a practice where these things are quite normal and actually encouraged.
Have to say I agree with lets about moving to Plan B - what do you think??
 
Now I've had time to think about it, I'm a bit appalled at their attitude as well :-/.

When I first decided to go back to the dentist (about 3 years ago), my appointment was a few months away and although I had toothache, I ignored it - until a friend intervened and said I should go sooner. She made the phone call for me and the phone was on loud speaker so I could hear it as well. They had a bad attitude with her back then - but she got the appointment moved because she was more persistent (and obviously not scared!). Because of their response on the phone, I was convinced that the dentist was going to be awful as well. Fortunately he wasn't as bad as I'd imagined - so I know that the attitude of the receptionist(s) doesn't always reflect that of the dentist (and vice versa).

I don't have a problem with getting private treatment - which is what my second option would be, except that given the amount of work I was told would be needed by the previous dentist (3 years ago - they're waiting until things settle down so it's probably worse now), even though I have insurance which would cover some of it, I couldn't afford it on a long term or ongoing basis at present :-/.

Although I'm an NHS patient at the moment, I do have the option to pay for private treatment if/where needed and use the insurance to cover some of the cost. But my worry would be that if I 'went private' completely, I wouldn't be able to afford everything needed (which apparently was 8 crowns, all wisdom teeth extracting plus a load of fillings - I don't know whether this is the case or not as they won't do anything until the reflux settles down (which could be tomorrow or could be never according to the doctors)).

Regarding finding someone who is able to carry out the treatment, I was told that a referral to hospital could be considered - but I don't know whether it's because things are that bad or whether he's just panicking because he's not seen it before. :-/. But whatever the reason, it doesn't make me feel any better.

There is another option (don't know why I didn't think of it before) but I don't know if it would be any good - I could ask if I could see someone else there instead (i.e. someone with more experience), but either way, I'm really scared and confused now - I just wish it was over [smiley=frightened.gif]
 
I'm thinking - it might be a good idea to get a second opinion in any event, regardless, just to see if someone else would recommend the same things. And *if* it should turn out that treatment would be too expensive privately (with dental insurance), you could always revert to Plan A?
 
Vicki -while you could ask to see another dentist in this group-you have another issue to contend with .Your impression of this particular group /dentist has been soured by the lousy/crappy experience youve had .Also ..reception is supposed to be the "face "of the practice ...and they dont seem to have done right by you , either . So-either see another dentist in the group-or go to plan B . Acid reflux-if it hasnt cooled down by now ....you need to address that issue with a G I specialist.Acid reflux shouldnt hinder one from attending for necessary dental care ..unless there is a compelling clinical reason for the delay. [smiley=grouphug.gif] In any event, Vicki...irrespective of whether its NHS or private ins ....the most critical /vulnerable teeth should be addressed first ---then phase in the remainder of the work as finances permit (if private) .Even if youre NHS ..do it in phases -if that works for you...to get it done-fine .Since stress /phobia is involved -consider getting 1quad done per appt ...to reduce the # of visits, needles, stress, ect...involved . just throwing out a few suggestions [smiley=grouphug.gif] Iknow youd rather be [smiley=hiding.gif] but- you can do this...despitethe latest potential setback.One small step at a time Vicky....This will , ultimately, pay off for you. Keith2
 
Keith2(Guest) said:
Acid  reflux-if it hasnt cooled down by now ....you  need  to   address that  issue  with  a G I  specialist.Acid reflux  shouldnt hinder one  from attending  for  necessary dental care ..unless there is a compelling  clinical  reason  for the delay.
I saw a G I specialist when it first started and after various tests he concluded that it's likely to be an ongoing problem so I have drugs to control it which I take on a few months on and a few months off basis as needed because it comes and goes. I did actually tell the last dentist all this and he said it would be better to wait until it settled down before commencing any restorative treatment. I can understand why, but my problem is that I've been told that it could be permanent or it could disappear tomorrow. At present the longest I've gone without the drugs is 12 months :-/.

So sometimes the erosion settles down for maybe 18 months and then it gets a bit worse again. So I'm not sure whether it's procrastination on their part because they're unsure of how to proceed, or whether they're waiting to see if it stops (despite me telling them what I was told about the possibility of it being a long term/permanent condition).

Keith2(Guest) said:
Iknow youd rather be  [smiley=hiding.gif]  but- you  can  do this...

You're damn right I'd rather be [smiley=hiding.gif] now because on tuesday it will be 2 weeks to the next appointment and I am getting really [smiley=frightened.gif] now. At this point I would normally have real problems sleeping at night but fortunately (or unfortunately - not sure which it is :P) I've got a cold at the moment so the dose of Night Nurse at bedtime means I'm actually sleeping surprisingly well [smiley=cloud9.gif].

I think you may be right about a second opinion (however much the prospect of it scares the sh*t out of me [smiley=frightened.gif]), so I'm going to try and email the place I found on the internet as a first option (the website looked quite promising - but as the saying goes, the proof of the pudding is in the tasting). It's probably too late to get an appointment before the 17th, but I can try. I would go for the one that was recommended but because the place is part of the same company as where I currently go, they're sure to ask where I'm currently registered and I wouldn't want any awkward questions if I did have to revert to 'plan A'. :-/.
 
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