Stick to the Teeth

Like roughly 90% of the rest of the world I'm not a huge fan of going to the dentist. I have good teeth, rarely have cavities, never had anything major happen beyond getting my wisdom teeth removed, and about the most painful part of my visit is getting the lecture on how I should floss more, but I still dislike it.

At least as an adult you don't have to deal with fluoride anymore. I'm sure the hygienist I had when I was about seven or eight still has flashbacks to the day I inexplicably chose the chocolate flavor then proceeded to throw it up all over myself. Ahh...childhood.

So anyway, at the end of every cleaning my dentist stops by for roughly two minutes to check over the hygienist's work and ask me a few questions. He looks at my tongue and my jaws, presumably keeping an eye out for other things affecting the mouth not directly related to teeth. He checks the structure and strength of the bones in my jaw, the muscles in my throat - that sort of thing.

This time his fingers lingered on this small lump just under my jawline, to the right of my throat, on what I thought was just an ingrown hair or something.


"Hmmm"? What exactly does that mean? It sounds thoughtful and foreboding at the same time.

"It looks like you have a swollen lymph node. Have you been sick?"

No. I don't get sick.

"If that's still there for more than a week or two you should probably have a doctor look at it."

It's been at least a couple months. Well then.

So I made an appointment with a doctor. In the meantime I did what everyone with a computer does when presented with an issue like this: I hit up WebMD.

Honestly, I'm not a huge fan of this site. The information on it is so limited and rudimentary that I feel like it's just a more organized version of the textbook from my freshman personal health class in high school. Plus, no matter what your issue, the diagnose always leads to have a doctor look at it. Which, honestly, is probably the best advice, since I don't trust my own diagnosis anyway. You know, not having a medical degree and all - that Japanese degree isn't going to cut it. Heck, I don't even know medical words in Japanese, so I'm even further behind that curve.

I should take that back; the other thing WebMD usually leads you to is a conclusion you are about to die (and see your doctor!).

I'm not entirely naive about lymph nodes - I know enough to know swollen ones are not good news. I looked them up anyway and found this. This is my favorite part:

"The glands on either side of the neck, under the jaw, or behind the ears commonly swell when you have a cold or sore throat. Glands can also swell following an injury, such as a cut or bite, near the gland or when a tumor or infection occurs in the mouth, head, or neck."

I'm reading this and thinking to myself... I haven't had an injury, a cut, or a bite...and I don't feel sick...so that means... HOLY SHIT!!!!

I of course shared this info immediately with Wifey, which only worried her more despite the admonishment that I'll drive myself crazy looking at this stuff and I should leave it to a doctor. Which, of course, I already knew, because we've both done this before. Which goes to show I just don't learn the first time, apparently.

When I get to the doctor's office the nurse takes me in and weighs me, which inexplicably includes my shoes and everything in my pockets, including my wallet, car keys, and cell phone. At least she let me put my book down. That leads to a weight of over five pounds more than my actual weight, which of course makes me look much more overweight than I actually am. Guess which number gets written down in my chart as gospel?

Then she takes my temperature (98.5 degrees), pulse rate (65 beats per minute), and blood pressure (160/106 - WOW!!!).

"Um, that can't be right."

"Are you sure? It was pretty clear."

"I'm pretty sure...the last time I checked it (at Haggen's pharmacy) was a couple weeks ago, and it was something like 125/75. That can't be right."

"I can do it again."

The nurse is not very happy at this point - I'm sure she isn't used to being questioned like this, since she is the expert here, not me. I vaguely wonder why they do this the old-fashioned way, with a stethoscope and hand pump, instead of with a machine that supposedly wouldn't have distractions. She does it this way again anyway.

"It's pretty clear - 160/106."

"Wow, that just can't be right..."

"You can ask the doctor to do it again when he comes in if you like."

