Wednesday, June 5, 2013

Negotiating Implants

Marty and I are in daily negotiations about getting her implants.  I tend to think she should get them, she says no way no how.  We are talking dental implants not the other kind…I personally like the natural stuff.

Marty has several upper teeth that are just not doing well.  They are loose and getting looser as a consequence of medicine and genetics.  As a disclaimer and clarification I have to say Marty was a fanatic about dental hygiene but it never mattered, she had bad gums and bone loss.  Having a third party take care of your teeth just makes the whole situation more tenuous.

We have been to see the oral surgeon, a doctor we shall call “Dr. Oral Surgeon”, twice.  He’s clearly skilled, has impeccable credentials, a really cool office, talks to Marty, talks to me and makes a lot of sense.  He’s not doing a hard sale on the implants but he really believes we have to do something in the not too distant future.  Implants, to me, seem to be the best “bridge” to the future for Marty, dental wise.

Marty says she likes him and she listens intently to what he is saying and the questions I ask.  On our first visit I introduced Marty to the doctor and started my usual patter, trying to put a human face on her.  I explained her medical history to Dr. Oral Surgeon and I explained her life history, briefly.  I told him that Marty was an educational psychologist who at one time worked educating family practice doctors.

Marty listened to my stories about her, and I could see her perk up about the time I started laying out her previous career.  She took the opportunity and looked at Dr. Surgeon and just as dryly as she could muster she said with an air of mental health arrogance, “And how do you feel about that?”  The business liaison lady who was standing there taking all of this immediately fell in love with Marty. 

As part of this whole negotiation process I’m trying to convince not only Marty, but myself, that these implants are the best thing for her, long term.  That’s different for me; I’m looking at this long term.  I have moved past the short term view, I have moved past the idea that Marty won’t be here much longer so long term cures are something to consider.  It’s kind of an odd thing to consider, but this is a different world view for me and for Marty.

When someone is chronically ill like Marty, when someone has walked on the edge of death, like Marty, thinking in terms of the out years seems capricious and fate tempting.  You look at things differently, you actually think about whether short term pain and discomfort is worth any gain because you might not experience the gain for very long.  This change has required a change in our decision making process, it has added a new level of complexity to the whole deal.  It’s good; it’s just a different view.

I also want Marty to make this decision, a decision that creates some risk and pain to her life, of her own volition.  Sometimes in caring for her I have to make executive decisions about her care without consulting or listening to her objections.  For example, she never ever wants to be in the hospital or go to the doctor.  That doesn’t make sense so sometimes I have to overrule her; she’s not a child, she’s an adult, but she is compromised, thus the negotiation.

Marty has been pretty adamant she was not digging the whole implant process; she has not budged on her position.  I finally told her that’s fine, that we should just continue to talk about it.  I told her I would bring up the idea of implants every now and then and that maybe we could come to the conclusion that she needed to have the work done.  

“Does that sound like a successful plan?” I asked.  “Do you think that will get us there?”

She looked at me, straight into my eyes, without a flicker of a grin and said, “I don’t know, it’s sure not my plan.”

That’s where we are.  She doesn’t want to do it; it’s not in her plans at all.  She is worried about the pain; she can’t get past the fact that her teeth don’t currently bother her.  I understand her trepidation, the whole dental thing freaks me out, I really don’t like the dentist.  Sorry, I had bad experiences early.

The good news is that we have options, or at least we don’t have to do anything now.  I fear if we wait too long our options will be limited and we don’t want that.  The other good news is that Marty Jean is fully engaged in the process and in her own inimitable fashion she is having her say.  

I like that part of Marty, I always have, it takes patience, but I like that part.  Now I just have to find a plan where we have agreement.  Our negotiations continue and somehow I feel like I’m in familiar territory…..the short end of the negotiation.

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