What fresh hell is this? Part II

Day 85  

General status update

Nose: eclipsed by mouth

Mouth: see below

Nausea demon: feeling very left out, as I’m being tormented far more effectivelyby others at the moment

Chemo Muse: says this is all terrific material – yeah, right. She doesn’t have to experience it.

Chemo Brian: I’ll be joining him on the sofa, shortly

The Anti-Tooth Fairy: like the Devil, she wears Prada.

Hair: not even on the agenda, right now

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Fatigue/weakness: continuing

Anxiety level (1-10): Stratospheric, what with a new infection to worry about.

State of mind: I am turning into Job – there will be a plague of locusts arriving any day now…

Remember the Tooth Fairy? You were a little kid, one of your teeth fell out, your mother comforted you, and 50p appeared magically under your pillow during the night. I loved the Tooth Fairy, as do all children. What nobody tells you, though, is that the Tooth Fairy has an Evil Twin, who turns up when you’re middle-aged, and does Really Terrible Things to your teeth, which is bad enough, but the real kicker is that you have to pay for it all, at huge expense. She's the Anti-Tooth Fairy, and this time it's personal.

One of the first things you learn when you first start looking into chemo is that chemo and dentistry don’t mix; with the risk of infection, and risks from infection, being so high during chemotherapy treatment, the last thing your oncologist wants is anyone coming near you with sharp instruments, and tooth extraction is completely verboten. Any kind of dental treatment can be carried out only with the permission of your oncologist, and your best bet is to get your teeth very thoroughly checked out, and any necessary work done, well before you start your course of chemotherapy, in order to avoid any unfortunate incidents during the 18 weeks you are in your chemical prison.

And that is exactly what I did. By the time I started chemo my teeth were all in perfectly good nick - apart from the one at the front that I knocked out just before chemo started, and which cannot be replaced until after my chemo has finished, thus giving me the unfortunate appearance of an Appalachian bag lady, but that’s another story – so imminent dentistry was not on my current list of major anxieties. Much as breast cancer wasn’t on my list of chosen diseases about which to be hypochondriacal, come to think of it.

When I started getting pain in my jaw last week, then, I simply assumed it was coming from a new mouth ulcer, mouth ulcers being one of the Afflictions of FEC. It kept on hurting over the weekend, though, and I ended up taking quite a lot of painkillers, and I couldn’t seem to find the mouth ulcer. By this morning it was really hurting rather a lot, and the pain seemed to be increasing by the hour, and it seemed to me that the last tooth on my lower right jaw might possibly have a kind of hole in it. I didn’t poke it with anything pointy to check, but all in all an emergency appointment at the dentist seemed like a good plan.

At 2.30 this afternoon, my lovely dentist, who works in what I can only describe as an Islamic Feminist Dental Practice, conveniently situated on the ground floor of the huge mansion block in which R & I live, informed me that the pain was not, as I had hoped, psychosomatic, but that there was indeed a deep hole in my tooth, and the nerve was probably irreversibly damaged, which didn’t sound good. An x-ray then confirmed that the damage was irreversible and there was also an infection in the tooth, and that was very bad news indeed; my oncologist had not only made a point of saying that she would much prefer it if I could manage not to acquire another infection before my next chemo cycle, she had also insisted on giving me that very expensive injection of Pegfilgastrim 10 days ago in order to prevent such a thing occurring.

The dentist then went on to say that the tooth was now essentially toast, although it could be ‘saved’ via root canal work; the pain was coming both from the damaged nerve and from the infection, and because of the chemo and my immuno-compromised status, she would need to consult with my oncologist urgently about what antibiotics I could be given, and whether the oncologist would permit her to do enough work at least to kill the nerve, pending further treatment later on. In the meantime, she inserted a medicated dressing into the tooth to help with the pain, and topped it with a temporary filling.

Fabulous, just fabulous.

I went home, alerted R to this latest disaster-in-the-making, and tried not to fret too much about the burgeoning infection in my jaw, just at the time in the chemo cycle when the immune system is at its weakest. While I waited for a phone call from the dentist, I thought very warm and grateful thoughts towards my oncologist, who had had the foresight to insist on that immune-boosting injection, without which neutropenic sepsis might well have already set in.

An hour later I receive a slightly exasperated call from the dentist’s receptionist, who I believe is her little sister, to say that they had been unable to get a reply from the oncology secretary, and no-one had yet replied to their urgent message. Could I possibly try calling the hospital as well? I assured her that I knew someone to call, and called the Chemo Matron, who had very kindly given me her mobile number and told me that I should call her immediately if any more problems arose. I had not anticipated actually having to do this, but doctors in the oncology department are not easy to get hold of, so it seemed the best way forward in what was a genuine medical emergency.

Becky got straight on the case and within half an hour had got Dr K to write a prescription for some high dose antibiotics, which I then picked up from the hospital pharmacy. Tomorrow I am to go into the hospital to have my bloods done, to see how the neutrophils are holding up in the face of this new infection, and whether I am deemed fit to have any dental treatment.

Meanwhile, I am treating the pain with some industrial strength pain-killers, and a couple of glasses of a vigorous Argentinian Malbec which R picked up on the way home from work, the better to drown our sorrows in ( I did take the precaution of checking with the hospital pharmacist that a glass of wine was not counter-indicated with these particular antibiotics).

R wondered, tentatively, whether red wine was the ideal thing with which to take one’s painkillers;  I replied as follows: ‘My mother always says that she finds it helpful to wash down her painkillers with a good strong dose of alcohol, and she’s 82 years old and a hell of a lot healthier than I am – I rest my case.’

Cheers…..