She's not happy with me at all at this point - and that's probably putting it mildly. I suppose if I were in her shoes in this same situation I probably wouldn't be handling it any better - likely worse - so I just let it go. She hands me a tiny patient history form to fill out while I wait for the doctor. After writing N/A on everyone line with regards to smoking, drug use, surgical history, major illnesses and the like, only writing down my 2-3 drinks of alcohol a week and exercise times, the doctor comes in.

(On a side note, what did he learn here from this sheet? Other than I have a couple drinks a week, the only thing it seems to me he learned is what couldn't cause whatever issue I have. Do these things cover something like 80% of all possible causes of issues? Great...all my doctor will ever be able to conclude is if I'm sick he needs to do more digging. Lucky me.)

I explain the issue to him and he looks a little doubtful, but he feels around my neck and throat anyway. He can't find the problem.

"Did you say it was a lymph node?"

"That's what my dentist told me."

I have to show him exactly where it is.

"That's not a lymph node. It's an ingrown hair. It'll go away on it's own."

He says this with a minor note of contempt he probably isn't even aware is on his voice. Probably this is aimed at me, for being an idiot who can't tell the difference. I must have missed that detailed class on lymph nodes when I was learning a foreign language.

"Well, I suppose that's good news."

I'm not happy about this, really. I had to leave work early and pay a $30 co-pay to be told something I had already assumed. Awesome.

"That's the last time I listen to my dentist for something that doesn't involve teeth."

"He was probably just being thorough." The doctor's voice trails off here, like he's trying to figure out if that's it or if my dentist is incompetent. "Still, he should know where the lymph nodes are though."

For the record, the lymph nodes are probably 2.5 inches to the right of where this bump is, so yeah, he should have been able to tell that, right? Or, if he's not an expert in lymph nodes, perhaps not talk about them and cause undue stress and financial impact to a patient, who trusts the judgement of medical experts because, well, they are the experts with the experience and the big, fancy degrees?

"Your blood pressure though - this could be a problem."

Now, while the number recorded was surprising, the idea of elevated blood pressure is not. The last time I was in for something completely unrelated my BP was something like 140/90, and at the time the doctor said to keep an eye on it, check it every so often, exercise more, and lose some weight.

Since that time I've dropped 30 pounds, exercise more, eat better, and have been checking it at places like the Haggen pharmacy. I relate all of this to my doctor, but he's unimpressed. So I ask:

"How much faith do you put in those pharmacy blood pressure monitors?"

"Not every much. they get overused and not very well maintained. You should get one for your home - they are about $60-70 at Costco. If it doesn't get better in a week or two you need to come back and have it looked into some more. It could be caused by stress, but I don't think that should skew the number too much."

Hunh. My last doctor said those machines were close enough. And we don't shop at Costco - we must be in the 5% of the population that doesn't.

So I looked up what they carry at Costco and then bought the same thing from Amazon, and it cost me $70. So this should be fun. In the end, I left work early and dropped $100 total for something I had already self-diagnosed accurately on my own before my dentist filled me with doubt. Rad. I'm thinking I should stop listening to him if it doesn't involve teeth.

I'm not minimizing what was found, if it is really an issue - I'm just not going to be grateful to my dentist for it. He had no idea and instead led me down an incorrect path of assumptions. Some will say it was fate leading him to do that and get the other issue found, but I'm not a big believer in that sort of thing. Coincidences, random accidents - I believe in those. But I'm not going to thank him for this.

I go to the dentist for a reason - to get my teeth looked at. I go to a mechanic to fix my car. I hire an electrician to fix an outlet. I would never ask one of these people to do what another expert should do or would have the knowledge to do, and they don't typically volunteer opinions on things they know they aren't experts in. I wouldn't expect any of them to give me writing tips, for instance.

Please, stick to what you know. And if you attempt to go outside of your perceived realm of expertise, you better damn well know what you are talking about.

That's the last time I listen to my dentist for anything not related to teeth.

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