manage my health with minimal disruption to my life

If you get the feeling your doctor is detached and unfeeling, he or she might well be.

http://www-news.uchicago.edu/releases/07/070927.decety.shtml

Physicians apparently learn to “shut off” the portion of their brain that helps them appreciate the pain their patients experience while treating them and instead activate a portion of the brain connected with controlling emotions, according to new research using brain scans at the University of Chicago.

Because doctors sometimes have to inflict pain on their patients as part of the healing process, they also must develop the ability to not be distracted by the suffering, said Jean Decety, Professor in Psychology and Psychiatry at the University and co-author of “Expertise Modulates the Perception of Pain in Others,” published in the Oct. 9 issue of Current Biology and currently available on-line.

[more at link]

I’m not saying that’s necessarily a bad thing. A certain detachment is necessary. I just think some doctors get too good at it.

I was starting to second-guess my dentist and was feeling Mrs. McGrath-y (O was you drunk or was you blind, when you left your two fine teeth behind?) so I read up a bit on crowns.

I found this on Wiki, which really supports my dentist’s decision to do a crown on the back tooth after the root canal, even though that tooth in particular was largely intact:

Although there may very well be enough tooth structure remaining after root canal therapy is provided for a particular tooth to restore the tooth with an intracoronal restoration, this is not suggested in most teeth.

The vitality of a tooth is remarkable in its ability to provide the tooth with the strength and durability it needs to function in mastication. The living tooth structure is surprisingly resilient and can sustain considerable abuse without fracturing. Consequently, after root canal therapy is performed, a tooth becomes extremely brittle and is significantly weaker than its vital neighbors.

Also, I’m guessing the very back molar is subject to greater pressure than the others, in supporting the whole line, so it had really better be sturdy.

So, I feel much better about my dentist’s decision process. Glad I thought about it … glad I didn’t ask her about it. :D

So, I had two root canals, molars right next to each other. Before I left for Alaska, I was in pain, and the dentist thought she’d better do them before I left, because it wouldn’t really be possible to get done on a cruise, if the pain got worse.

Only, she’s not an endodontist and doesn’t normally do root canals. So my teeth hurt all through the cruise, and managed to develop an abscess. The endodontist did the root canals properly when I got back, gave me penicillin. Hurt for a week, slowly got better, but after the deep ache subsided and the abscess went down, the gum in between the two teeth still hurt. Endodontist said it would continue to hurt until I had the build-up finished and the crowns put on.

Last week, I had the build-up. I don’t know why they call it a build-up instead of a grind-down. They put temporary caps on. The build-up wasn’t supposed to hurt afterwards, but the gum swelled up at the site of the novocaine injection, which just added to the existing gum misery – a little duet of gum throbs.

Then, the caps started digging into my gums – they were freaking HUGE caps. I hope it’s because temporary caps only come in one size or something, and not that the actual crowns will be that size. They’re about half again as wide as my normal teeth. They’re like Matt Dillon character’s teeth in “Something About Mary”, when he gets those big fake teeth, because he mistakenly thinks Mary likes big teeth.

Or they were like that. The caps came off today. The dentist said not to worry if they did, and I’m glad not to have the damn things digging into my gums anymore. But now I’ve got this huge, gaping, unprotected hole between the poor little nubs that are all that’s left of my poor teeth after the dentist ground them down. And it hurts.

I don’t really understand, if the tooth structure is intact, which mine were, why they need to grind down a perfectly good tooth so they can replace it with a fake top, when only the inside of the tooth was bad.

This is the best modern dentistry has to offer? Couldn’t they pour in some quick-setting compound and put some sort of mold on top to set it into a tooth shape? They can do such amazing things. If they can do gum grafts and dental implants, why are they still grinding down perfectly good teeth? It just seems medieval.

I can’t sleep. I am so cranky. And I’m terrified the crowns will come back from the lab and they’ll be huge Something About Mary teeth.

So I was at a conference for work last week, and by Friday I suddenly realized I was over my cold from hell, which I’d had for about 3 weeks. I had a moment of joy. Pure joy.

Then I came home, and woke up Sat. morning with the works – sore throat, painful eyes, clogged ears, achey joints, severe fatigue, and, as always, the congestion lodged in my lungs, mucusy limbs resolutely crossed, declaring it shall not be moved.

Not a cold, though – just my old friend. So very tired of this mystery malaise.

