Recovery and Travel - June 8-18, 2008

Regular readers have likely noticed the medical action has slowed down a bit since all this started. I am personally grateful that the uncertainty range of outcomes is much narrower now, and I can actually plan to do things that need to be done - both for work and for play. On top of the bladder surgery recovery I got to have my first root canal as well. But other than the tooth issues, June is free from medical procedures. So I planned a week-long business trip to the D.C. area, and it took place last week. You may also recall that I recovered from the second surgery much more quickly than the first. Dr. Hopkins said he had no idea why one was different from the other. He thought the second one might be worse, because he had me in surgery quite a bit longer and hit 4 areas instead of 3 (two tumors plus one bladder puncture).

But really I feel pretty good these days, and had no issues packing for the trip. Road-warrior travelers know the new rules for engagement - you are permitted ONE carry-on bag (I use a rectangular gym bag that holds a lot and takes hardly any overhead space) and ONE SMALL personal item = an enormous laptop bag crammed with all kinds of useful stuff. After years of backbreaking luggage lugging, I finally bought a nice set of wheels
(Concorde II) to cart the stuff around, and that's allowed, too. Got loaded up and headed for the airport parking lot. Much to my annoyance, the area nearest the terminal (where I usually park and walk from) was permanently sealed off and empty of cars - gone forever. The airport has implemented a ginormous parking lot with three zones: Red, White, and Blue. But because locals are TOO STUPID to remember what color zone they parked in, the airport authority now routes every bus to EVERY SINGLE stop. What used to be a 5 minute bus ride or 10 minute walk is now a 20-25 minute tour of remote parking. Very annoying. Fortunately I had gathered some intelligence on where to park and minimize the hassle. Still took 13 minutes to get to the drop-off point, with ZERO WAIT for the bus. Would have been over 25 minutes had I missed that bus!

I breezed through the
Black Diamond Lane at security (for expert travelers) and made my way to the B concourse. Oddly, there were no United flights of any kind listed on the terminal monitors. I found a United agent and asked what was up. "We changed our schedules on all flights today, and because it's Sunday, the city won't update the monitors." Having lived here over 10 years, I have learned to (usually) shrug such things off. Fully loaded regional jet was on time to Denver, and I had a first class upgrade on an ancient 757 for the long leg from Denver to Dulles. The odd arrangement of seats meant that only one of the two could put their briefcase under the seat in front. The window seat was taken, along with the briefcase space. So I unloaded everything and made do. My seatmate turned out to be a decent guy named Shawn, and we alternated between small talk, reading, and watching the truly awful inflight movie: Spiderwick Chronicles. Shawn watched it as a pre-screen for his kids, and he agreed with my assessment. Arrived in DC a bit early, and schlepping carry-on bags around the cars, airports, and aircraft, was easy and pain free - as was walking great distances through airports. But the night after arrival I had very intense bladder and anal sphincter pain (weird) when anything in the intestines moved near the bladder – about 30-60 seconds per episode. Even though it kept waking me up and I had codeine, I am too stubbornly drug-free to take it for anything except constant pain. It got better Monday as I walked around, but bad again Tuesday night. But by noon Wednesday it was nearly gone. I figure the movement of things around the abdomen had a delayed reaction, and doing the exercise was probably a healthy and necessary thing.

My root canal tooth was still somewhat sensitive, and the fistula/sore in my gums lingered on. Still I was able to eat and publish a slate of restaurant reviews on my other blog, so the trip was productive from that standpoint. It was also very productive from a work standpoint, and I was able to make the acquaintance of several good contacts from a partner company. All the big aerospace companies are in competition, but we also work for each other in various arrangements. So the cooperation level is generally good, and is probably unprecedented in the commercial environment. I was drinking a good amount and peeing a lot, especially at night, so good quality REM sleep was lacking. By Friday I was toast. Arrived very early for my very full flight home - no hope of an upgrade (I was number 11 for 3 available seats). I had to settle for a decent aisle seat in Economy Plus. Much to my chagrin, the movie tape jammed and the cabin crew showed Spiderwick Chronicles again! We arrived in Denver 90 minutes late, with 10 minutes to get halfway down the concourse. This is commonplace and is known as the "Denver Dash." Fully 18 people on my 757 were racing to get to the 50 seat regional jet. Uncharacteristically United held the flight, since one of the 18 was confined to a wheelchair. Got to Salt Lake airport and home right on time and went straight to bed. No intense pain that night like early in the week, so that's a good sign!

Root canal is up to 98% good now. I don’t know if it was the dentist or my up-tightness in general that made it linger. Tried chewing some almonds today, and that was a bit much - but not impossible. In the bladder area there is some slight soreness, and the bladder seems to have mini-spasms when it's too full or empty - lasting maybe 10 minutes. It feels more "not quite right" than painful or uncomfortable. On Saturday we leave on a 9 day motorcycle trip centered around WeSTOC XIII in Taos, New Mexico, which should provide more abdomen stretching and organ strengthening opportunities. Hopefully the recovery will be fast and all this stuff will go away before they start intentionally irritating the poor organ with the BCG treatments on July 3!

