Down in the Mouth

With all that’s going on here, I managed to add insult to injury… all by myself.  While trying to open the new jar of honey so I could sweeten Bear’s tea, I broke my tooth.  Don’t ask how; it’s too embarrassing to explain.  At any rate, I was sleep deprived, still recovering from that terrible bronchitis and all I could think was, “Why didn’t that hurt?  I’m standing here with a piece my tooth in my hand and it doesn’t hurt.”

It took a few minutes for me to focus. That’s when I realized it was a not my real tooth; it was the plastic replacement for one of my two front teeth.  I don’t know if you can describe breaking your tooth as lucky, but this one was for me – no pain.  I contemplated not having it fixed since it didn’t look that bad. Ah, but I could hear the lisp when I spoke.  I’d spent quite a bit of time in speech therapy when I was a youngster to lose the lisp and I didn’t want it back again.

Hmmmm, I’ve been trying to figure out how to whiten my teeth.  I was fine with my tooth color until whitening became possible.  People looked wonderful and really healthy with white teeth.  I wanted white teeth, too, until I heard how much that would cost me.  For vanity?  No way, but now that it’s a necessity….dentist

I asked my dentist, Dr. William C. Kaus of Bellaire Smiles here in Glendale, Arizona, if I could get a lighter replacement bridge. I figured that since the bridge covered six of my top front teeth, the ones you see when someone smiles, it might be worth a shot.  He agreed, so we’ll go for the brightest available for the temporary bridge and see if the permanent bridge needs to be a darker hue.  I find myself excited about this.

Here’s what it has to do with Chronic Kidney Disease.  I always urge you to speak to your doctor, every kind of doctor you have.  That includes your dentist.  I told him about my fear of pain in my mouth, the fear I’ve had since I opened a car door into my mouth at age 19.

That’s what caused the need for the root canals in my two front teeth and the need to file them down, way down.  I’d forgotten how very long they had been.  I was warned the teeth might darken and flake in 20 years or so, but 20 years is a long time to a 19 year old.

They lasted longer than 20 years, but did eventually fall apart.  That’s when they were extracted and the bridge with the two new front teeth and anchors for two teeth on either side was inserted.  That’s probably a quarter of your mouth.  Let’s see you have 32 teeth and I had four wisdom teeth extracted which means 28 minus the one that… well, you get the point.

I asked for nitrous oxide, even though replacing a bridge is not a painful procedure. According to Medscape at: http://emedicine.medscape.com/article/1413427-overview, nitrous oxide – commonly called laughing gas or sleeping gas – goes nowhere near the kidneys.  I remember researching when I first was diagnosed with CKD and calling my nephrologist to make certain it’s safe.  (Confession: I am a dental coward since that car accident.)  It is inhaled, goes into the lungs, and then is exhaled via respiration (breathing).  It doesn’t go anywhere near the kidneys.laughing gas

Dr. Kaus recognized that my fear was very real for me, assured me that nitrous oxide – which is combined with oxygen before you inhale it, by the way – would not be a problem and very gently asked me if I’d like something a bit stronger, say, valium.

Everyone’s heard of valium, but I didn’t know much about it and preferred not to take it.  When I was in the throes of bronchitis (was that only last week?), the ER doctor wanted me to take cough syrup with codeine in it, but I’m really, really sensitive to drugs and knew that was going to knock me out.  I didn’t see the point and politely declined that, too.  I’m not good with drugs.

So, valium.  Can and do CKD patients use this drug?    I found this warning at http://www.pdrhealth.com/drugs/valium  (Physicians’ Desk Reference):

“Use Valium with caution if you have any type of kidney or liver problems.”

There was nothing about WHY you need to be cautious in your use of valium.  I spent an hour or so more researching, but all I can find were admonition after admonition to tell your doctor if you have kidney disease and repeated mention that the dosage of the drug valiumhas to be accommodated to your degree of kidney function.  But that’s true of any drug you take.  The lack of specific information for non-medical people about valium only re-enforced my decision not to take the drug.

I am thrilled to remind you that, just in time for Chanukah, Amazon.com has included What Is It And How Did I Get It? Early Stage Chronic Kidney Disease in their Kindle MatchBook  program. That allows you to buy the Kindle edition of the book for $2.99 instead Book Coverof its regular price of $9.95 if you have EVER bought the print copy of the book from Amazon.  Happy Chanukah.

I am actively looking for ways to make the book an affordable gift for Kwanza and Christmas, but think this program is going to be it.  I like how much more accessible it makes the book to those who may need it but weren’t in a position to pay the regular price.

I spent the weekend at a Landmark class where I usually meet the most interesting people.  This weekend was no exception. I discovered that one of my classmates has a nonprofit to offer help to chronic disease sufferers and another is a Doctor of Oriental Medicine.  Both now have copies of the book to share with their patients back in Denver.

Until next week,

Keep living your life!

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