I arrive at the nursing home yet again to see more patients who are in need of dental treatments. Mrs. F had been inflicted with severe senile dementia - she would not have tolerated any strangers, let alone recieve any dental care. I told the nursing home staff to give her some medicine to relieve anxiety and also partially sedate her.
Time passes as Mrs. F begin to calm down. I attach a device called Pulse Oximeter. It's function is basically what it's called.......measures your oxygen concentration in your blood via a little clip on the fingers or toes. On a healthy smoke-free person, 100% is expected. Mrs. F's oxygen saturation started off at 93%, probably due to previous years of smoking, lung infection, or some other pulmonary ailments.
And all this time, Mrs. F screams out, "I hate you.........I hate you."
Mrs. F was to have all her teeth removed so a full denture can be fabricated. I proceed to numb her mouth, but she was flailing her arms and legs, making it almost impossible to work on her. I had to get Mrs. F's two daughters to pin her down while I proceeded. When her mouth became numb, I started to one by one, extract her teeth. The first tooth came out without a hitch except for some "gurgling" in the back of her throat, probably a combination of her saliva and blood from the tooth extraction. Her oxygen saturation dipped into the high 80's and gradually returned to the low 90's. I think to myself, "Hmmm.....she probably momentarily choked on her own fluids. I should take extra caution to dry her mouth."
"I hate you!"
I continued on to the 2nd tooth, and again, I began hearing the gurgles in the back her throat. Her oxygen saturation this time dips to the mid 80's and even tually stays in the high 80's.
"I hate you!"
I proceed with the 3rd tooth. Without missing a beat, I hear the gurgles again. Mrs F became very quiet and not fighting me as much. This time the oxygen saturtion dropps to low 80's and continued to drop to the high 70's. It then continued to drop to the low 70's. Fuck, she is suffocating on her own secretions!!!
I removed all my instruments and pushed everyone off of Mrs. F and tilted her head forward with her mouth open. Fluids consisting of mucus and blood began flowing out of her mouth and onto her bed sheets. I stick a suction tube down her throat and clearled the last bit of fluids. The oxygen saturation pleateaus at high 70's for a while, then mid 80's, and finally low 90's.
Mrs. F was not moving or responding for the next several minutes, then finally shouted, "I hate you!" That was the best thing I could hear her say at that moment.
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GEEK ALERT!! (dont read unless if you are a geek like me)Those of you who have taken any kind of physiology class in high school or college may remember a little concept called "oxygen saturation curve."
Basically, at 100% oxygen saturation, the amount of oxygen available to your tissues is 100. At 95% oxygen saturation, your tissues only see 90. At 70%, your tissues only see 40 available oxygen. Mrs. F was basically not breathing for that brief moment.
