I went to the oral surgeon today to have a wisdom tooth removed. Well, in all honesty, Dr. D. and his resident (or that is, I am assuming she’s a resident) are eligible for some much-needed lessons in disability awareness and much more general communication skills. It was bad.
As I went in, I was feeling presumably normal preoperative anxiety plus a little sensory overload. Despite this, it seemed that the procedure started out as it should go: the medical assistant took me into the operating room, guided me to the chair, and told me I’d be getting some anesthetic injections into the mouth first. The first disability stupid thing that happened, was her asking me: “Can you talk?” Her tone of voice indicated a mixture of annoyance and condescension. Well, I am verbal, but I’d been so overwhelmed that my speech was less than optimal. She couldn’t have known this, of course, since I haven’t actually told these people that I’m on the autism spectrum. However, what would have been done if I’d not been able to talk, for whatever reason? What happened during the remainder of the operation, where I don’t think you’re supposed to be quite chatty due to doctors having their instruments in your mouth all the time, indicated that quite likely they’d pretty much just have guessed me not to have anything to say anyway. During a particularly uncomfortable part of the procedure, someone asked: “Are you okay?” and, after I didn’t respond – how was I supposed to respond? -, immediately filled in that I was. I fill in that this means she wasn’t interested in an answer.
The operating room was, unfortunately, quite overloading with background music and surgeons talking at the other end of the room. They eventually turned the music off, and maybe they would’ve done so earlier if I’d asked, but I wasn’t able to communicate all that effectively at that point. As I laid in the chair awaiting the local anesthetic, I got increasingly anxious and overloaded. Add to this the discomfort from the anesthetic itself – to my surprise, it wasn’t even too painful -, and you can imagine that I was quite unquiet. As a side note, I don’t normally have dental phobia, but the entire overwhelmement of the environment, oh my.
Dr. D. was going to decide all over again which side he was going to operate on. I thought Dr. V., whom I’d seen on Monday for the preoperative consultation, had decided the left side would go first. (For your information: if you are uncomfortable with a new doctor at every new visit, I don’t recommend you ever get anything done at St. Radboud University Medical Center’s orofacial surgery.) Apparently, not so: Dr. D. took a look at the X-rays already looked at extensively by Dr. V., took another look into my mouth, and decided the right side would go first. I got worried, since Dr. V. had been ambivalent about that side. Specifically, she’d not been sure whether the upper wisdom tooth would have to be removed, and this had seemingly been the reason she’d wanted me to get the left side (where both teeth need to be removed anyway) to be done first. What would be happening to my right upper wisdom tooth?
As I said before, there was some kind of resident in the room as well. She didn’t introduce herself, so at first I assumed she was the medical assitant who had already introduced herself – I don’t recognize voices immediately, but people seem to assume that I do. However, medical assistants aren’t supposed to be operating, are they? I’m pretty sure I found her performing pretty much all of the procedure. If she was a resident, I think Dr. D. ought at least have told me that he was going to have her take part in the procedure. Now I got even more confused: was this woman going to operate on me, or was Dr. D.? During the operation, I was hearing many things that would be good candidates for the “Things You Don’t Want to Hear During an Operation” list. Dr. D. and the woman-who-didn’t-introduce-herself were hardly talking to me, despite the fact that they knew I would hear them (the humor list presumes doctors think you’re under total anesthesia), but they were talking to each other all the time. Now I must say, I didn’t understand any more from what they seemed to direct at me than I understood from their communication amongst themselves. I seem to have made out that they were debating amongst themselves which kind of stitch to give me, but I’m not so sure about that, and I seem to have made out that I was instructed to keep some kind of weird-feeling thing in my mouth for half an hour, but I couldn’t make out what it was or how I was supposed to keep it in its place.
Their entire communication sounded like I was not supposed to have anything to say anyway. Before the instruments were stuck into my mouth, I overheard either Dr. D. or the woman saying that I wouldn’t need an operating sheet over my head and eyes, since I woudln’t be bothered by the operating lamp anyway. How do they know? Maybe now I realize what relevance Dr. V.’s question last Monday whether I am totally blind might’ve had – I usually take this to be unwarranted curiosity. I’d been unable to talk at that time and the nurse who was with me might’ve said yes. Now I do have light perception, and a lamp that might already hurt a sighted person’s eyes so badly that they’d be sleepshaded for comfort (that’w what the flyer says), would certainly hurt my eyes. This became quite obvious when the light was shone seemingly almost directly into my eyes, without sheet, of course, since the people had decided I wouldn’t need one. I tried to protest, but couldn’t get the words out. I hid my face under the large operating sheet that covers your entire body for hygiene reasons, and was told that of course they wouldn’t be able to reach my mouth that way. I knew, but how else was I going to protect my eyes? They finally asked if the light bothered me, and I was eventually able to say it hurt. They then gave me the face sheet anyway. Honestly, why won’t you just ask a person before deviating from regular practice? The flyer said clearly that you’d be given a face sheet to prevent being blinded by the operating light. If I’d not had light perception, and had felt that the sheet, if used for no other reason than eye comfort, had better be left out, I’d have made this request. There is no reason to think for me like this.
As I was relatively comfortably covered under the face sheet and the anasthetic had started to kick in, the operation itself went relatively comfortably. I didn’t really mind the fact that I was not told what they were doing, but I got confused by what they were saying to each other and the occasional word directed at me. When the lower wisdom tooth was removed, the upper wisdom tooth debate started. I was somewhat able to follow it, but I tried not to listen and just let them make the decision, although all the back-and-forth chitter did make me quite confused. I was eventually told that they’d be removing the tooth to prevent it from hurting something (I seem to make out it was the lower gum it might start damaging, but I’m not sure). Oh, fine with me. But then Dr. D. turned to the X-rays once more and changed his mind: since the tooth beside the upper wisdom tooth is quite badly damaged from caries, he feared it might break off or need to be removed someday, and the wisdom tooth, that looks alright, would then be able to replace the other tooth. Also fine with me; by this point, I was entirely unable to follow anything that was going on and would have it either way. There is still a small chance that it’ll have to be extracted anyway, but if I understand Dr. V. correctly, the dentist would be able to do this.
When I went back into the waitign area, my nurse was given a script for mouthwash. I am not sure when I’m supposed to start using that, since the woman also said I wasn’t supposed to rinse my mouth for a while (maybe today?). I was also told that I could be taking paracetamol (Tylenol) as a pain reliever, even though Dr. V. had prescribed ibuprofen and I’d actually already taken one of them before going in, as recommended by Dr. V. (As a side note, for some reason I got ibuprofen in water-solluble powder form, and the manufacturer made a horribly failed attempt at making it taste like orange – yuck!) That was fine with the woman too, although it’s stronger than paracetamol. At this point, it’s six hours post-operation, anesthetic has worn off, but I’m not having any pain and haven’t needed any more ibuprofen. However, lack of physical pain is clearly not the only determiner of a procedure gone well.