Thursday, August 27, 2015

dry mouth

I am a dentist and also suffer from oral cancer.  I was diagnosed with osteosarcoma of the right mandible 4 years ago.  Initial treatment included removing my right mandible along with my right parotid glad.  After that I had many courses of radiation and chemotherapy.  Both of these took a toll on my ability to produce saliva.  As a result I have an extremely dry mouth every day.  As mentioned, I am a dentist and know many of the common treatments for dry mouth including hyper hydration, salivary substitutes, drugs to increase salivation, stimulation of saliva with various mints or by chewing.  Unfortunatly because my glands are so extensively damaged none of these treatments has been adequate.

From personal experience I can tell you that dry mouth is no fun.  It makes it hard to speak, harder to swallow, and is just generally uncomfortable.

If I use a salivary substitute, and I do, I find that it provides me a few minutes of relief but not very long.  So the other day I had this idea that popped in my head and I tried it.  The idea was this.  Instead of water or a salivary substitute, why don't you use a little bit of coconut oil?   I had some of this in my home and I gave it a try.  The results were very satisfying.  As mentioned salivary substitutes provided minuted of relief however coconut oil left my mouth feeling moist for hours after taking it.

It is so easy.  Coconut oil can be bought almost anywhere and is inexpensive  In addition it is a very healthy oil, it tastes good and it melts at body temperature.

Here is how I use it.  When my mouth is dry I simply take a spoon, gather up a piece of coconut oil about the size of a pea and put it in my mouth and move it around for about a minute before swallowing.  The results have been very nice.

I intend to write an article to be published because I think others would benefit from my discovery but in the meantime I will start with simply posting a blog on the topic here.  I hope that it is of benefit to you.

Saturday, August 22, 2015

A paradigm shift

So, as you may know, I have had some serious health problems as I have fought oral cancer for these last four years.  During that time I have gone to countless doctors visits.  I believe that there are some valuable things we can learn from what our brothers and sister physicians are doing.  Let me tell you one that seems to be working out really well in my office.

Most of the time when I go to my physician for an appointment I am first greeted by the receptionist of course but the next person to greet me is a medical assistant.  This person carefully reviews my medical history, updates my medication list and gets my vitals.  I have become very attached to some of these medical assistants.  In many cases they are very kind and seem to really care about me as a person.  I can think of one case recently where I learned that my medical assistant was taking another position out of state and I literally wept when I heard the news.  I was at least at attached to her as I was to my physician.  I still miss her beautiful face and the kind way that she always treated me.

So, I began thinking about how this model might be applied in my own office.  I have a very busy practice and I ask a lot of my hygienists.  Some times they don't review the health history as well as I would like or update the list of current medications.  They are pretty good about blood pressure, though they forget sometimes.  They rarely do other vitals.  Most of my patients are very fond of my hygienists but I think that same fondness could be associated with another person.  I have chose in my office, to call this position the hygienist coordinator.

In my office her job duties are as follows.

  • First and foremost, to great my patients promptly by name and with the greatest love and kindness that they can muster.   I tell them that I want my patients to weep if they hear that my hygiene coordinator is leaving for any reason.
  • Second to do an EXCELLENT review of medications, health history and to capture vitals.  For us that includes, blood pressure, temperature, pulse oximetry.  With many of the changes that appear to be coming it may soon include blood sugar as well for people that we consider to be at risk,
  • Then to take excellent digital radiographs and a full series of extra oral photographs and make sure that they are in the chart to be viewed.
  • They are to keep my hygienist perfectly on time.  In other words, they will greet my patients out front exactly at the appointed time so that there is no waiting and at the same time inform the hygienist, "I am now going to get your 10:00 patient.  Please know that I will have them ready for you in 15 minutes.
I made some simple changes to my panorex room to convert it for the use of my hygienist coordinator.  We have pretty state of the art vital monitors and all of the other equipment that she needs to do her job.

In my office I usually have three hygienists at a time and several doctors..  This new position has allowed us to work much more efficiently, stay on time, get better records and not lose the personal touch that is so important in our office.  We have been doing it for about a year now and I have been so happy with the result so far.