I'm depressed. As I've spent a great deal of time thinking about why I'm depressed I've come to realize it (in part, at least) has to do with a fairly small but rigid set of principles by which I try to live my life. They serve admirably to make sure I do my best to avoid harming others other than in specific situations and to lead my life, I once thought, in a manner which would be as beneficial as possible to the world I live in. One of the strongest of them is the tenet that one must always take responsibility for those things one is able. Your actions are your responsibility, as is your speech. But one problem is that there's no upper bound on what I should take responsibility for, under the assumption that those who will, should.

I'm rereading Surely You're Joking, Mr. Feynman! which is an excellent book about a man who, from what I know about him, I admire deeply. Earlier tonight, I read a passage he'd written about his time at Los Alamos working on the Manhattan Project. It was a time of personal stress for him (his wife died of Tuberculosis around then after a long illness) and a time when all the men and women working on the project were working under a crushing responsibility - both professionally and, in many cases, ethically. I have found myself going back to that passage several times. Here it is.

Then there was John von Neumann, the great mathematician. We used to go for walks on Sunday. We’d walk in the canyons, often with Bethe and Bob Bacher. It was a great pleasure. And von Neumann gave me an interesting idea: that you don’t have to be responsible for the world that you’re in. So I have developed a very powerful sense of social irresponsibility as a result of von Neumann’s advice. It’s made me a very happy man ever since. (emphasis mine)

Early last January, I began to experience quite a bit of discomfort in the gums surrounding my molars. Specifically, they seemed to be swelling rather badly, causing a rift to open between the gum and the tooth; food, especially angular food such as potato chips, would routinely get stuck there and dig into my gums. The pain was excruciating, and eventually I decided to go to the dentist. I was informed that the problem was that my wisdom teeth were not only coming in, they were coming in sideways. They would absolutely need to be removed.

After a lengthy discussion with my mother, we decided that the most cost effective method was to go to the local dental college to have the teeth extracted by the medical students there. The date was set for mid-April. My struggle began.

I was significantly more calm about the whole thing than I perhaps should have been. I did extensive research on what to expect and steeled myself for the pain that would come. But, as I have found time and time again, experience always trumps research.

From what I have heard, many people do not go the route I did. However, the benefit of having my "surgery" done at a college was that I was guaranteed to go under with nitrous. They hooked an IV into my arm, plugged my nose with a breathing apparatus and told me to breathe deeply. I took a large breath and the lights slowly began to swim...

When I awoke my first thought was "Wow, I feel absolutely fine!". While the nitrous was still flooding my body, I felt an overwhelming sense of gratitude towards the nurse I was suddenly hugging. "You're so nice to me..." I managed to stammer out, holding back tears (nitrous does funny things to people, I suppose). I attempted to walk, but they insisted I use a wheelchair (ostensibly to prevent nausea and falling due to unsteadiness).

Once we were in the car and heading home, the pain began to creep up as the anesthesia and painkillers slowly wore off. I reclined my chair as far back as I could while attempting to clear my mind and regain feeling in my jaw area. My mother commented that I should try to eat something, anything, so that the painkillers I had been prescribed wouldn't make me sick. I agreed, and we stopped by Wendy's, where I took a few bites of soft serve ice cream before immediately vomiting it into the spit-tray the college had given me on my way out.

When your wisdom teeth are removed, typically you will have your cheeks stuffed with gauze, to both encourage blood clotting as well as prevent a majority of said blood from leaking down the back of your throat while you're still numbed up (this may seem a little odd, but when your mouth is numb, swallowing is difficult to feel or control, so it is quite possible for a large amount of blood to slowly drain down into your stomach, making you sick. Keep this in mind). This gauze may or may not need to be replaced, depending on how careful you are, how quickly you clot, etc. Obviously, having vomit stained pieces of cloth touching open wounds in my mouth wouldn't do, so I now had to change them out for fresh pieces.

