Thursday, March 24, 2011

Twice the Fun

What's worse than a root canal? How about a second root canal on the same tooth!

The crown my dentist put on my cracked tooth last year did not prevent the problem he predicted could occur (20% chance, he thought) and that, if it did, would require a root canal. So in January I visited an endodontist and underwent this procedure. I expected some swelling and pain, but thought this would go away relatively quickly.

However, the swelling never went all the way down and the pain never went entirely away. I went back to the endodontist once and he adjusted/reshaped the crown so I was not biting on it and causing trauma to the ligament or bone. After more weeks of "wait and see" it became apparent that the predicted healing was not taking place.

So today I went back to have the procedure repeated. I'm always concerned when a medical professional has a discussion with me that goes something like this (especially when my mouth is full of medication that is making my gums numb):

Dr. Nelson: "Well, if your tooth was cracked when the crown was put on, then re-doing this procedure might not take care of the problem. You may need to have the tooth removed and go with a bridge or an implant."

Me: "So it sounds like you don't think re-doing the root canal will solve the problem."

Dr. Nelson: "It might. We can try if that is what you think you would like to do. Or would you rather have me stop now and you can go back to your dentist?"

Me: "Let's see if I can remember what they taught me in dental school so I can make this decision."

Okay, I admit the conversation didn't take place in precisely the way I've represented it. But it did feel like I was being asked what I thought was the best thing to do. I know, I know ... the medical expert can only inform and advise, and the patient has to make the decision. But I expect an opinion, based on years of training and experience, about the best course of action -- not asking me what I think would be the best thing to do.

In the end Dr. Nelson convinced me that we should try the root canal again (at no charge). I'm a little skeptical after our discussion, but we'll hope for the best and be prepared for the next step if necessary. At least I know a good oral surgeon in our stake.

Monday, March 14, 2011

Blood, Sweat, and Fears

When I was a graduate student in Salt Lake City I started donating blood platelets. At that time my primary motivation was financial. While it was NOT legal to pay for blood or blood products, it was permissible to pay donors for their time. More than 30 years later I continue to donate platelets though there is no longer any remuneration for one's time; my primary motivation is to help cancer patients.

Unlike donating whole blood, an apheresis donation involves both arms and takes about 90 minutes. (A one-arm process is available, but takes even longer.) The following images give some idea of the process, the machine used, and how I am situated when I donate ... except I have a portable DVD player on my lap watching a video.

The process of donating platelets is called apheresis. According to Merriam Webster, the definition of apheresis is "withdrawal of blood from a donor's body, removal of one or more blood components (as plasma, platelets, or white blood cells), and transfusion of the remaining blood back into the donor —called also pheresis. The origin of the word is from -apheresis (as in plasmapheresis) with the first known use in 1977.

One of the biggest problems with an apheresis donation is predictable -- for an hour and a half you cannot scratch where it itches. And you don't realize just how much your nose and face and head and neck itch until you can't scratch.

The other issue is more irksome than a problem. Usually you don't have time to finish watching a movie before the procedure is over. So unless you watch a movie you've seen previously or run home and watch the rest of the movie, you don't see the ending. But I'm pretty sure the good guys win. I hope the platelet recipients also win.