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Old 09-15-2008, 05:03 PM   #1
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Dentist visit

Friday night, dad developed a toothache. I gave him some Aleve, and since he has had aches and pains that have come and gone, frankly did not think too much about it the rest of the night. Next morning, it still hurts, and by this morning, I was sure it really was a toothache. Since we do the "every six months xray/cleaning/exam", and his was just a couple of months ago, I never imagined it could be all that bad.

Dentist shows me the film at 2 pm - he has an abscessed tooth! Not to where it was puffing out his face, no fever, no swelling - just the beginnings of an abscess where he currently has a crown. Dad pointed at top right, and it is actually BOTTOM right, but nevertheless, he has a problem indeed. Of course, it can't be taken care of till Wednesday, cuz that's when the oral surgeon can see him, but he has antibiotics and pain meds.

Well, on the way home from the dentist's, I stopped and got the Amoxicillin and (yikes!) Vicoden. Let me tell you - a demented man with limited mobility is a real treat when hopped up on Vicoden! Of course, the idea is to numb the pain, and it has done that. Good. Score! But - it sure jacks up his little bit of ability to walk. I gave him some chicken/rice soup, crackers, pudding, iced tea, 1 Amox and 1 Vicoden. Gave it about - oh, 30 minutes - the time it takes him to eat - and said, "Daddy, do you feel like you could sleep?" He nodded, so off to bed we go.

Took us 30 minutes to traverse 15' of hallway. Poor guy. But I got him undressed, in bed, and sayonara, daddy. Zonked him right out. I went to check on him a minute ago, and he was awake, but making no verbal sense at all. I toileted him, and popped him right back into bed after a good long drink of iced tea.

Vicoden won't hurt him, will it? I called his primary to ask, but have not heard. Any experience with this stuff?

...little deb

 
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Old 09-15-2008, 08:36 PM   #2
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Re: Dentist visit

Yep.... three tooth extractions between my two parents and a broken arm gives me experience in the narcotics. I have learned to ASK for half strength. It definitely takes away what cognition they do have. You also need to watch for constipation.

Not sure if you were here in January when Mom fell and I ended up staying in the room with her for 5 days. She had the flu and a horrible cough so my sister had requested stronger cough meds.... yep you guessed it. It was Vicoden based. I was there three days and she was not getting any better. The third day I honestly thought she was having a stroke. She slumped against the wall and could not walk. She was confused and barely able to communicate. When I ask to see the cough med and they opened the Narcotics drawer I knew. I told them she was to have NO MORE!! 24 hours she was better and in 2 days I went home and she was fine. Not only had it zonked her out but the lack of coughing had given her a touch of pneumonia. Several times before I have ended up going home because Mom took a pain med, lost her ability to think, and took too many for too long. At one point she was taking the pain meds instead of the antiviral for shingles... and taking twice as many as she needed. I am NOT a fan of pain meds and the elderly and they are prescribed like candy.

Dad's narcotics were put in the trash and 2 separate tooth extractions and a toe nail removal were all handled with over the counter pain relievers. Mom had a pain pill after her tooth extraction but after that it was all over the counter pain meds. If it can be managed with over the counter meds I would not use the pain meds. Neither of my parents seem to feel pain like they used to and function much better without the over powered pain meds. If you have to give them pain meds, and I did with Mom's broken arm, I ask for half strength percocet and it worked great without the dramatic effects of the vicodin.

I have said this before on the forum. Physicians, including dentist,are too free with the heavy narcotic drugs and the elderly. I have flushed enough narchotic meds that I found at Mom and Dad's to supply a small hospital. Not only is it danger for them to take them while they are alone because of the effects of the meds, they tend to confuse meds which makes it dangerous, and it is dangerous to have them in the house in these days of drug addicts. He does need the antibiotic to get rid of the infection but if he can take the OTC meds he is better off.

Love, deb

 
Old 09-16-2008, 12:12 PM   #3
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Re: Dentist visit

Well, we are 24 hours into antibiotics and Vicoden. I have been giving him less than the suggested dosage of the Vicoden, and he seems to be tolerating well. Sleepy, as expected and as typical for him anyway, but his BP is good, and he is eating when I sit him at the table to do so.

Tomorrow is extraction date. 8am. I don't look forward to this. I hope he manages to tolerate it well, and recovers nicely. Something tells me, though (and I hope it's just me and not God) that this is gonna be a bumpy ride.

Dad's color is concerning me. He just looks ill to me, and he admits that he is, in his words, "Not well". He cannot manage more than 3 words in a row, his hands are cold all the time (circulation changes?), walking is a TOTAL challenge. But he eats, and his BP is good. I do not know the hallmarks of what is important to note. All I can do is feed him and take his BP and pulse, and although his BP is super low (104/64), I conclude that it's ok.

