Oral Surgery Pending

I hath returned. I have been on strong pain killers and antibiotics to treat the abscesses while *still* waiting to undergo oral surgery. Third time and third hospital / clinic is a charm? Long story short, Mayo can and will do the procedure, but doesn't have a contract with the state dental aid, so it would cost a lot more, and be out of pocket.

I had to get an emergency referral to a hospital in Minneapolis ( almost 2hrs from where we live ) and hope that they will do the procedure for me. I have spent the entire month fighting with various people trying to get everything straightened out just so I can get these damaged teeth taken care of before they get worse, and I am still waiting to hear back from the new hospital, who has been notoriously horrible about returning calls like they said they would.


Recapping since my last update:

The pain was really bad because the infection flared up again. It had a few days to set in because I was denied a prescription for antibiotics and more pain killer by the Mayo oral surgeon I had been referred to, despite him noting signs of the infection returning upon the original Mayo consult at the beginning of February.

I had asked him during that visit about getting more medicine to keep it under control because I could 'feel' it starting to feel like it had before when it got real bad and he said he'd prescribe some after the procedure if needed. We thought it would be done the following week after state aid cleared. Then I find out Mayo doesn't have a contract with the state dental aid. So they were ready to do the procedure and set a date and time, and medical aid would pay for the operation setup and anesthesia part of it. But it doesn't cover the work on the teeth and the extractions, that's dental aid.

So I was forced to wait in limbo as no one did their jobs and I had to end up making calls myself to the state aid to get straight answers, because a a very snarky nasty woman in Mayo's estimations department just told me I was SOL, instead of explaining correctly and clearly what had happened, and instead told me no matter what my aid companies told me, it would be incorrect and they wouldn't cover the procedure so I would have to go somewhere else.

So that was another week and a half of waiting for no reason. When the infection blew up again because I had been forced to wait so long without being treated, I contacted the Mayo oral surgeon so I could get a prescription for the antibiotic and Vicoprofen, because at that point the pain was a blinding hot evil pain, the gums and jaw were obviously puffy, warm, and swollen and I could not move my mouth/jaw without excruciating pain, the slightest touch set it off. Mike was ready to take me to the ER a few different times when it got real bad since I wasn't getting any help or relief and wasn't able to eat or sleep and a few points near passing out from the overwhelming pain.

I had to call several times to get anyone to return my call, only to find out after the staff told the oral surgeon what was going on that "he was no longer treating me since they didn't take the state aid dental contract, and wouldn't write any prescriptions for me".   Go back to the oral surgeon who referred you to us or your normal dentist, they told me.

The normal dentist I was seeing had left the clinic I used to go to and was between practices, and neither of those clinics take the state aid, so I couldn't see them. So I called the original oral surgeon who didn't want to do the procedure because of my autonomic quirks, and they said they wouldn't write any prescriptions for me because they had referred me to Mayo, and Mayo should be the ones doing it, which made sense.

So I called Mayo back and explained all this, and they still outright refused to write a prescription for the antibiotic despite how obvious it was I desperately needed one. So WTF am I supposed to do because you won't help me, I asked them. You need to go find a new normal dentist, they tell me. Are you serious? It's not like I was asking for anything extreme. Just an antibiotic and Vicoprofen. I wasn't asking for anything stronger or insane like Oxycodone or Morphine or anything horrible.

I was lividly angry at that point, and between the overwhelming pain and the anger and frustration, I couldn't think straight. Here it was mid afternoon and I am scrambling like mad before the weekend to find a dentist that accepts the state aid. After many calls, I finally found one, and almost died when they told me they couldn't see me till April (it was mid Feb then ). When I explained it was an emergency and everything about the infection/abscess, they fit me in.

It was a low income clinic, but they were very nice. The doc took one look at the xray they took, carefully peeked in my mouth with a wince and said "Yeaaah don't worry about trying to open all the way, I can see it fine as is. I have no problem writing those prescriptions for you, you need them with those teeth looking like that. Anyone would."

