Monday, March 19, 2012

The Toothache Saga

"Some tortures are physical
And some are mental,
But the one that is both
Is dental."

Ogden Nash

On the 1st of March in the year of the Mayan Calendar Apocalypse That Will Definitely Not Happen, I experienced my maiden toothache which involved my second upper left premolar (or the "25", as a dentist would call it). For most of last year, that tooth had robbed me of the pleasure of cold beverages due to its schoolgirlish oversensitivity and just a couple of months ago, I finally had its cavity filled in with dental composite. In the ensuing weeks, I went absolutely bananas on iced drinks and ice-cream, trying to make up for all the icy goodness I've been missing out on.

Then it struck. It jolted me up from sleep an hour after midnight on pre-dawn Friday, throbbing so intensely that I was starting to imagine ripples of humming pain emanating from my jaw like agony sonar. Fuck fuck fuck, I moaned in my head because I once read a study detailing how swearing can increase pain tolerance. The only thing even approaching medicine in my house at the time was a bottle of vodka so I tried that as well (it did have a mild numbing effect, but that wore off in a hurry). Finally, I decided to head to the casualty department at the hospital I work at to see what miracle modern medicine can work for me. My colleagues there were rather swamped at the time so I was obliged to write in my own clerking notes. Surreal.

The strongest thing they could offer me at the time was a shot of diclofenac. A female colleague made me lie down on a bed and asked me to take off my pants - something that hadn't happen in quite awhile now and in almost any other context I would have happily obliged.

"No way!" I reacted, almost too violently. It's just that I don't think I can ever look her in the face again after she had seen my portable cushions. And if the situation was reversed, I would never even think of asking her to shed her knickers - I imagined that that would be tantamount to sexual harassment. Then again, I suppose I would have complied if I have the chiseled marble ass of a Greek god. In fact, if I am that callypygous, I might consider never ever wearing pants again.

So I took 3 mililitres of diclofenac in my arm like a fucking hero and it worked - but only in the sense that the pain from the injection was so intense that the toothache felt diminished in comparison (note to self: never give intramuscular injections measuring more than 1 mililitre in my patients' deltoids). I was then discharged with some tablets of diclofenac and paracetamol just so I would keep till dawn breaks when dentists would emerge from their warrens hungry and ready to scavenge for human suffering pop into their clinics.

The diclofenac did eventually powered the ache down to a tolerable pitch and I no longer consider sticking my head into a microwave oven to be a sensible Plan B. I managed to gathered up the tatty remains of the quickly aging morning and slept on them. In the joyless daylight, I called in sick and turned up at the dental department looking down the barrel of a root canal or even an extraction. I had tried my best to preserve the tooth but at that point, I really couldn't give a mile high club about saving it anymore. I just need the pain to stop. Now. At any cost.

The dentist first gave me a shot of lignocaine right into my gum, and it managed to hurt more than my ill-advised 3 mls injection the night before. Once I got good and numb, she proceeded to drill at my composite filling down to the rotten core of the bicuspid and find (surprise!) that it wasn't rotten at all. The pulp was not exposed yet, as she initially suspected, but it "was certainly very close to being so."

She then gave me the option of proceeding with a root canal or going the conservative route and giving the tooth a weekend's chance to get bored of its game of torturing me. Against what I suspect to be my better judgment, I opted for the latter. The only obvious benefit I got out of the visit was that I couldn't feel half my face for the rest of the day. I also couldn't drink anything without half of it leaking out of my mouth. By evening, the pain had resumed chipping away at my sanity. My meds; they were about as effective as a spork in a gunfight.

On Sunday, after a couple more nights of the dental equivalent of the Chinese water torture, one of the surgeons I work for prescribed me these babies,

Tramadol and Etoricoxib
Pictured: blister packs of relief.

My Prescription for Tramadol and Arcoxia
My prescription.

He told me that he suffers from lower back pain from old athletic injuries (which he apparently sustained from the ruthless bloodsport of water polo) and these are the pills he takes to quell it. Arcoxia or etoricoxib is one of the most powerful drugs of its class and is used to treat musculoskeletal pains. Tramadol is a painkiller related to codeine and morphine, and we usually give it patients after surgery to deal with their agony of having been cut open. Was it wee bit overkill for a toothache? Yes and please, sir.

Seriously, if I could lay my hands on some opium like I did back in Jodhpur, I would have done it in a heartbeat.

Anyway, the arcoxia and tramadol combo was so effective that all I felt after dosing myself is a vague, barely-there tightness in the enamel. By the end of the week, even that dissipated as the inflammation petered out.

And all is peaches and puppies with the world again. For now.

Acknowledgment: Thanks, synical, for introducing the word "callipygous" into my vocabulary. I wasn't aware that "steatopygous" has a positive counterpart.

Still has 32 teeth in his head,
k0k s3n w4i


nicolett said...

I've never actually used it to alleviate any pain, but marijuana might work. But then again the marijuana laws and availability in Kuching ... I'm not so sure.

Anonymous said...

oh no! you have acute pulpitis!

k0k s3n w4i said...

nicolett: you are missing an "a".

Anonymous: oh no! you are stating the obvious! :p

Ted Grimmer said...

Ogden Nash might be stating the truth. Existential anguish and heartbreaks are nothing compared to a grueling toothache! Hahaha. Kidding aside, dealing with one can be a pain! I remember having one last month. I immediately went to my dentist and it turned out that I had bad tooth that needs to be extracted. Gotta love our dentist!