I called the doctor yesterday, and made an appt for next week - after he recovers from this tooth thing.

Is there anything, in y'all's experience, that I should watch for after this dental thing?

I need a hobby. Maybe I will start collecting towels and snowballs - just to keep my mind off dad.

...little deb

 
Old 09-16-2008, 01:24 PM   #4
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Re: Dentist visit

Trust that the dentist will know what he is doing, and will not do your Dad any harm. They often take BP before an extraction, and if he is worried about anything your Dad is showing, he will take proper measures.

You will want to bring a list of all meds your dad is on. If he takes a blood thinner, even aspirin, maybe he ought to leave it off starting now and keep off it until the extraction has healed. Ask his doc or dentist to make sure.

He may be very drowsy and 'out of it 'after the surgery. Let him sleep it off. Just give him plenty of water. In my long experience, dentists are much better at the old adage "do no harm" than medical doctors ....

I'll remember you and him in my prayers, 8 AM tomorrow!

Love,

Martha

 
Old 09-16-2008, 02:28 PM   #5
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Re: Dentist visit

Thanks, Martha. I hope you're right.

I guess my biggest concerns are just that dad is "not right". I can't even put my finger on it. He looks awful, doesn't talk much, sleeps a LOT, and has said he doesn't feel well. He can't tell me HOW he doesn't feel well, and given that the doctor is not about to sit there and wait the intermidable period while dad tries to speak, I need to know how he feels bad.

And now with this new tooth thing, requiring an oral surgeon, I am just worried sick that he may not "bounce back" like he has in the past.

Maybe I just need another glass of Chardonnay....and a towel.

...little deb

 
Old 09-16-2008, 06:34 PM   #6
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Re: Dentist visit

Please don't worry so about your dad's tooth. The extraction hurts a lot less than the abcess. The tooth part, at least, will be ok.
Thinking of you, and recommending 2006 Toasted Head Chardonnay,
Q

 
Old 09-16-2008, 06:36 PM   #7
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Re: Dentist visit

Three tooth extractions later..... they all went well. Dad had to be off his blood thinners and asprin for 5 days before the extraction and a few days afterwards because of potential bleeding. Neither of them used much pain med except OTC. After the first one Dad came home and ate a steak... it was tender but it was beef. It didn't slow him down for a second. He looked like somebody hit him in the face with the second one. There was a lot of bruising. We had a difficult time keeping ice on it because he didn't remember why he needed it. He would tell us he was fine until he looked in the mirror and then ask what happened to his face. Mom had a little more difficulty but she is not as far along as Dad is in her dementia.

All in all it was basically a non-event compared to what I expected. They tend to not remember what happened and don't seem to feel pain (or Dad doesn't) like you and I would. He is the one with the circulation problems as well and that may be part of the inability to feel pain. As for indicating "what hurts", it is very difficult for anybody with dementia to determine what hurts, where it hurts, or why it hurts. The only way I knew Dad was having a tooth problem was because he pulled on his ear one too many times and that is unusual behavior for him. His second extraction was due to a broken tooth and he swore that one never hurt. But then again he had a toenail removed, put on his hard shoes, and said that didn't hurt either.

As for the excessive sleeping, Dad is doing that as well. Perhaps circulation, perhaps response to his confused surroundings, perhaps who knows what. I just know it happens. The cold hands may be circulation or something else. The best thing to do is what you are doing.... checking with his physicial.

I will keep you both in my thoughts and prayers tomorrow morning and hope all goes well.....

Love, deb

PS.... you have the best rock collection on the board hehe... thanks to Dad

 
Old 09-17-2008, 02:57 PM   #8
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Re: Dentist visit

I LOVE Toasted Head Chardonnay!

Janie

 
Old 09-17-2008, 03:01 PM   #9
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Re: Dentist visit

After today's extraction debacle, I am headed to the liquor store...for Toasted Head Chardonnay. Thanks for the tip! Now the question is...is the wine for ME or for daddy? I think he would like a glass of wine - but he was a Cabernay Sauvinoin Red drinker in his day.

No, no wine for daddy. He would be SUPER wobbly then. No. No wine. I will wait till he's sleeping, then, *pop* - a glass for me!

...little deb

 
Old 09-17-2008, 07:12 PM   #10
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Re: Dentist visit

The wine is for you. I know someone would have to fight me to get a glass of mine. I'm drinking Walmart wine tonight, bad day and no money. Mom had been fairly lucid, but I have a cold, my mom-in-law is worse, and my normally nice husband is mean.

 
Old 09-17-2008, 08:39 PM   #11
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Re: Dentist visit

Q - it never fails, does it? After a rough day, it just gets rougher.

After dad had extraction, refused to keep gauze in mouth, chewed on it like gum, wouldn't stay "down", was like a fart in a skillet he was so restless...then, the 12 yr old comes home.