She could see they'd abscessed again and the inflammation was spreading. I had only actually asked for the antibiotic, because I was afraid they might turn me down if I asked for the pain med since it's narcotic. She asked me if I needed stronger stuff than OTC meds, and I told her that would be nice since Aleve wasn't working, and she was like "Yeah, I wouldn't imagine it would".

She wrote me the prescription for antibiotics and the pain killer, was nice enough to write another referral for me noting the inflammation and infection as of her current examination, and wished me luck. Later I got a call back from a case worker with the dental aid, and they put in an emergency request for a mandated condition procedure so I could go to the new hospital in Minneapolis that could do the surgery with anesthesia, and is apparently the only clinic local enough that accepts both state medical aid and state dental aid. Apparently Mayo and Olmstead Medical, which are the two major hospitals here in town, do not accept the state contract, which amazes me in a "WTF why not?" sort or way.

It's insane I had to rush to find a new dentist and get an emergency visit with them, just so I could get an antibiotic to get relief until I could go to the hospital in Minneapolis, because the oral surgeons who had seen me most recently and knew the condition of these teeth ( which would theoretically only get worse over time if left untreated ) refused, and for what reason? I have never, ever had such a bad experience with anything medically related, but this experience made me very angry with Mayo, specifically the oral surgery department.

I feel like their refusal made me suffer longer than I should have had to, and gave the infection and searing pain a chance to get worse, before I was able to find someone who would give me an antibiotic. Sorry, but you don't just ignore a patient who is in such a bad situation.

Which came up in conversation in the next part of this epic and insane journey through medical red tape BS. I had to jump through hoops just to get an appointment at this new place, because they didn't have any set appointments since they work trauma and such. So I had to call on a specific day, and that 'reserved' me a consult for a week out from that day.

The day before the consult at the new hospital, I managed to get a last minute appointment with the RN who I was assigned to when my normal doctor left for his fellowship middle of last year. I hadn't been in to the clinic in a year because I didn't have insurance, didn't have money, and owed them so much from all the previous testing which still didn't give any concrete answers except I have some form of Dysautonomia and something else with my body is not quite right, on top of the Fibromyalgia.

When you have chronic ongoing issues like that and need medication and such, it's not a good thing to not be able to see your doctor. I discussed some things with the RN about getting a note or medical info to bring to the dental consult specifically requesting the anesthesia due to medical necessity with my autonomic issue, renewing my handicap hang tag, and discussed symptoms I have still been experiencing despite my medicine, which prompted her to look at my lab records and order some bloodwork and tests that I apparently never had done, that might shed some light on a few things. I will be having those things done after the oral surgery is completed.

She was awesome enough to dictate the letter right there while in the exam room over their recording system, and ask one of the office staff to expedite it since I needed it for the following day, and have it brought to us so I could walk out with it. It was refreshing to have such a positive Mayo experience after all the other BS I had dealt with that week from the Mayo oral surgery department.

The following day, up to Minneapolis Ember and I went. After some confusion on where we were supposed to go to find this place in this huge hospital facility in metro Minneapolis, we finally found our way there and went through the same steps as each previous consult.

Enter medical info into system, get a panoramic xray, and speak with dental professionals. Overall the staff, and really everyone we ran in to walking around on site, were really nice and rather curious about Ember. People were a lot more talkative and interactive than what we experience in Rochester, and I can't even say it's because people are more or less used to seeing service dogs working. Can Do Canines is in the Twin Cities, but in Rochester there are very few working teams as compared to how many are in Minneapolis and surrounding areas. People just sometimes seem more reserved to start conversation on the topic, I guess because they are afraid to offend or violate the ADA or something.

I kept hearing people in the hall muttering things about the neat dog in the exam room, which made me giggle to myself. When heading to get the xray, a group of the staff was discussing something about another patient, and paused to say hello and tell us how beautiful they thought Ember was and ask about what breed she was. We had a lot of people guess flat coat retriever, which is the closest pure breed she resembles, except she has brown brindle on her legs and they do not.

One of the staff politely asked if they could pet her. I explained she was working at the moment, but on our way back when we got back to the exam room, I'd let them. So a few minutes later we came back and I gave Ember her que and had her go into a polite sit/stay while seven or so people from the department got their dog fix at work, haha. It seemed to brighten their moods, which made us happy, and Em loved the attention. Afterwards Em went back into serious mode and the staff all promptly went and washed their hands at nearby basins.

