Paul's Heart

Life As A Dad, And A Survivor

Archive for the month “July, 2013”

The Dentist

Being diagnosed with cancer and having to go through chemotherapy, pretty scary, right?  Having to undergo open heart bypass surgery… definitely scary, right?  But going to the dentist, the anxiety produced is more than the total I felt between the cancer and heart surgery combined.  That is right, up until one point, I was more terrified of going to the dentist than when I had gone through cancer treatments and laying on the table next to the machine that would keep my body alive while the bypasses were performed.  And believe it or not, there actually is one good reason to be concerned about going to the dentist, but not what you think.  My reasons for delaying my appointments bordered on ridiculous.

My earliest memories of the dentist were not too bad.  Sure I had cavities, but Dr. Weaver was good working with kids.  My first reaction to receiving novacaine did not go well as I reacted like an eight year old might, legs thrashing about in pain.  A little nitrous oxide took care of that.  To make sure that the laughing gas had taken effect, I remember Dr. Weaver taking aim at an airplane mobile hanging from the ceiling in the corner, with his water gun which would be used to irrigate my mouth as needed.  But in the years that followed, I had no issues with getting to the dentist, or having cavities.

But somewhere along the road, a fear, and anxiety developed.  I cannot even explain it, but it led to me not being seen for over six years.  And even then, I had gone through two more dentists due to the fact that I had moved to a new city, plus, that same anxiety was becoming an issue.  I cannot say that at that point, my long term cancer survival issues had played any role, because those late developing side effects had not appeared.

In 2008, eighteen years after my diagnosis of Hodgkin’s Lymphoma, I faced open heart surgery.  All went well, and I was introduced to the world of long term cancer survivors and the many issues that many face due to the toxicity of what we were treated with.  I had broken a tooth.  I knew I needed to get seen before anything went wrong, such as an infection, so made the call to a local dental office.  It was during this appointment that I met Dr. P.  She is a young woman, but very skilled, knowledgable, and empathic with her care.  She had advised me on the risks I face, sepsis with the abscess that had been discovered examining the broken tooth.  An infection in the blood (sepsis) traveling to the heart, can be fatal, possibly within hours of being discovered.  To make matters worse, from my diagnostic plan in 1988, my spleen was removed to see if I had signs of Hodgkin’s Lymphoma in the spleen.  This procedure left me “asplenic” which means that I cannot fight off infections, or as well as a normal person.  She had mentioned root canal for this tooth due to an abscess, followed by a crown.  My anxiety level hit the roof, and out the door I went as I decided to just have the tooth pulled as this was going to be needed to be done by an oral surgeon.

Following the tooth extraction, despite knowledge of how important good dental hygiene is, especially to a heart patient, I made a conscious decision not to return to the dentist for regular check ups.  I had done a lot of reading concerning the issues of not just asplenic or cardiac issues, but how frequently heart issues are discovered just by going to the dentist.  Simply put, if you are someone who does not floss regularly (and who has not gone to the dentist and not been asked or told to floss regularly), it is not just the risk of gingevitus developing, but the bacteria could just end up in your bloodstream, leading to sepsis.  Septic shock is fatal if not caught soon enough.

It had been a couple of months past the six month check-up window that had been assigned to me.  I just kept delaying the appointments.  Then something strange happened, and often.  Until I finally relented the phone calls kept coming.  It was Dr. P calling personally to follow up on me, and the importance that I get into her office to be seen, regularly.  To make sure that I understood her sincerity, she hit me where it would make me pay the most attention.

Dr. P. acknowledged my late term side effects, and the concerns with the jaw, mouth, and teeth due to the various treatments I had received for my Hodgkin’s.  She stressed that it was important that I come in for the regular cleaning and check-up.  I actually lost count on how many times she called me personally.  But Dr. P. was not going to give up.

When I finally made the decision to come into her office for the cleaning and check-up, Dr. P. took the first half hour of my appointment, just listening to me.  Listening to me babble on about my irrational anxiety about going to the dentist.  In what may have been her last opportunity, she began a discussion about pain management.

When you get a tooth cavity filled or the tooth itself pulled, the dentist has various means to numb the nerves and surrounding gum area to eliminate or minimalize the pain.  Dr. P. does not use nitrous oxide, but she does use Ambesol along with novacaine.  The Ambesol topically numbs the gum area to be injected.  The novacaine will do the rest.  But what if you have not been given enough novacaine?  You ask for more.  The chances are probably close to 99% that you can have a booster of novacaine, in fact, several boosters if that does not work.

It has been three years since Dr. P. convinced me she was not to be stressed about.  During a recent visit to have a cavity filled, my gum was not cooperating and it took seven stabs of the novacaine before she could proceed to fill my tooth.  But she took that time.  I trusted her.  I think I am finally over my dental anxiety.  As a cancer survivor exposed to radiation therapy to my lower jaw, the structure of my upper and lower jaws is crucial.  And she knows that.