He is hormonal and touchy, alternately grouchy and weepy, daughter comes home and is demanding, and then hubby comes home and is distant and tired. No one gives a crap what kind of day I had with the 82 yr old toddler, the ringing off the hook phone (Excuse me, ma'am. Have you decided who you are going to vote for? Yes, good day, ma'am. I am calling from the Police Association, raising funds for ...Good afternoon, ma'am. I am with the Citi Group, calling to offer you a program we call Citiassistance...)...dad up and down and up and down, munching on his gauze, 12 yr old begging for some attention, dog needs out, cat needs in, dishes still in the sink...dad up and down, still chewing on the gauze...sheesh.

And to top it off...like you...no $$. So, what do we do, q?

I know! Here's a towel <deb flips q a pink towel>. Let's wring it hard, and wait for tomorrow to see what treasures tomorrow will bring, and in the meantime, hit the Walmart wine HARD!

Thinking of you, q. It ain't easy.

...little deb

 
Old 09-18-2008, 03:12 AM   #12
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Re: Dentist visit

Little Deb,

I'm sorry it was such a hassle. And then the family doesn't understand. Today is a new day - things will go better. They can't go much worse, can they?

Maybe it's time for round the clock care for your dad. Think about it - your kids come home and you are there and not busy with the 82 year old toddler (well said!) ... you have already taken care of the dog and cat, and now the 12 year old gets your full attention. After half an hour he is satisfied and goes off to do his homework. Your husband comes home and gets your full attention. He laments over something that happened at work and you listen sympathetically and he is grateful for you. He even asks you how your day went. Now he is afraid to, because he knows it will produce hours of venting ... no criticism meant, that's just how it is on Planet Alzheimer.

Once or twice a week you visit the toddler with some small presents or candy, he is happy.

Consider it. You wont even need the wine...

(Mom had no money, no house. An Elderlawyer got her into Medicaid. Meanwhile - after her money was spent down but no Medicaid decison yet made - the NH kept her there for only her SS check until Medicaid kicked in.)

love,

Martha

Last edited by Martha H; 09-18-2008 at 03:14 AM.

 
Old 09-18-2008, 09:56 AM   #13
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Re: Dentist visit

Martha is absolutely right!!! I think she will agree that we don't realize how much caregiving takes from us... until we step out of that roll and find all the things we have neglected and missed while we are doing what we "need to do". Your son does need your attention, your husband does want your attention, and your daughter does want your attention. Martha is absolutely right, they don't dare ask "how was your day" because they already know. Caregivers do tend to isolate themselves and become obcessed with their caregiving. I know I did!!!!! Then I found out that it was easier to get into the roll than to get out of it. It took a major episode to shake me out of my rut but now I am soooooooo glad something did. Just glad nobody was hurt in the process..... including me. When I woke up from my caregiver stupor I saw the friends and family I had neglected, the health problems I had created in myself, and ...... Mom and Dad are actually better of where they are now!

Yesterday was an unusually bad day but it will not be the last unusual day in your future. They seem to come more and more frequently. Use that as a yard stick of what needs to be done. Little deb, you are spread way too thin. Your frustration is as much with what you can't do as with what others are avoiding doing. I agree with Martha, it's time for you to take that step you have been considering for too long. You need HELP!!!!!!!! If it is only a few hours a day, say in the late afternoon and evening, but you definitely have to get some help. We all care about you too much to see you struggle so. So here some more towels to tie up the loose ends and a few rocks to throw at anybody that stands in your way. I will even throw in some good wine when help is in place......

Love, deb

 
Old 09-18-2008, 11:32 AM   #14
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Re: Dentist visit

Taking just a few minutes to touch bases....

Wow. Did I ever NOT expect today! I made dad pancakes and eggs for breakfast, and he ate every bite. But. He seemed to be unable/unwilling to talk at all. He would answer with one word - like I asked him his name, and he said, "dunno". Hubby tried to talk to him, and dad managed some gibberish. I took his bp...101/47!, so I gave him some more juice, and clipped his nails and filed them..in silence. I told him he needed some more rest, and gave him his walker and helped him to bed.

He woke up a bit ago, bp back to where it belongs, but he is not talking. No numbness, no signs of a stroke. He is peeing ok, so kidneys are still apparently ok, but man...this is a blow.

I am planning on an ER visit shortly if he doesn't "turn around".

Thanks for the support, y'all. You are all right. This is more than I can do...I need help, post haste. And I will get it. Maybe even today.

...little deb

 
Old 09-18-2008, 12:28 PM   #15
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Re: Dentist visit

I would not go to the ER just because he is not talking. Maybe he is in a mood. Maybe he has nothing to say, or can't formulate the words. If he is eating, drinking and peeing, he is physically OK. Give him a few days to recover from the extraction. Don't panic. Take it as it comes.

Love,

Martha

 
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