An Extraction Under Conscious Sedation

Posted on February 19, 2003 in Dentition

I took the blue valium and an eryc an hour before I arrived at the office as they’d instructed me. A short, Asian nurse paused in front of the bathroom and instructed me to take a moment to empty my guts to the porcelain god inside. When I came out again, she led me to a brightly lit surgery with a view of Irvine Avenue. I joked that the people on the street had a first class seat where they could see the drama of my tooth’s execution. She assured me that the glass was black on the other side and then went about preparing the utensils Dr. D’Almo would use for the “procedure”.

Another nurse, named Tammy, came in. She clipped a heart rate meter to my left forefinger and strapped the blood pressure cuff to my arm. “You’re going to feel a little pressure here,” she said and I replied “I know. I have this done all the time.”

“I think we’ve met, haven’t we, Joel?” she asked as Dr. D’Almo entered the room.

“Yes,” I said. “You were the one who taught me how to brush my teeth using the Sonicare toothbrush,” I said. “And you told me about the $3 spaghetti dinners that you can get on Wednesdays at Cooks Corner.” Dr. D’Almo blinked at my mention of the notorious biker bar. Tammy and I chuckled.

“I’m going to have to find a vein so I can stick a needle in your arm,” as if the sight of the crystalline IV sack hanging over my legs weren’t a sufficient warning. He asked me if I was one of those people whose veins were difficult to find. I checked my left arm and noticed a slight depression at the spot Dr. Tsai’s phlebotomists favored. “Just follow their tracks,” I giggled. He looked and decided to use the right arm because it was nearer to him and didn’t have the blood pressure cuff.

They had me squeeze a lavender ball, the gift of a detail man whose product I felt too lazy to read. I liked it because there was a little metal nut in the center which let me know when to stop squeezing and release the pressure. Tammy told me to squeeze and hold. “You’re going to feel a pinch now,” said Dr. D’Almo.

“Yes,” I said. “I’m expecting it.”

The needle slid in the larger of the two blue veins and rested there while Tammy taped it into place. Dr. D’Almo commented on “all the hair” and I laughed. “Yes, I know about that, too.”

He picked up a shining syringe for the local and squirted out a bit of the anesthetic. I closed my eyes as the silvery steel needle approached my mouth. “There’s going to be a slight sting,” Tammy said from behind me. “Uh-huh,” said I, the man who’d probably felt more than a hundred of these pricks in various parts of my mouth over the years. I felt more three more sharp touches as he pulled it out and moved to inject the local at another corner of the tooth he’d chosen for execution. What seemed to be about thirty seconds later — too soon — he asked me if I was getting numb. I said that I was, miraculously enough. The “procedure” proper began.

Sometimes, I heard the three of them talking to one another. I think that they spoke to me, too, but I don’t remember how I answered them. Instruments entered my mouth and I dreamed that every one of them looked like a pencil-thick stainless steel baton that was blunt at both ends.

I think I heard him say that he was going to cut the tooth in half. I’m not sure if they pulled it in one piece or had to break it up, though I thought I felt him tugging at a recalcitrant root with a sturdy pair of forceps.

I had trouble, during and after the “procedure” seeing the single file of events. The drugs they used to sedate me prevented me from accumulating the complete set of folders from which my memory could draw to write about what they did later. If you’d used me as a clock to count the minutes it took for them to do the extraction and the bone graft, I would have told you that it took maybe ten to twenty minutes. The actual surgery took about an hour.

Aside from the pricks of the needles at the beginning, I remember no pain.

The tugging of the stitches in my gums warned me that the job was done. They woke me by saying my name. I opened my eyes. Dr. D’Almo asked me when the last time was when I’d eaten. I said at about six. “You’re likely to be feeling a bit light-headed then.” He’d remembered that I was a diabetic. He had Tammy find a can of diet shake. I read the label at her request to be sure that it was OK for my diabetes. I pointed out the numbers that I consulted on the nutrition label and deemed it good. I drank it down while she fetched a wheelchair to take me out to Lynn and our car.

I spent the next six hours applying a cold compress to my face — twenty minutes on and twenty minutes off. The vicodin helped stave off my nervousness and the pain.

This morning I got up the courage to look at the chasm between teeth numbers 29 and 31. The stitching looked like cobwebs pulling together several purplish pink loaves. I welcomed the hour when I could safely rinse and spit out the slightly ammoniac blood. I’ve been eating pudding, apple sauce, and deviled ham. They’ve told me that I can eat pasta and well-cooked vegetables. Tomorrow and Friday are the day’s when the swelling and pain are supposed to be the worst. I’ve got vicodin handy and a couple of good books which promise to complement its opiate effects: a Yeats anthology of Irish fairy tales and a book about secret societies.