I know I should get the allergy patch test, but it’s hard to see any good outcome, so I keep putting it off. I worry it will be one of two things -

• They’ll find I’ve developed an allergy to cats, and I’ll have to decide what to do about Sasha, or
• They’ll won’t find anything in particular. That would be so discouraging. Every test I scratch off the list without any insight into what’s wrong means an ever-diminishing list of possible solutions.

I guess there’s (3) also, that they’ll find some allergy that I can reduce but not eliminate, and prescribe more allergy drugs. Which doesn’t seem promising, as I’m already taking generic Claritin, which is the only one I’ve notice a real difference with.

I’ve thought about it extensively, and I think the only logical conclusion to be drawn is that I must quit my job and move to the Caribbean. :D

Seriously though, what I really need is a rest cure. Win the lottery, I’d be well.

I’m discovering the benefits of saying No, and adjusting work and social activities to my energy level.

Last night, for example, I didn’t see a movie. B. went off with the guys and saw Smokin’ Aces. Before, I might have hauled myself to the movie and added to my general energy deficit – but I was wiped AND not hyped to see it, so took a pass. I’m so glad I did. B. had a great time with his gang, I got some rest, and didn’t have to see a violent movie I really didn’t want to see.

Today, I took a sick day, because short of 6 months on a tropical island eating lots of seafood, napping in a hammock, and getting spa treatments, sleep is the only real treatment I have at my disposal. In my e-mail to my boss, I said I was taking PTO, because I’m not feeling well and need to take it easy.

Need. I’ve never said “need” to my boss before. But it’s true. It makes no sense to try to bull through when I’m wiped, especially if there’s no deadline pressing, just normal workload. Much more efficient to rest when I need to; that way I have energy to do the things I need to do, instead of wasting it on non-essentials like hauling to the office, when there’s nothing I can’t do from home.

I look forward to finding out why the fuck I’m so tired, congested, and achy all the time, and FIXING it, but in the meantime, saying no is helping.

So, I had the root canal. It was nasty – fetid – but no pain. No pain!

The endodontist warned me that part of the tooth might cleave off along the crack, but it didn’t. Then.

Two days later, eating bagel & lox, I crunched down on something hard. There were two little white bits, about the size and color of the coarse salt on the salt bagel. I spit them out, and didn’t put two and two together (duh) until later, when I noticed my tooth felt unusually sharp. And … half missing.

I always thought losing part of a tooth would be like those horrible nightmares you get, but actually it was fun sliding my tongue around the weird groove. I guess I didn’t mind because they were going to cut that part down for the crown anyway.

After awhile (a long while, I’m easily amused) the novelty wore off, and then I started feeling very mortal. Not old – that came later – but very aware that this is it. This one body, this one life (that we know of). It was a bit sobering.

But only a bit. There’s something strangely freeing about it all. Maybe because I’ve been terrorized by losing-a-tooth nightmares for as long as I can remember – and it wasn’t that bad! Only because nobody can see it. And I don’t necessarily want to live out my other recurring bad dreams. But still. Freeing.

I have an appointment for the root canal Friday. Never thought I’d be psyched to get a root canal.

I was poking around the tooth, and discovered it is the tooth that’s hurting, yes, but also somewhere else that’s impinging on the tooth. But not the gum, like I would have thought. It’s, like, in the middle of my cheek. Just below the cheekbone. There’s some sort of tender, swollen mass, and when I press on it, it twings the tooth nerve.

I don’t even know what’s in that area. You know how you have a vague idea of where things like sinuses are located? Whatever this is, it’s not on my mental map. I’m glad my ENT appointment is this afternoon – maybe he’ll know what it is.

Tonsillitis is back. {curse}

Okay, last I updated, it was before the holter monitor. So:

- The holter monitor showed some irregularities, and my doc referred me to a cardiologist. Month and a half wait – appt. is early Feb. Stopped taking Wellbutrin, per doctor’s advice, to see if that might be causing the palpitations. Palpitations have dropped off, but so has my energy.

- Tooth – awful. Can’t remember if I went into it here – just godawful pain. Went to the dentist, turned out I need a root canal and a crown. (Or possibly a bridge or implant, because there’s a crack, and he won’t know until he gets in there how good the tooth integrity is.) But it was December, end of the year, schedule was busy with people using their FSA money, etc.

They said the nerve would die in several days and the horrible pain would be over, so I could wait a couple of weeks for the appointment. And that is, in fact, what happened.

