~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Today, at age 47, I had all four
of my wisdom teeth extracted. The top two were fully erupted, the bottom right
one was a partial bony impact and the bottom left one was a full bony impact.
By my request, I was given a local anesthetic only, the procedure took about an
hour, and was entirely painless. I was able to drive myself to and from the
appointment, and treated myself to a movie on my way home before the anesthetic
wore off.
From everything I've read or have been
told, it is very rare in the United States to have impacted wisdom teeth removed
with only a local anesthetic. Apparently, the standard of care is to provide IV
sedation (usually Versed) for a procedure that is absolutely painless if the
local anesthetic is administered properly. Before finding the dental surgeon
who performed the extractions today, I was told by a nurse at a different dental
surgeon's office that IV sedation is "better for everyone involved" when
impacted teeth are removed. Of course it's better for the provider when an
extra $400-$500 can be tacked onto the bill and the patient won't remember a
damned thing about what was done, and the patient can't object to his treatment
because he "lacks capacity" under sedation. What arrogance to assume sedation
is always "best" for the patient! Unless the patient states a desire to not
remember the procedure or is so anxious that the procedure can't be done any
other way, there is absolutely NO benefit to the patient.
It wouldn't be so upsetting if
this was an isolated comment by a very callous nurse. About three weeks ago, I
had my teeth cleaned at a clinic at a technical college. At that point, I knew
I was going to have my wisdom teeth removed, and informed the hygienist who was
supervising the student working on me. She made some comment about making sure
I had someone to drive me home and being careful until the sedative wore off,
and I told her that I had absolutely no intention of being sedated. The
hygienist replied that the pain would be too great for a local anesthetic, and
that I would need to have IV sedation. When I told her I knew what Versed was,
that it does absolutely nothing to block pain, and that I already scheduled the
surgery without sedation, she stared at me wide-eyed and open-mouthed. She
mumbled something about the "dental surgeon knowing what was best," and I left.
I was so bothered by her comment that I called her the next morning to ask why
she lied to me. She completely denied lying about Versed, and said she had told
me only that my surgeon would know whether or not the pain could be controlled
by a local anesthetic.
When I first read this blog
about 6 months ago, I thought many of the entries were over-the-top in painting
a picture of a conspiracy among medical and dental providers about dissembling
the true purpose and use of Versed. From my own experience with an endoscopy
clinic earlier this year and having my wisdom teeth removed today, I convinced
that there is at least a culture, if not a conspiracy, around this drug. There
is a big difference between being told "this drug will help you relax" and "this
drug will cause you to not remember anything that happens to you, although you
will be awake." If more patients understood what they were being given, and
why, more would refuse Versed. I suppose that some providers can justify the
lie if they believe that a number of patients might forgo important procedures
if they became anxious about the notion of being given a drug that would allow
them to be awake, yet rob them of their memory. And it may be true that some
patients would not be treated, it is not up to a provider, or up to ANYONE, to
decide what is right for a patient, except the patient!
I've also learned that there
ARE providers who will work with you and respect your wishes about not being
administered Versed (or Propofol, or other amnestics.) If this is what you
want, just be firm and state your intentions clearly. Someone who thinks they
know what's best for you, regardless of your wishes, is probably not someone you
want providing your care. Be patient, and find the right provider. He or she
is out there!
No comments:
Post a Comment