One of the medical staff came in to examine me and discuss options after he looked at the xray and at the teeth directly. As with all the previous experiences, he admitted that I was a special case for them, and they were not totally sure of the best way to proceed since I was requesting the anesthesia, but just like everyone else agreed the teeth needed to come out.

When I explained the whole horrid experience with the Mayo oral surgeon refusing to write the prescription for the antibiotic and pain med, he frowned a lot and said "I probably shouldn't even say anything about it, but you don't need to be a doctor to look in there and realize it's infected and needs medication. Whether you are the one doing the procedure or not, you don't just see a patient and then not treat something like that, especially when it is so bad and effecting the patient so much."

He asked me a lot of questions about my medical history and I mentioned to him as I had every other oral surgeon person that I have had surgeries previously, including the recent laparoscopy turned appendectomy which was full OR sedation, and the upper GI endoscopy and colonoscopy which were IV sedations, and I was fine with the anesthesia. He left the room at a few different points to speak with other staff about my situation, and at one point I heard someone else out in the hall say something like "just let her know we can't guarantee anesthesia can be used", which really smashed my hope that this was going to be any easier.

He came back and we discussed a few other things, and that came up, and I flat out told him if they forced me to be awake for the extractions, that I knew I would feel the pain through the normal numbing medications they use ( the stuff doesn't work well for me because of my quirky hyper-sensitive pain receptors ), as I have had similar issues in the past, and that it would trigger an autonomic response that would cause me to pass out on them, not to mention how much it would effect my blood pressure and whatnot just leading up to the actual extractions. I also expressed my concern that since both teeth are only half teeth or less and damage extensive, that I was afraid of it all shattering when they tried to do the extraction and just making it worse if I was conscious during it all.

I told him the only reason I had ever told any of them about it, is because it had been recommended by my doctors in the past that because of my combo of rapid heart rate and low blood pressure and the quirks with them interacting, I should mention it to medical professionals any time anesthesia was involved, just to be on the safe side so they were aware of it and no surprises. But informing any of these clinics has worked against me from the beginning, to the point where I think they get paranoid about agreeing to do anything. Because they are afraid of a lawsuit?  It's not like I am asking for an insanely complicated procedure, just knock me out and remove two teeth. Mayo was ready to do it without any other questions, until they realized I had state dental aid and turned me away.

We left off with them basically telling me my case would have to be reviewed by the people who would probably be doing the surgery, so they could decide if it was possible to use anesthesia, and if they could do it with IV sedation or if they'd have to go full out OR setup for sedation. All of which they'll have to get prior authorizations from the medical and dental aid.  They were supposed to call me back the next day and let me know what they decided, and never did. So I waited and called back beginning of this week, and proceeded to play phone tag, waiting on hold for a total of a little over an hour between the multiple calls, only to be sent to a voicemail so I could leave a message for one of the surgery nurses there. Who hasn't returned any of my calls.

I called back and expressed my increasing aggravation at not knowing what the hell was going on because no one was bothering to contact me and let me know what they were going to do. I actually talked to the same desk staff person multiple times, and she apologized that she couldn't get access to any of the info, for whatever reason I have no idea, but she told me to try calling back the next morning and they'd try and grab someone on the medical staff who could talk to me.

So that brings us to current time. I called this morning and it was like night and day, the person who answered the call took all my info and got me to a very helpful person in the correct department, who also took the time to take all of my info and assured me that she was going to go speak to the medical staff for me and call me back with info before the end of the day. Maybe someone flagged my account with a note, maybe things service wise just go downhill there after 12pm with whoever handles the phone lines.

I got a call back and the new hospital has agreed to do general anesthesia in an operating room for the procedure!  Now the only thing we are waiting for is the prior authorization requests from the state aid to approve it all. I really hope they don't give me a hard time over this sedation thing, and I can finally just get the surgery scheduled and get this taken care of once and for all.

Back to playing catchup with emails, posts, and comments.