Down In The Mouth

A pretty picture is not all I brought back from Chattanooga.  While it is truly beautiful there, I now have over 150 books waiting for a good home.  I’m donating them to doctors’ offices as fast as I can so the newly diagnosed can get their hands on the book as soon as they’re diagnosed, but I’m not fast enough!  Contact me at for a personalized copy of What Is It And How Did I Get It? Early Stage Chronic Kidney Disease for the discount price of $10.00. (It sure is a good thing I’m not in this for a profit.)

But that’s not why I’m down in the mouth.  They’re just books after all and we know the best things in life aren’t things.

It’s last Friday’s emergency root canal.  That was unfortunate (still VERY tender) for me, but fortunate for you.  Why?  Well, I’d never even thought about what impact Chronic Kidney Disease might have on  dental treatment before.  I’ve learned a little bit and I want to share it with you.

When my dentist poked the tooth and I said, “Don’t,” he arranged for this root canal the very next day telling me I must see Dr. Bradley H. Gettleman of the three endodontists at the Westside Endodontic Professionals, Ltd. practice here in Glendale, Arizona because he was so personable that I would get on very well with him.  After a rocky start due to my apprehension at having this procedure at all –  I admit it, I was scared – we did get on well.

So well that I invited Dr. Gettleman to guest blog.  You can guess what happened there.  Just like any professional worth his salt (hah!  I mentioned a dirty word – salt), he was too busy with his practice, writing a chapter in a textbook and his family.  You’ve got to admire that kind of honesty.

We talked a bit about how our disease impacts endodontistry and figured out that the anesthetic is what we needed to focus on.  Dr. Gettleman not only explained (as I will in a paragraph or so), but showed me the book he based his decision upon and then lent the book to me so I could quote directly from it for this blog.

The book (which I didn’t know even existed) is Dental Management of the Medically Comprised Patient, Fifth Edition  by James W. Little, Donald A. Falace, Craig S. Miller and Nelson L. Rhodus. You need to realize that as CKDers, WE are medically comprised patients.  Don’t ever forget that.

In a previous blog, I’ve mentioned my brush with emergency room physicians when I had an as yet undiagnosed bladder infection and they insisted I could take sulpher drugs.  They were wrong.  I have Chronic Kidney Disease and cannot take sulpher drugs.  I didn’t want to take the wrong medication again.

As it turned out, the tooth was caught before it became infected so I didn’t need any antibiotics, but there was  the anesthetic as already mentioned.  I was nervous.  What would he want to use?  Would he suggest I not use any since I was being so insistent that the drug not leave the body via the kidneys?

I remembered the pain of a previous root canal over a decade ago.  It was so awful that I cringed just thinking about it.

I thought maybe I’d just let Dr. Gettleman take charge, but couldn’t do that.  There’s a reason I keep telling you to be in charge of your own body.  I couldn’t abdicate that responsibility because I was frightened.  It was just fear of pain.  You see, my mouth is my weak spot since I opened a car door into it when I was 19.   Surely, I could figure this out with the endodontist’s help so I wouldn’t have to endure pain.

Remember I don’t track very well when I’m scared.  That is, after all, the reason I wrote the book in the first place. Dr. Gettleman gave me the information I asked for and explained it to me as I sat there dumbly.  Then I barraged him with questions about what he’d said concerning liver exiting  and kidney exiting drugs.

Okay,  I got it that there was no anesthetic he could use that would exit solely via the liver.  Then he mentioned one that only 2% of exits via the kidneys.  I am stage three.  I was willing to chance that one.

When I finally understood the name he was telling me, I felt a little foolish (Don’t you!  You need to question about drugs and treatment.) It was lidocaine. Perhaps you know it as Xylocaine. Either way, it is one of the most common drugs used in such procedures.  Right there, in  Table 11-2 Drug Therapy in Chronic Renal Disease on page 270, I read that the normal dosage is “okay”  and that most of the drug would be exiting via the liver.

With my mind at ease, I only felt the initial injection and one quick pain in an area which hadn’t been anethesized enough.  Dr. Gettleman soon remedied that situation. I am astounded at how very painless the procedure was… and gratified I was able to take a drug that wouldn’t further comprise my already compromised kidney function.  Thanks Dr. Gettleman for the education and the ease of the process. How nice to know there’s one less thing for me to fear in this world.

So now my lesson is yours.  I get such a kick out of personally learning something that I can pass on to you.

Until next week,

Keep living your life!

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