The problem is sometimes you have to get it wrong before you have the chance to get it right and in medicine the window of opportunity rarely gives one a second chance. I got the chance to right the wrong.
The human body is a supremely complex organism and, understandably, any dysfunction of the whole is often not a result of a single adverse event. The origin of the major symptom may not be immediately obvious. Such is the life of a physician; expected to render an immediate and correct diagnosis based on limited and often outdated reference.
I am a dentist; trained in the art of microscopic repair. I fix things. Anyone could see that Dave needed fixing. His teeth were worn to mere nubs and the obvious solution was to recreate what he had destroyed. Gold and porcelain! Jewelry for the teeth; both beautiful and strong. He became mobile art. A monument to restorative dentistry. Restored. Rehabilitated. Recreated.
A few years later I fixed him again. Shame on him for destroying my work! A series of patches, replacements and repairs ensued and so the battle began.
He won. I was never able to strike a balance between the organic and inorganic; his teeth and my dentistry. I was, after all, attempting to treat the symptom of his real disease.
You see, Dave has severe obstructive sleep apnea never diagnosed. He stops breathing nearly once a minute, on average, all night long. The incredible wear on his teeth was caused by nearly constant grinding in a desperate effort to open his airway and stay alive. Obviously, my dentistry was a lower priority. I misunderstood the real cause of his problem. I also failed to recognize the significance of his medical history which included two heart attacks by the age of 53, acid reflux disease, or that he was a very heavy snorer. That’s not my job right!?
Sleep apnea is a deadly condition which places significant load on the heart, the arteries and alters normal sleep patterns. The symptoms can be vast and seemingly unrelated, including excessive daytime sleepiness, diabetes, high blood pressure, headache, chronic pain, depression, acid reflux disease and even my arch nemesis, excessive grinding and tooth wear. Heavy snoring is usually associated, especially if accompanied by gasping and choking or a long pause between breaths.
Subsequently, I have developed a special interest in learning and practicing dental sleep medicine. Sleep apnea management is not a widely known arena in dentistry and requires training and proficiency. I joined two dental sleep medicine academies, began traveling and studying, and am preparing for certification testing at this time.
As a result, I got a second chance to treat Dave using a specially designed plastic device which fits over his teeth and moves his jaw forward while he sleeps, opening his airway and improving his breathing and sleep. He feels more rested. His headaches have decreased in frequency and intensity. The overnight oxygen saturation in his blood has improved and his snoring has decreased. I don’t know about the tooth wear yet, but I have to believe it will become less of an issue with time. In all likelihood, I may have added years to his life and I thank Dave for giving me a second chance.
You see, I love being right.