Stupid little women

Perhaps I expect too much. I do not like to be treated like I am a stupid little woman. It's bad enough if someone thinks I am smarter than I am and talks over my head assuming I can understand it. If it's tech-talk, I might get turned on. Otherwise, I prefer to be talked to on an appropriate level. Usually, after talking with someone for a while, we get a feel for their intellectual level. Not always, apparently.

Then again, maybe I am just a bit touchy due to all these body parts that hurt at once and my efforts to try to understand the issues and the proper treatments. It also helps if all medical people agree on what is wrong and what needs to be done. In order to be helpful in my own way, I do tend to do some research myself because I figure it helps to be able to communicate with my doctors regarding my health. The more I can understand, the better I can assist them with my treatment plans. The better questions I can ask, the better they can understand my issues. Communication is important, and I try to do my share.

This whole issue with being stabbed by a pointy stick in the gum and ending up with a gum graft - it's funny in a sick way. I agree with that. How stupid do I have to be to poke my own gum out? OK, no need to dwell on that answer. It was just one of those unexpected and silly accidents that end up taking a large toll.

In order to be helpful, when I am asked for information regarding my health I offer all I can. Dr W's paperwork required a list of my current medications. While I might feel that some have nothing at all to do with dental issues, I put down the entire list, including things like calcium supplements and multi-vitamins. In that list is a medication called Fosamax, which is given to people who have or have had bone loss. Osteoporosis, osteopenia, that sort of thing. I have been taking it for years and duly included it on my list. Nothing was said to me about my medications before the surgery.

When I popped up in Dr W's chair with the information that I have exposed bone in my palate and that my dentist had sent me for a check, Dr W was a bit impatient with me, telling me that it's not uncommon for that to happen. I was supposed to know that, how? Dr W did not give me much information in advance. Suddenly he added the tidbit that Fosamax can cause the bone to not heal properly, or some such mumbled story. I told him it was on my list and he hadn't mentioned it. I was ignored, of course. As mentioned in my earlier post, he sent me on my way and asked me to return in a week to assess the healing situation. We also agreed I would not take Fosamax for a while, and oddly enough, I hadn't been taking it since a week before the surgery. No particular reason, but I just didn't.

Today I returned. Meanwhile, earlier this week I grabbed a package insert for Fosamax. You know that little sheet of paper that the drug stores provide regarding medication? I don't bother with those. They don't say anything. I ask for package inserts, those tiny folded up papers that come with pharmaceuticals and provide everything anyone ever wanted to know about that medication. My ex-husband is a pharamcist; we used to own a pharmacy where I worked at times in addition to my regular full time job. I am aware of package inserts and I read them.

The one for Fosamax, which is a bisphosphonate, says under "warnings:"

"Osteonecrosis of the jaw, generally associated with tooth extraction and/or local infection, often with delayed healing, has been reported in patients taking bisphosphonates. Most reported cases...but some have occurred in patients with postmenopausal osteoporosis." This is a small portion of the warnings related to this issue, but but I remembered Dr W telling me about exposed bones and possible delayed healing, but he hadn't mentioned anything about osteonecrosis. That sounded to me like a pretty scary word, since it means, literally, "bone death." While Dr W and I disagreed over my mouth and some teeth having been infected, we can never resolve the disupte because I went to my internist for antibiotics related to my throat getting infected, and then my sinuses. The infections appear to now be gone.

Today Dr W told me that my mouth is doing very well. The transplant is healed and I may stop being afraid of using the front part of my mouth. Easy for him to say - it HURT when he again grabbed my front lip hard and pulled it down. It hurt when he polished my front teeth. It still hurts. My lip is still swollen. I still have tingly-feelings, like when tissue is getting the feeling back after numbing shots. I still have soreness around the donor site, and he said one section is not healed. (I still cannot eat normal food.)

OK, I can deal with the fact that I am healing slower than normal, even though that is just not my history - I heal faster than the average person in most cases. It's just how my body is. However, he really got my attention twice.

First, he got my full attention when he took one of those nasty little metal poke-y things and tapped directly on my jawbone. From the INSIDE. I cannot describe the sound of that - it didn't cause pain, just a very, very weird feeling and an unpleasant sound.

Second, he told me that it might always be like this. My tissue might not fill in the hole as expected and I may always have 3 mm of bone exposed. He said it would be a very rare situation, but it could happen.

I told Dr W that I had read the package insert for Fosamax and that it mentioned osteonecrosis. He must have assumed I was looking for a definition of the word - he stopped me in mid-sentence and told me that yes, that means my bone might be exposed. (I don't believe that is the meaning of osteonecrosis, but he is the doctor so I dropped it.)

Would I have allowed this procedure had I known that taking Fosamax meant my mouth might not heal at the donor site? Might he have suggested that using donor material that is available, rather than risking my bone being exposed forever, could be a better choice for me? I will never know the answer to those questions, and many more.

I needed to write this down for my own information in case I need it later. If someone else who might have this procedure done, or another dental procedure while taking Foxamax and they ask questions in advance that could prevent problems for them, then I am glad I did it.

So far, I haven't hurt anything else, at least! Just the torn tendons in the one finger and the on-going foot issues. The feet are improving :-)

ST is hoping my new bubble wrap suit will be transparent. So is he.