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2005-11-26 - 4:42 p.m.

I reemember what I wanted to write about earlier today!

I wanted to write about my DENTAL CARE experience! I want to write this soas to REMEMBER to relate this to my DR. When I have my follow up on MON ( the appt at which I tell him that my discussion of FEAR of medication and any substances in my body was REALLY the precursor way of beating around the bush and getting to the point that I REALLY SHOULD TRY AN INCREASE in this medication to give it a chance... before giving up on this and trying another)

Today Westely noted I am kissing and touching the children more... hmm... maybe indeed this IS the right thing for me and I just need MORE of it...

But I digress. The main thing I need to tell him about is about how I am so sure I am ADHD. I have to remember to tell him the story of my dental care which for the first time was a GLARINGLY SAD example of how I have COPED? I hate to use that word... but lack of any other coming to mind....

It really is glaringly obvious and now startling to me that I did things like this for SO LONG (Once again, maybe the medicine does work at some level as I have this awareness?)

I joked when I went to the dentist for a CLEANING and had to tell them I FORGOT TO THINK ABOUT BEING PREMEDICATED for a heart murmer, how at one point it felt like confession when I went to the dentist a few years back for my first professional care and said

"Forgive me hygenist, it has been seven years since my last professional cleaning "

I confessed to this hygenist that I DID IN FACT HAVE A DIAGNOSIS Of mitovalve prolapse and a heart murmer and therefore I WAS SUPPOSSED to get medicated before any dental procedure. Now here's the REAL CONFESSION... I told her THEY WON'T FIND ANY MENTION OF THAT AT THE LAST DENTIST I WENT TO.


I did alot of reading. It is a VERY SMALL percentage of patients with the heart condition who get septic system infections due to dental care-- something like 1% . However for those 1%, if not caught and treated for the systemic infection IMMEDIATELY the outcome can be DEATH. Because of that risk, even though it is not LIKELY that sepsis will result, premedication with an antibiotic is routinely done for all dental patients with heart murmers or mitrovalve prolapse.

But I got SO SICK of making appointments for dental care, struggling to REMEMBER about them, and struggling to GET THERE ON TIME FOR THEM, only to get there and have that dreaded question "Did you get premedicated?"

That I decided after my research to just OMIT that heart info and go in and get my damn teeth cleaned once a year.

Now this hygenist who wouldn't give me the cleaning as I wasn't premedicated and now that I have kids (OK I HAD KIDS THEN TOO.... I guess now that I am treating my ADHD so perhaps I see another effect of this medication... perhaps limiting my RISK TAKING tendency etc... etc... among other things)
But she did take E-RAYS and the dentist did do the exam. And like the others who have done so OHHED and AHHED over my teeth which I am fastidious about. It was a moment of pride after the seven years of NOT being to a dentist that the hygenist years ago had such a look of horror when I answered the question of the last time I had been to a dentist, and with fear she looked at my mouth,then cleaned it and there was not much for her to do. It was a riot how she had to call over EVERY staff member and all these hygenists and two dentists in that office back in Buffalo all had to look at my teeth. It was with pride I had that exam then and they marveled at STILL NO CAVITYS!

(But I have since read it has more to do with genetics whether one has good teeth! Kind of like ADHD... its really neither to my great CTEDIT I have great teeth any more than it is a personal flaw I should feel shame for that I have ADHD... but I digresss again....)

So the current dentist's praise made me feel so much better after feeling silly that I again FORGOT ALL ABOUT the premedication requirement.

I also felt better that THE IRISH DENTIST, and OLDER guy was also TEMPTED to just go ahead and have my teeth cleaned! REALLY he said "Maybe we could... " but had the self control and wisdom to stop that urge and said "we better not, we better wait til we hear back from your Cardiologist"

The real kicker here is that I am in fact also vidicated in my behaviour (thought not really as it is in fact SHEER LUCK on my part!) because of two things: Over the past 15 years there have been changes in the practice of dental care of those with heart condiditons:

1. They now proscribe MUCH LESS ANTIBIOTIC than they used to (Like 1/4 the amount as it was demonstrated the large amount wasn't really necessary.)


2. When I went to the Cardiologist recently he found NO SIGNS OF EITHER A HEART MURMER OR MITROVALVE PROLAPSE! HE also said the DIAGNOSTIC CRITERIA has changed for those condiditons and sometimes when ill it can APPEAR someone has them when their body is under stress (AND I WAS IN THE HOSPITAL WITH A KIDNEY INFECTION WHEN I GOT THAT DIAGNOSIS) He in fact Thinks I DON'T HAVE ANY SUCH HEART PROBLEM! And he is in fact an expert!
(Thus the reason the DENTIST was tempted to clean my teeth. He trusted my honesty in admitting my story of not having told the last dentist and in acknowleding I have ADHD and am now finally treating it so don't feel the need to cope in other ways so much! I told him it was my way of actually getting dental care done! )

I scheduled ANOTHER appointment for JAN. That should be ample time to get feedback from the Cardiologist I saw to the dentist.

And I write as it helps me to REMEMBER as I HAVE to tell my other Doc this story. Its one he will likely be interested in as it really does tell of how I managed to cope (if one can call it that!) with the challenge of ADHD for YEARS.

Well- there it is- I HAVE COMMITTED THE LIE OF OMMISSION OF TRUTH ! And it served me well, at least in that short term goal of getting my teeth cleaned!

And I CAN"T STAND to not have clean teeth!

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