When Mama Ain't Happy, Ain't Nobody Happy...

When Mike was home for Alex's wedding last month, I suggested he go the dentist, Dr. X, for his 6-month check up. A little history, here. I'm not a big fan of Dr. X, because for some time I've believed he's more interested in making money than in being a good dentist. We "inherited" Dr. X when he bought the practice of Dr. B, our previous dentist. Dr. B was an excellent dentist, but he sold his practice and is apparently now happily making gobs of money selling real estate. Soooooooo...although I'm not a big fan of Dr. X, I thought he was at least adequate as a practitioner.

Mike and I both went in and had our teeth cleaned, and Mike was told that he needed a filling, no big deal, they could fit him in that afternoon and have it over and done with. Of course, I said go ahead, get it over with...and so he had the filling, done by a dentist neither of us had ever seen before. I don't know if he was a locum tenens or a new partner, but he was substituting for Dr. X...and that was that, or so we thought.

Last Wednesday, three weeks after having the work done, Mike called and said that he’d been having a fair amount of pain, pretty much every day, from the tooth with the new filling. Ever the sensitive mother, I said something blase, like, “Well, new fillings can be like that; take Tylenol or better yet, you don’t have stomach problems, take an NSAID...”

Yeah, that’s how I talk to my kids, I realized as I wrote it just now, I actually said, “take an NSAID” because, having spent 5 years working with a bunch of psychopharmacologists, and now working with a bunch of PharmD’s, and being the nerd that I am, we spend a fair amount of time discussing drugs and classes of drugs in my house, and I knew that Mike would know what an NSAID is...pronounced en-sade, btw, and you can read more about them HERE if you don’t live in such a weird household, and yet, like me and my kids, you find that such nerdy stuff interests you...

Friday morning when I got to work, I checked my e-mail and was surprised to see a note from Mike. I was even more surprised by the time stamp: it had arrived in my in-box at 7:01 AM, which is 5:01 AM in Tucson. Mike wrote that he’d been awake for most of the night, in really bad pain, and asked me to call him when I got the note. Of course I called him immediately. He sounded awful, so I suggested that he find a dentist in Tucson; that he call and say it was an emergency, and that he needed to be seen right away. He did, and Friday afternoon, after examining Mike and taking some X-rays, the Tucson dentist, Dr. S, said that she could see why he was in pain: the new filling was “way too big”, as a result of which Mike’s bite was (and has been since the work was done) “way off”. Also, his gum was badly abraded, probably because with his bite being off, the gum had been cut with the edge of the oversized filling each time he chewed anything in the past three weeks.

Dr. S spent some time grinding down the offending filling, carefully checking Mike's bite with each adjustment. When she was satisfied that his bite was OK, she sent him on his way with a prescription for doxycycline (a tetracycline antibiotic), "in case you have an infection" and an industrial-strength, prescription NSAID painkiller (800mg Motrin), both of which Mike had filled and began taking immediately.

All of which sounds great, except...as I write this, at 2:30 AM Sunday morning, he’s at the University Health Center in Tucson, waiting to be seen in Urgent Care. He called a little while ago, in an incredible amount of pain, so I told him to go there immediately, both to try to get something adequate for the pain, which is so severe that the industrial strength NSAID has had no effect at all...and to make sure that he doesn’t have an abscess or some other raging infection in his jaw...

Thus the title of this rant: when mama ain't happy, ain't nobody happy...and bright and early Monday morning, Dr. X and his locum tenens or partner will become aware of that, too...

UPDATE - the Urgent Care doc said they don't do dentistry, but he was sufficiently impressed with the degree of pain and swelling that he dispensed 20(!) Vicodin for pain. This was late Saturday night/early Sunday morning. Despite the Vicodin, Mike was still in considerable pain, and a few hours after getting back to his apartment, at about 10AM Sunday morning, his jaw began to swell dramatically. The swelling continued, steadily, all afternoon, and when I looked at the digital pics he'd sent me to monitor the swelling, I became alarmed. Tonight (Sunday night) I suggested he search the Yellow pages for an emergency dentist, and he found one, and called and left a message. He was on the phone with me when the endodontist called him back, within 10 or 15 minutes of Mike's leaving the message. When Mike described his symptoms, the endodontist told him he needed to see him immediately.

Mike's girlfriend, Brooke, (who's been taking great care of Mike while all this has been going on) drove Mike to the endodontist, who lanced and drained a baseball sized abscess in Mike's jaw. The infection is so extensive that he discontinued the doxycycline and prescribed two antibiotics, Penicillin and Flagyl, that Mike is to take every 6 hours, around the clock, for the next week. He said that because of the size of the abscess, it may fill and have to be drained again, and he asked Mike to check in with him tomorrow, and scheduled him to be seen again on Thursday.

He told Mike that the x-rays he took to look at the abscess showed clear evidence of where the infection started: in the root canal done by Dr. X in July 2005 on Mike's tooth #14. According to the endodontist, the x-rays reveal two problems with that root canal: i) it was not sealed properly, and ii) it shows what appears to be a piece of a broken dental instrument lying in the bottom of that unsealed root canal.

Uh-huh. Nice work, huh? Oh, yeah, unlike Dr. X (who has, on occasion, double-billed me), I keep meticulous records. I pulled Mike's dental file, and looked at the bill to see what Dr. X charged for this incompetent couple of hours of work, and there it is, on the bill, in black and white: $1755.00.

He may not be good, but no one could ever accuse him of being cheap.