- Unfortunately, the weekend before my Monday appt., my now-and-again tonsillitis flared up something awful – very swollen tonsils with white spots, sore, red, raw throat, a lot of pain, general achiness. Thought that wasn’t the best of conditions for recovery from a root canal, so I cancelled. The receptionist was ticked, and told me call after the new year to get a new appointment. I went to my doc and got antibiotics for the tonsillitis. Wasn’t strep, just some weird recurring infection.

- Yesterday I took the last of the antibiotics. Throat still not totally cool, but mostly better, and no general aches & fatigue, so good. Coincidentally, yesterday, the tooth started hurting like hell again. I thought the nerve was dead and that wasn’t possible, but whatever. I call the dentist to make the root canal appointment. I leave a message at 2 pm, I don’t get called back. I called again today and it’s still the message machine.

My dental plan is HMO, so I don’t think I can just go to another dentist.

I’m a little worried the infection has spread. Also my tooth hurts. And my stomach hurts like hell, because I’ve been taking Advil pretty steadily over the course of the tonsillitis, along with Tylenol, and sometimes aspirin.

I just hope they can get me in soon to get the damn root canal done. I hope I only need a crown, and not a bridge or implant. I hope the tonsillitis doesn’t come back. I hope I don’t need to get my tonsils out. I hope I can go back to taking Wellbutrin, to get some energy back. I hope I can figure out what the fuck is wrong with me, this joint-aching, eyes-ears-nose-throat-hurting, chest-congesting, energy-sucking CRAP.

I have an appointment with an ENT next week, I’m hoping he’ll have some suggestions.

I also have a scrip for a sleep study. I’ve held off because it’s a lot of time to commit, it’s expensive, andfrankly I’m pessimistic they’ll find anything. Despite many people telling me I frequently stop breathing and then choke awake in my sleep, two previous studies have not found this. I don’t think people are mistaken, I just think the artificial atmosphere of the lab – cool temperature, people there, not very comfortable bed, their waking you up and turning you over – are simply not conducive to deep sleep, which is when the episodes tend to occur. It might also simply not happen every night. I know it tends to happen more often when I’m extremely tired or run down, or have a head cold.

But if I DO do the sleep study, and they DO find apnea, and I DO get a CPAP machine, that could have a very salutary effect.

I’m tired of being so sick and tired so much of the time. It’s affecting my work, it’s affecting my mood, and it’s affecting my social life. Way too often I have to bail on plans because I’m just. too. tired. and sickly. I know people understand I’m sick, and I try to only bail on group things, but still, I feel rude. And I’m scared of becoming a burden on B. I dopn’t want to be sick like this.

My heartbeat has been irregular all today and yesterday. Yesterday I told B. about it, and he freaked out, saying I should get a doctor’s appointment immediately. I said I’d wait until today to see if it went away.

Well, it hasn’t gone away – or rather, it wasn’t beating irregularly this morning, but then it started again – but I haven’t told him, because he’ll just worry, which isn’t helpful while I’m trying to decide what to do.

The reason I’m hesitant to see my doctor is, given my history with her, I’m really afraid she’ll think it’s all in my head that I’m a hypochondriac. :( Or that it’s just some panic-related thing.

I can’t face that skepticism again – it’s withering. I KNOW what panic attacks feel like, and this is not the thudding heart you get in panic attacks. And subjectively, I don’t feel particularly anxious, as I would in a panic attack.

It’s just that instead of going ba-DUMP, ba-DUMP, ba-DUMP, my heart is going ba-DUMP, baaaa-_dump, ba (wait) ba (wait) DUMP.

I checked my pulse to make sure it wasn’t just a misperception, and the pulse matches the perception.

Also, my head is killing me.

So my plan is to wait until I see my shrink on Friday, and tell him. But I’m kind of scared in the meantime, and I can’t think of any friends or family who won’t freak out and say GO TO YOUR DOCTOR NOW. And I know I’m not seeing the situation clearly, but I can’t think of a better plan of action. :(

If you read this, dear Sherlock, any advice would be appreciated.

Both my doctor and my shrink are convinced that my symptoms are either caused or exacerbated by depression. The massive fatigue isn’t due to the chronic respiratory crap and achniess – it’s due to depression. Oh, your mood’s okay? Well, you can be depressed and feel fine emotionally. Your body is depressed.

I’m frustrated. I think I’m going to just decide for myself that there IS a physical basis for the fatigue, achiness, and chest congestion/sore throat/itchy eyes/clogged ears/stuffy nose. And proceed from there.

But it’s really hard when your doctors are saying, “Well, no, it’s not all in your head … but yeah, pretty much, it’s all in your head.”

Sorry, this is an old whinge. :/