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Good patient, bad patient.

Dear Patients, Spring has arrived – some of us are looking ahead to a long Easter holiday weekend, and others, Spring Break. Maybe you’ll finally head out to dig in the garden this week, or just go for a walk without a jacket. And maybe, you’ll just get five minutes with your college kid at home, on the couch, to find out who they are these days — and how much laundry they need done. Meanwhile, I find myself excited that I just might be able to chew a Marshmallow Peep or a speckled chocolate egg this weekend. You see, a few weeks ago, I had a gum grafting procedure to reinforce my receding gums. This is not news to most of you, who have now heard about my icky procedure in gory detail on Facebook. What you may be surprised to learn though, is that I was a lousy patient. What made me a lousy patient was NOT that I missed medication doses or didn’t follow my instructions to the letter. I did all that. I was a bad patient because I was actually trying to be a GREAT patient. I wanted to be “easy” and not “needy” and not a “complainer.” I did precisely ZERO research about the procedure before. I didn’t ask detailed questions. I didn’t discuss realistic expectations for my recovery. I didn’t ask for pain meds. I didn’t call when things were not going well. I tried to persevere. Newsflash: perseverance does not have to equal suffering. So while I’ve told this story on Facebook multiple times, one part — the part where I admitted defeat and took control of my suffering — is worth repeating. Now, if you have a planned gum grafting procedure, please know that the following was MY experience. Some people I have spoken to indicate they had a much better time than I described. Also worth noting: my doctor and his office were top-notch. NONE of what is to follow is a reflection of their care – they were accessible, kind, compassionate, and responsive. I cannot imagine what this would have been like with anyone else. I was prepared for the “yuckiness” of the numbing procedure. Dr. A was meticulous about this part (thankfully). He numbed my palate and gum line repeatedly using several different anesthetic administrations. I felt nothing when he “harvested” the graft from the roof of my mouth. Despite trying THREE different suture techniques to secure the graft, I felt nothing. However, I did notice that he seemed to be working hard. Later, he would tell me that he battled “my small mouth and uncooperative tongue” for the better part of the procedure. (Shh. Surface area-wise, I DO have a small mouth.) Once the graft was finally in place, he placed a putty bandage over the grafted gum, then put a custom-made acrylic appliance over the roof of my mouth. Driving home, I was a little woozy but ok. I picked up my antibiotics and big bottles of ibuprofen and Tylenol. I was to take 800 mg of ibuprofen every six hours and mix in Tylenol 1000 mg if needed. My face and chin were massive in the morning, so much so that I couldn’t eat. At my one-week follow-up, Dr. A removed the appliance to clean it and then replaced it. He suggested I take it out again later that day but reinsert it if I had pain. Being the “good” patient that I was, I did not call to tell him that when I tried to replace the appliance, I gagged… over and over and over. I simply was not able to do it. So, instead of calling, I just left it out. The pain from this point forward is impossible to describe. I’ve heard people liken the pain to when you burn your mouth with hot pizza. It felt more like I gargled with sulfuric acid. The pain radiated from the roof of my mouth to my gum line to my ear and jaw. Ibuprofen took the edge off but only lasted 3 hours. After that, I would bury my face in ice for two hours and just cry. This went on for 48 hours. Then, finally, after sitting up all night with me while I writhed and cried, Chris insisted that I call Dr. A’s office. They got me in within hours. Dr. A was so attentive and empathetic. He examined me and explained that I had a lot of swelling at the harvest site. Apparently, the appliance had quieted the exposed nerve endings. Without it, they were on fire. I then sheepishly told him that I simply could not put that thing back in my mouth because it made me gag so much. “Oh,” he said. “I can fix that.” He then shaved about a centimeter off the back of the appliance so it would not stimulate my gag reflex. Next, he painted it with a topical anesthetic and put it back in. He then wrote me a prescription for 5 Percocets. By the time he had finished the script, the pain in my mouth was 100% GONE. It was miraculous. I am pretty sure I saw angel wings sprout from his back as he walked out. That was a turning point. From that moment, the recovery was fast and easy. Today, I have nearly ZERO pain – one week ago, I was in agony. The moral of the story is that having an unexpected outcome or being in pain—or being scared—does NOT make one a bad patient. But conversely, staying quiet, not asking for pain meds, avoiding making the call, or trying not to “bother” someone, does not make one a good patient. Help us help you. Treating things that might be a little hard to bring up – like depression, anxiety, sexual dysfunction, or a host of other new symptoms or changes you might experience — is not just our job. It is our life’s work. Your trouble—no matter how big or small or difficult to talk about—does not constitute a character flaw. If a medical issue is a stumbling block in the path to your best life, we are here to help you lift, shift, or navigate your way around it. So stop trying to be a good patient. Make the call. Speak up. Ask for help. Any doctor worth the confidence you place in them will jump at the chance to help. If they don’t, you have the wrong doctor. If they do, bring them a sleeve of Marshmallow Peeps at your next appointment, and ask all the questions you want. They’re eager for both.


-C


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