On a side note... Toothache! - May 27 - June 9, 2008

I wonder if, now that I've turned the ripe old age of 49, it should be the case that everything falls apart. I mentioned in my previous posts that I had a lip and gum injury in the right side of my mouth since surgery day (May 21). On the evening of the following Monday (Labor Day) I developed a classic toothache on my lower right side. It felt like I had a corn husk or piece of something UNDER the tooth, and it got MUCH worse through the night. As soon as I got to work on Tuesday, I called my dentist for an appointment. He had an opening that afternoon at 2:30, and it was none too soon. Dr. Johnston had a hunch as to the cause, but after some work with a "tooth sleuth," some X-rays, compressed air, poking, and zapping with electricity, he was a bit puzzled. "You have a virgin tooth there - no fillings whatsoever. Rather than reacting slowly like a dead tooth, it is hyper-reactive." Having lurched around in the chair through the various procedures, I could only drool my agreement. "You may have a reversible pulpism," he continued. "Now you're just making things up!" I replied. Dr. Johnston explained that at first he suspected a dead tooth - a candidate for root canal. But since the tooth had no fillings and was acting very much alive, he thought it might just be temporary inflammation of the peridontal ligament. So he prescribed a large dose of Ibuprofen, starting with three Motrin tablets right there in the office. An hour later, sweet relief!

I continued the medication throughout the week, switching to Aleve to reduce the dosage frequency. Seemed to work until Saturday, when the pain resumed. Switched back to Ibuprofen
and it got better again. But by Tuesday, June 2, it was bad again. I got to see Dr. Johnston at 10:30 this time. He repeated all the exercises of the previous week, including new X-rays. The injured area was still on my gums, sore and irritated, fully two weeks after surgery. Dr. Johnston though it might be a "draining fistula." He poked around and did not get the expected results - again. Visibly excited by the mystery, he said he was pretty sure that I had an abscess below the tip of one of the roots, but that was extremely rare in a "virgin tooth." Finally he took X-rays of the opposite side for comparison and contrast. That clinched it - abscess. Great... So how do we fix that? Root Canal! My first. Great... And when can we schedule it? A quick check revealed a cancellation the following day at 8AM. Great... While I was happy enough to have the mystery resolved, I was not looking forward to the experience. Dr. Johnston assured me that the reputation of the root canal procedure was overblown. It's like a filling, but it takes a bit longer - up to two hours. I was mildly reassured. But still not looking forward to it at all.

The next morning I arrived on time, barely. Dr. Johnston had indicated I could watch a movie during the procedure, so I brought a DVD of
Toy Story 2 with me. They slapped me into the chair, popped in the DVD, clipped on the headphones, and then swabbed me with the nasty topical anesthetic. Yech. Then Dr. Johnston gave me one of the BIG injections of local anesthetic. I did NOT take it very well, but we got through it. Based on my negative reaction to the shot, he installed the lovely dental dam which isolates the tooth and protects your mouth and windpipe from flying fragments - see photo. Then he had to drill into my virgin tooth to expose the center. After two seconds I had to stop him - not numb enough! So all that stuff had to come out and we started over. ANOTHER huge injection, and things were pretty numb all over. He asked if I had ever used gas - nitrous oxide. Having spent a lifetime just saying no to drugs, I had not. He suggested adding it, to take the edge off. Since I recognized my anxiety, and had not done any breathing exercises or hypnosis, I agreed. I could not smell it at all, as they mixed it with oxygen, and it did make me relax the furious bite I was holding on the spacer on the other side of my mouth. Of course with the gas lines, light, assistant, and Dr. Johnston all in my face, I could not see the TV at all, so I half listened to him talk to his assistant and mostly listened to Toy Story 2. Now I have to go watch it!

The doctor had informed me that this particular tooth should have three roots, but that he had seen as many as 5, and as few as one. We knew there were at least two from the X-rays. Once he had drilled through the enamel, he said, "That's the critter!" verifying his diagnosis, but then he added, "As far as I can tell..." I was less out of it than most of his gas patients, and was able to do sign language to ask h
ow many roots. Three. Good, I guess. Less drilling! About 90 minutes later I was done. Since the tooth was in otherwise good shape, he chose not to crown it. That's good - I have one molar crown already, thanks to a kernel of grain in a Boca Burger, and I hate it. So we got a nice white plastic filling and were good to go. No return visit! Dr. Johnston showed me the X-ray of the tooth taken afterwards, to verify that all the roots were fully filled to the bottom. Looked OK to me. I asked him if he had seen any visible signs of decay, and he said "No," leaving us both wondering if the virgin tooth was the right one. He even called me at home that evening to see how it was going. "Got a grapefruit sized lump on the side of my jaw!" I told him. Since I was coherent, he knew I was kidding. He forecast soreness for a day or two, and it's lasted a full week. But each day is progressively better, just pain on chewing on that particular tooth. And no toothache at all. And the sore on my gums is nearly better now, fully three weeks after surgery. Am I blaming this all on the surgery and ham fisted anesthesiologist? Not really. But she surely was responsible for the sore throat and cut lip! So I guess I am another textbook example of an exception - getting a root canal on a virgin tooth! I wonder if that's also caused by smoking???