A Personal Story: Heart Valve Replacement & Dental Health – Bob, West Lebanon

Bob is 61 and lives in West Lebanon, New Hampshire. Five years ago, Bob discovered that he had some teeth that were loosening, one of which fell out. Recent x-rays and exams indicate that due to bone deterioration, Bob needs a total of ten teeth extracted, with a partial bridge replacement on the bottom.

Bob has also had a heart valve replacement, which complicates his dental care. He needs to take anticoagulation drugs regularly, as well as amoxycillin before dental procedures to make sure there’s no infection in the valve. The nurse from Bob’s anticoagulation program told him he needed to give himself subcutaneous anticoagulant injections twice a day five days prior to getting his dental work done, a procedure Bob is not comfortable with. He researched his condition online, finding recent articles which do not suggest the necessity of the injections, and now doesn’t know who to trust or who to believe.

Bob also lives with PTSD, and carries cards which read: “I experience symptoms of post traumatic stress including higher anxiety in situations where I feel helpless, out of control, and where my choices are limited or where I feel invisible. Please give me visibility and voice as well as engage me around how I can help you help me in our time together.” Bob sees the situation around his dental care as one where his choices are limited, and one where he has not been included in the decision making process: “My way of conceptualizing it is that one component of the health care system is going to decide for me what my choices are going to be without allowing me to make an informed consent decision.… The idea of injecting myself with an air bubble without being a phlebotomist is stressing my post traumatic stress.”

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