Daily Archives: December 29, 2009

Observations of My Oral Surgery

Today I had the initial part of my implant work done to replace the departed “Undead Tooth of Terror. This was the first time I had oral surgery vice normal dentistry.  If you have never had it the only comparison to regular dentistry is that it involves teeth.  It is real surgery, albeit not like getting your noggin or ticker opened up.  However in the weeks leading up to this surgery I experienced a fair amount of anxiety and even a couple of nightmares related to the procedure, including if something went wrong. When you prepare for something like this, or any other medical or surgical procedure you sign a consent form. These include the risks associated with the procedure as well as the anesthesia.  One of these complications or risks is death which is not on my list of things that I want to experience in the next 30 years or so.

Implant Screws

I’ve done a lot of hospital work in major teaching hospitals, mainly in critical care, ER, Medical, Surgical, Burn, Neurosurgery and Pediatric ICU’s.  I have become quite adept at learning about what goes on in those places, to include understanding something about how critical care intensivists of all types work to include a lot of the technical things that they observe with patients.  I am probably one of the few chaplains who that has a copy of The ICU Book and can read heart rhythms, understanding the relationships of blood pressure, cardiac output, oxygen saturation levels as well as a host of other cool to know things.  When the Abbess was in the Emergency Room at a local hospital I made the diagnosis of her Epiglottis before the physicians.  After that one of our attendings at my hospital told me that wasn’t too late to go back to Medical School.  The thought is intriguing but alas, even Padre Steve doesn’t want to go back to school for that long at this point in life.  However I could probably play a very convincing doctor in film or on TV if given the chance.  I will entertain offers if someone wants to shoot something like MASH.

Today was interesting.  I was taken into one of the oral and maxillofacial surgery operating rooms.  These are equipped with the kinds of monitoring equipment found in an OR or an ICU.  I have observed these on quite a few patients and can read them rather well.  Today the difference was that they were monitoring me and not another person.  So this intrigued me, I have not been to a operating room since I was 7 years old at Bremerton Naval Hospital.  Things have changed in the 42 years between visits, or at least my perspective has changed.

I was seated in what looked like a dental chair on steroids.  I was hooked up to the monitor with a 4 lead EKG and pulse oxygen monitor and had a nasal cannula. An IV was placed and I was asked a litany of questions.  With all the monitors hooked up my doctor came in and talked about the procedure and a light anesthesia ‘cocktail” of drugs including Fentanyl and a couple of others that I cannot remember right now.  A large table was placed before me with a large number surgical and dental utensils.

Normal Sinus Rhythm

I looked up at the monitor as they got things going and made final preparations.  My heart rate was in the 58-67 range in normal sinus rhythm, in fact a very nice looking rhythm. My respiratory rate ranged from 5-11 a minute and my SPO2 or oxygen saturation ranged from 96-99.  Noninvasive blood pressure was 116/71 with a mean of 86.  Not bad for someone nearly 50.  The drugs we injected through the IV access point and I entered what is called “twilight” sedation.” It is a state where you are sedated but can still follow simple commands from the surgeon if need be.  I could hear what was going on but it was like being in a dreamlike state.  Occasionally I could hear the surgeon giving directions to his resident and also the noise of the drill, which was not the normal high pitched sound of a dental drill.

When it was over they brought me up out of the sedation and I looked around, my numbers were still close to what were on the monitor to begin with so I was still alive.  I was allowed to see the x-ray with the placement of the implant mount which is actually screws into the jaw.    I was informed that a bone graft was done and that I would only be able to have liquids and soft foods for the next two weeks.  I’ll have a follow up next week, be off of work until the New Year holiday, no PT for a week and light duty, including being told “not to talk too much” to allow the implant and graft to heal.

As I was collecting myself  I saw the corpsmen disposing of trash and “hazardous waste from the room.  In clear container, actually a container that is used for suctioned fluids from the mouth, was something that looked like a strawberry daiquiri, it was the blood and water suctioned from my mouth during the procedure and was about half full.  I commented to the corpsmen what I thought it looked like which caused them to laugh in agreement and said that I was a beer drinker.  I was wheeled out of the hospital in a wheelchair to the Abbess waited for me in my trusty 2001 Honda CR-V. I can’t drive through tomorrow and am to take it pretty easy.

The pain has been manageable and has been a far cry from the agony I went through during the summer with the Undead Tooth of Terror, something for which I can definitely thank the Deity Herself.

This has given me a small glimpse at the perspective of one of the patients that I see every day, so it has been worthwhile in a number of ways, and not just as a means to better dental health.  I remember Henri Nouwen’s book Beyond the Mirror which recounts his experience as a patient following being hit by the mirror of a truck alongside a road.  Such experiences are important for those who provide any kind of care, especially pastoral care.  For me the almost surreal experience was to borrow a phrase from Star Trek’s Mr. Spock simply “fascinating.”

All I can say is that at least beer is a soft food and though I have an implant I will never look like Mariel Hemingway.

Peace

Padre Steve+

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