A New Leaf

A while back, I wrote a story called “CABbaGe – Not Just A Green Leafy Vegetable”.  It was a play on words mixing the vegetable cabbage with the heart bypass, called Coronary Artery Bypass Graft.  This was the second life changing event (the first was my cancer), that should have resulted in the major lifestyle changes, diet and exercise.  While initially, the shock did have me eating foods I would never have been caught eating, the novelty wore off.

For the last five months, I have made major eliminations to my diet, no more soda, no more fried and fatty foods, and no red meat.  This is an effort to cut down on flare-ups from complications of my Hodgkin’s treatments decades ago.  But it has not been a good enough.  I still have not been getting the right amount of calories, protein, carbs, etc.  Several weeks ago, among everything else I have been dealing with my health, I finally heard the words, “you are pre-diabetic”.  Then again, why should now be any different?  It has to be.

So, another egg is put into the basket of care that I receive up at Memorial Sloan Kettering Cancer Center, dietary.  I am assigned to a dietician who has knowledge of my health history, the knowledge of therapies that were used to treat me, and the late developing side effects that I have been dealing with.  That was the good news.

Now for the bad news.  Her assessment of me, my habits, and my history, of six major health concerns with diet and weight, I am at increased risk of five of them.  Wait, I already deal with them:  esophageal issues, heart disease, diabetes, high blood pressure, and sleep apnea.  All of these affect a persons health and increase risks by themselves.

Now for the better news.  Though this is now the third time I am attempting this.  But this is the first time that I feel I truly have a dietician in my corner.  In fact, she has assured me the aggressive approach that she plans to use with me to get my weight down.  She knows the risks I face if I do not follow through.  She cares.

For now, the first phase is about getting me to do something I have not done in a long time, eat regularly.  It is not about eating certain foods, but getting the right amount of calories into me, and getting the right amount of exercise.  The line has been drawn.  I will be following up with her in six weeks.  Though I cannot control what my treatments have created, I can prevent anything else from developing.

Then it will be on to the next phase, getting me to eat things I have forever turned my nose up at.

And The Race Is On

I have been campaigning for our local school district now, going on my third year.  I learned alot from my first campaign effort in 2011.  We had a great slate of candidates to run against the incumbants, but with all of us having little experience running a campaign, we spent a lot of time spinning our wheels with efforts that could have been concentrated on something else.

I think we have a great start to the 2013 North Penn School Board race because we never stopped campaigning at the end of the election in 2011.  We continued to stay active attending school district meetings, meeting voters, reading articles, and attending training sessions.  And then things really fell into place when along with our campaign manager, several other volunteers stepped up their efforts to help us.

The primary election season went very quiet compared to 2011.  In 2011, the incumbants chose to employ a strategy that they hoped would infuriate the voters and eliminate us from any kind of competition.  They chose to use the picture of a handgun, to promote their school board re-election campaign.  It was truly an offensive piece of literature, accusing myself and fellow running mates, that if elected, we would be “committing armed robbery” on the taxpayers.  To quote one of the former board members (he lost his re-election bid, most likely due to this flyer), “we had a message to get out, and we got that message out.”

I will never forget that smugness.  With annual reports of gun violence in schools, to promote the election of the leadership of the school district using a picture of a murder weapon had no place, not just in local politics, but any politics.

2013 is considered an off-year for elections.  There is no presidential race, no election for governor or any other high profile office.  But North Penn School District is the 6th largest school district in the state of Pennyslvania.  It should come as no surprise that our school district election has attracted alot of attention.  Other school districts are watching to see how a mostly Republican dominated school board stands up to a huge challenge of its power by genuine vested members of the community.  Local government officials are paying attention to this race.  Off-years generally produce the lowest voter turn-out.  But with the momentum from 2011’s election, we are hoping to prove that theory wrong.

The primary this year was indeed very quiet.  Even the election day itself went without issue with the exception of a few questionable tactics by poll-workers representing the party of the school board.  There was not even any newspaper coverage.

Well, the Summer is half over now, and as the school district makes preparations for the upcoming school year, it is also a time for our campaign, to line up on the starter blocks.  We have a huge undertaking on our hands taking on a monstrous machine in the form of the four incumbants.  But we, as candidates, who also happen to be parents of North Penn students, home owners and taxpayers, believe that this is the year, to finally make educating the students of North Penn a priority in the decisions that aer made by the district.

It has been over a month and a half since the election, but last night, we got our feet “wet” again with an invitation to another local office’s campaign.  It felt different than two years ago, when we were trying to get ourselves “known” to the public.  Now I was being introduced as someone with an opinion and direction that matter.

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