Sadness

It's been one of those weeks.

My left gum's been acting up since monday. The fleshy bit just beyond my last molar where my wisdom tooth used to live.

Initially I didn't pay it much heed since I remembered I'd had my wisdoms extracted in NS. But there was an odd little bony prominence underlying the swelling which puzzled me, and I was reminded how I'd only had three wisdom teeth extracted previously because - according to the NS dental specialist - I only had three to extract.

As the week wore annoyingly on I somehow, for some reason became increasingly convinced that my mysteriously missing fourth wisdom tooth had appeared, and that the prominence I could feel was the corner of said tooth.

On thursday night my gum swelled quite dramatically. I found myself pressing instinctively on it - it hurt like hell, but it seemed to force the swelling down a little, although I felt rather feverish afterwards and my throat began to hurt. I also had a rather odd taste in the side of my mouth everytime I pressed, which I passed off as some form of sensory short circuit in my posterior tongue, or perhaps it was just the taste of my finger. My faltering medical mind decided that I had somehow managed to press away all the oedema.

On friday morning I was exhausted from all the pain, and although the swelling had subsided somewhat and the pain was less acute I sought help from a dentist. I'd meant to visit the dentist before work. Unfortunately it transpired that my shift wasn't 12 to 8 as I had imagined (why?!? why did I do that????) but eight to five.

NDC wasn't an option since they don't do walk-ins, and turning up to beg for help from a colleague just didn't seem right. And I only know a couple of them - what chance they would be around.

I arrived at my family dentist at eight only to discover that he was closed for a couple of days.
I briefly considered NUS but the thought of joining an A&E queue was far too daunting.

So I hopped into a taxi to head for Queenstown. That's when my phone rang and the bombshell dropped - I was already on shift. And the other guys were waiting for me to show up.
I felt - quite naturally - terrible. I rang back to offer to go back to work, and visit the dentist after work, but by then the damage was done. My consultant waved me away, having already recalled another MO to cover my absence and bade me sort out my tooth.

There are two dentists in Queenstown.
One doesn't put up his opening hours, and apparently opens late in the morning.

The other has his opening hours proudly displayed as 9.00 am.
Which has been crossed out in OHP marker and amended to 9.30 am.

9.30 am found me sitting on my bag (where I'd been the entire hour) reading my stupid surgical textbook. The receptionist showed up and told me that the sign may say 9.30 am, but doctor doesn't come in so early! He only comes at ten and probably won't be able to fit you in without an appointment! But nevermind, you wait.

So I waited. And wished I was a dentist.

Fortunately he did see me after all thanks to the first patient of the day being tardy.

Initially he thought I had a dental abscess, but after prodding it he thoughtfully said "hmm, it's bone" (which I'd told him...) and decided it was an unerupted wisdom tooth.

Much to our joint surprise, the OPG showed that I no longer had any wisdom teeth at all.

His final diagnosis was that it was a taurus - some form of bony spur - present in 5% of the population, and that my gum had become infected through minor trauma inflicted whilst eating, and now it was symptomatic and required surgical removal. One day MC, no painkillers (I guess that's what I get for being a doctor - the assumption that my bedside table is stocked with free goodies) and no antibiotics. (Because, he said, he wanted to start them after the operation on monday.)

I felt quite the fraud, to be honest. My pain was minimal, and the swelling mostly resolved. I wondered if the whole thing would settle down for good by sunday.

I've grown to dislike workig in A&E. I used to love it. In Singapore I dread going to work.
The largest part of it is how most - approximately eight out of ten - patients don't speak English.
Struggling through histories with my half-past six mandarin is screamingly frustrating, especially since the patients invariably say "huh?" the first time I ask them anything, neccessitating mindless repetition and doubling each consultation time.

There are other reasons work at A&E is driving me insane. I'll save them for a later post, suffice to say I have now been marked as a "bad" MO for slackness and insubordination, which try as I might, I can only dredge up three potential scenarios in which I disagreed with senior decisions but, in two cases bowed to seniority, and in the third rang a specialist colleague to confirm the proper course of action. Oh and the now-famous incident of the MO who Ate Outside the Department. Nevermind that I was three minutes away and completely ignorant of the ban, thanks to reservist committments obliterating my first week on the job. Once a sinner, always a sinner eh.

Yesterday evening my gum ballooned again. The pain was excruciating, so naturally my body told me to press on it again. I had the presence of mind to spit up this time and found that the nasty taste I'd been having in my mouth on pressing on my gum was actually pus.

Disgusting. A gingival abscess.
Cathartic too - the bacteremia I produced everytime I squashed on my gum must have been causing the fever, and the sore throat and lymphatic swelling. And hence the reduction in swelling after I pressed each time.

I'd been feeling a bit bad about the MC I was about to take post-procedure, since I'm told by T my peridontal friend that in essence I'm having another wisdom tooth op, only instead of having a tooth extracted I'm having a bone filed down, and be prepared to suffer for a week and be on MC flat on my back in pain at home.
I'd meant to take three days out of the seven, but after my little "warning" yesterday evening for my perceived transgressions, coupled with sheer exhaustion of working through this stupid toothache, I find myself rather looking forward to this little respite.

Bitter? Me?
It must be the fever.

Wait till I start ranting about all the things in A&E that have driving me nuts... and the said cases of insubordination that I just have to bear silently at work as my cross - the lowly MO who Spoke Out of Turn. Sigh.