I opened my mouth and gingerly removed the stained gauze strips, and very slowly eased new ones in. Unfortunately I was still numb and, being unable to gauge exactly where to stuff the gauze in, I involuntarily touched the back of my throat, immediately vomiting again into the tray. Seeing the soupy mixture of puke and blood made my heart race and I began to sweat. I was not having fun anymore.

The pain steadily crept up on me, becoming more and more agonizing as the two hour drive home continued. I finally made it home, stumbled into my room and immediately got into bed, flipping on the TV. I was informed by my accompanying grandparents that my mother had gone to get my prescription filled, and that it would be about an hour and a half before she got back. My memory here is fuzzy; I recall twisting about in my bed for an interminable time, drenched in sweat and unable to focus on anything because of the pain and anesthesia.

She finally returned a few hours later, with lots of soft foods for me to eat when I began to feel better. She handed me two vicodin pills and suggested I take them then so they would kick in before I fell asleep. I took them immediately and fell asleep 20 minutes later, awakening two hours later to use the bathroom. I sat up slowly, stood up, and immediately pivoted to my right and vomited into the trashcan. No need to remove the gauze this time; it had fallen out when I puked. Blood began dripping steadily from my mouth into the trashcan, and I began to cry. I had not expected this. Nobody had told me about this part of the experience.

The rest of the night was uneventful; I finally got into the routine of slowly drinking water, sleeping for hours, and very slowly and steadily standing when I needed to use the bathroom. I went to sleep with my back to my headboard, sitting up so that the blood wouldn't pool in my stomach (I realized later that this is why I vomited when I stood up; the painkillers played a part, but it was mostly from swallowing so much blood throughout the day). I awoke the next day to find almost no blood on my gauze; I was finally clotted!

From this point everything went rather smoothly. I began icing my cheeks on day 2, but apparently I had waited too long or began too early, because I retained my chipmunk cheeks for almost a week afterward (on the bright side, my girlfriend, who was amazingly supportive and awesome during the whole process, thought this was adorable and made me feel a lot better about my appearance). I lived off of a spartan diet of jello cups, fruit smoothies, and applesauce. It seems like the only commercials that played for the whole week were for the new Double Downs from KFC, and I was ecstatic to begin eating real food again.

After about a week and a half my swelling was completely gone and my final suture had finally fallen out. I was healed, and my life had returned to normal. The dentists let me keep my teeth in a biohazardous waste bag, and I fully intend to keep them forever, as a testament to the hell I went through that first day.

Tips For Post-Removal Recovery

  • Exercise great care in cleaning your mouth. You should have been given saline solution, so use it after EVERY meal. Do not swish the liquid in your mouth; rather, tilt your head gently from side to side and then let it drain out.
  • Do not eat solid food until you have been clotted for over a day. This is more subjective, as some heal faster than others. However, a good rule of thumb is that if you're bleeding, you shouldn't be eating anything solid. You probably won't be able to close your mouth enough to chew it anyway. Also, jagged, crumbly foods such as potato chips will likely get stuck in the hole and become infected if you aren't following the first tip.
  • You will experience swelling within the first few days after the removal. This can be mitigated significantly if addressed quickly, and may be avoided almost completely. A popular method is to fill a bra with bags of ice and tie it around one's head so that both cheeks can be kept on ice. However, this is a good way to get frostbite if you forget to remove it every now and then. Instead, take a bag of frozen peas, wrap it in a cloth, and alternate cheeks every 20 minutes.
  • Under no circumstances should you drink anything through a straw for at least 2 weeks after the operation. The risk of dry socket is very high. Dry clot occurs when the pressure inside the mouth becomes too great and the blood clotted in the socket is dislodged, opening the socket up all the way to the bone in your mouth. This is excruciatingly, unbearably painful, and some women I have talked to have likened it to giving birth all over again. The worst part is that there is nothing whatsoever that can be done to end the pain; supposedly, even morphine is overpowered by the sheer misery that is a dry socket.
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