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.