Saturday, November 23, 2013

I may need a legal guardian.

In previous episodes:

  • I've recently quit my job for medical reasons.
  • I'm still working part-time to tie up loose ends and ensure a transition.
  • My liver is limping along.
  • My rheumatoid factor is slightly elevated and I am slightly anemic.
  • I am exhausted.
So, in all my wisdom, I decided to go through with an appointment I had scheduled for some dental surgery to address receding gums. I thought this was wise because my dental plan would terminate when I left this job.

As the surgeon injected the anesthetic into my gums I realized that this chemical might be metabolized by -- you guessed it -- my poor liver.

Did I stop him? Did I say something?

No. Because I am a Good Girl who Does not Inconvenience Others.

(The dental assistant had asked about any medications I was on, but didn't ask about any changes in my health, so it didn't occur to me to mention anything.)

So the procedure continued uneventfully, except for a slight difficulty with excessive bleeding because: liver.

Figuring that the damage, if any, was done, I went home, applied the ice pack to my face and slept for 5 hours, ate some supper, then slept for another 10 hours. I decided not to fill the prescription for super-duper painkillers and am instead relying on ice packs and sleep.

So, perhaps not a "huge" mistake, but certainly not a smart move. Feel free to smack me upside the head. But gently because my head kind of hurts right now.



    “Isn't it nice to think that tomorrow is a new day with no mistakes in it yet?”
    ― L.M. Montgomery

    “To err is human, to forgive, divine.”
    ― Alexander Pope, An Essay on Criticism

    “I make mistakes like the next man. In fact, being--forgive me--rather cleverer than most men, my mistakes tend to be correspondingly huger.”
    ― J.K. Rowling, Harry Potter and the Half-Blood Prince

  2. It's true, most anesthetics used in dentistry are metabolized by the liver. The ones that are not are generally only used as topical gels. I would have to review my pharmacology again (so don't quote me on this), but I'm pretty sure the periodontist you went to might have still used the same anesthetic, perhaps just a bit less of it. Severe liver or kidney disease is not a contraindication of using most dental anesthetics, but it needs to be used with caution because it increases risk of accumulative toxicity, or overdose, as the body metabolizes it slower than normal. In a person with normal liver function, toxicity is usually minor and goes away by the end of your appointment if managed properly. If you have very low liver function, that accumulation of chemicals in your body probably stuck around for a while.

    As for you not being asked for updates to your medical history, that is unfortunately very common. There isn't enough time in an appointment to ask the questions needed to be asked, but that is an accident waiting to happen. Most people leave out something in their medical history, and that is why it's our responsibility to ask. If you had gone home and started feeling very ill, you would have pieced the two together and gone to the hospital. What happens to those who do not understand the relationship of liver damage to drugs?

    1. I thought I had replied, but I guess I . . . got distracted?

      Anyway, I certainly didn't blame the dental team. I am responsible for my own health and should have called the office beforehand to reschedule.

      For those who don't know any better, then, yes, there is increased risk. One good thing about this was that, because I also had a sedative (another liver-hit, but my blood pressure was scarily high without it), I was required to be picked up by someone, so I knew I wouldn't be alone.


What did you think? Any comments?

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