Monday, April 03, 2006

Spitting is better than Swallowing

Fun and games.

Went to ER last week due to Rachel having a Pilonidal cyst (check out pilonidal.org for gory details) - nothing like being asked "Does this look infected to you?" OUTside of work. So that's all better, having had it drained. (Gooey!)

(Aside to Rev. Wallick - now a higher risk of Crohn's, acc to the ER phys. asst - interesting)

Monday there was a bat in the house. Always fun to toddle over to the neighbors (hi Matt!) and say, "Um, yeah, have you got a fish net?" at 11pm.

The most FASCINATING thing to happen to me was an experience with a patient who ate a crown. (actually an onlay, but we won't get into that)

This is a fascinating lady who is a hoot at cocktail parties, I'm sure, but, by her own admission a "pain as a patient." (I did NOT say it; she did....) Anyway, upon trying this crown in, I put cement on it, seated it, had her bite and said, "Stay biting for a few minutes." For SOME odd reason, perhaps it was the nitrous, she elected to OPEN a few seconds later. As she moved her tongue around, and I looked on in horror, I saw the crown (onlay! less retention..duh...) dislodge and float around her pharynx area for a few fateful seconds.

Springing into action, I whipped off the nitrous, pulled her head to the side and encouraged her to cough. "Turn! cough! couch couch! Go aaaugghhkk!" (the latter word is MUCH better when I tell the story in person, as people say, "oh, how was that again?" in a facile attempt to make me go aaaugghhkk again)

She did not aaaugghhkk. She went, "glug...gurrr...ack....GULP!"

Down it went, as I futilely attempted to fish it out with a cotton pliers (dental tweezers to you lay people).
"Oh," she remarked, "a piece of something went down my esophagus!"

Oh, not just a piece, but THE something. After making sure she was breathing ok, I walked out of the room so as to avoid the temptation to either grab her by the throat or bash my own head against the wall in frustration. Certainly I could have been more watchful that she didn't open and sure, I could have had a 2x2 gauze there to catch it if it fell. (although, YOU try to leave gauze adjacent to #2 AND have the patient close and then you'll really see gagging!) Nevertheless, I thought, "Oh dear Lord, I SAID to BITE!"

After returning, I encouraged her to eat plenty of fiber, Metamucil, what have you. We'll get her back in 2 weeks after the lab makes a new restoration. "In the meantime," I said, "you will be pooping out gold. We should all be so lucky."

"What if I get it back?" she asked. Er. You mean....retrieve it....er, AFTER? "Sure!" Well...um....

Actually, I DID recement a lost aka swallowed crown back in school....just ran it through the autoclave, tho I learned that when a patient hands you ANYthing you want to probably have a glove on.

Well, on Monday, she called and reported that after dining sumptuously on Mexican food all weekend, she RECOVERED the restoration. All I could think of was Trent Reznor of Nine Inch Nails singing that one line, "I wear my crown of s---/ upon my liar's chair/ full of broken thoughts/ I cannot repair." (of course, the Johnny Cash version is not only a more powerful song, but he manages to clean it up, "I wear my crown of thorns.")

So, after some sterilization, we cemented the bugger right back into place. Only took 2 hours this time. I was careful.

Adios, amigos.

3 comments:

Don Wallick said...

Hi Nate ... Well, Rachel has my sympathies. A brief excursion at pilonidal.org tells me that this must be one very painful condition. I'd be interested to know the connection between this and Crohn's.

Nice work with that crown. When we have found a way to simply deal with the filth and muck of life that people may hand us, and then go on doing what we can to help, then we have truly grown in compassion.

Janice Struckhoff said...

Good story!! Thanks for a laugh.

Anastasia Tuckness said...

Hard to believe, although I did once hear a story (in a column by Neal Bowers, author local to Ames, Iowa) about a woman who regularly swallowed and "recovered" her wedding ring...