Way back in 2016 we were living aboard in Back Creek, Annapolis, Maryland when it became painfully obvious to me (James) that I couldn’t live with my incredibly painful dental situation. Dena was seasonally managing the Watergate Point Marina and I was working at Bacon Sails so neither of us had anything even close to a dental plan that would deal with my oral issues.
My aforementioned dental apocalypse actually started a few years before then. In 2011/12 while we were wintering in Baltimore and just before our epic adventure from Baltimore to Maine and back down to Connecticut, the tooth pain started to get really bad. So before we got underway from Fells Point, I went to a local dentist with cash in hand to take care of a toothache the old fashioned way: needle-and-yank. Well, the doctor basically told me that I was genetically orally fucked and that all of my teeth should be removed in favor of some form of alternative mastication system, i.e. dentures or implants. In my head I told her to shut the fuck up and pull but in reality I thanked her for her expert advice, asked her to remove the worst aching tooth, threw down my $120 bucks and went sailing.
I spent the next four years in agony. No really, it was horrible. If you’ve ever lived with a constant toothache from paycheck to paycheck without insurance, I can literally feel your pain. It’s an intensity far beyond my worst nightmares and it never goes away, not even in your sleep. While we were wintering in Groton, Connecticut, in ’12/’13 I went to another dentist for another removal and he (after giving me anesthesia) tried to make me sign a contract for a $30,000 set of implants. It was at that point I decided I would rather be in pain than spend my life in American medical-debt prison.
That same winter we scored a gig as Cruising Editors for the Waterway Guide, a job that was very close to perfect for us but without even a remote chance of a dental plan. For the next three years we sailed up and down the Atlantic Seaboard rewriting and editing the mess between Cape Fear, North Carolina, and Downeast Maine. We would sail and write in the summers and get part time wage-slave gigs in the winter until the pain just got to be too much for me to take.
That brings us back to Eastport in the autumn of 2016. Dena’s job at Watergate Point was coming to an end for the year and my gig at Bacon Sails was a take-it-or-leave-it kind of deal. I mean they wanted me to stay but winter in a chandlery is a lesson in patience punctuated by sleepy-eyed boredom and the retelling of retold stories.
And besides…my mouth was killing me and I do mean that literally. By that time every tooth on top was broken, infected or both. My breath was so bad that it gagged even me and Dena, bless her incredible soul (or whatever), was finally at the end of her patience. It was time to make a decision about my teeth.
As I said before, I didn’t want to waste any time or money on the American Medical Complex, that’s just silly. We could sail to Mexico, Central America or Brazil where we had researched and heard the dental care was good and a whole lot cheaper but I was in an immense amount of pain and not up to an offshore adventure at that point. But there was another option.
We could go back to India!
In 2008 we spent almost the entire year in the Indian subcontinent from the Punjab to Kanyakumari. We ended up settling in the state of Kerala in the city of Thiruvanathapuram. We went there because it was inexpensive, the food is awesome, neither one of us had ever been there and, let’s face it, Hindustan is about as exotic as it gets! We ended up, both of us, writing novels that year in India but not without also thoroughly exploring the culture, the food and the environment of that incredible place. We fell in love with the entire experience and, let me tell you, India is an awesome experience in every sense of the word.
We wouldn’t have thought of India as a place for dental care if we didn’t have some experience of medical care there. I (Dena) got very unexpectedly pregnant not long after we settled into our flat on Pournami Nagar. It made me terribly sick and I dropped about seventy pounds in only a couple of months.
Besides the sickness, I didn’t want to be pregnant or raise a child. James and I were in agreement since the night we met that a life without children sounded better than one with. We’d been free to do so many adventurous things with so little backup resources, free to live on the fly, and we wanted to continue living as we’d planned.
Abortion is legal in India but socially judged and not all that easy to access. My searching for information brought us to the free public hospital for women and children and, whew, was it ever a judgy visit. Also, the waiting rooms teemed with people waiting their turns and, though there was cleaning going on constantly in every room we entered, a serious amount of age and grime throughout the place, right down to cracking leather on one of the exam tables.
Long story short, I miscarried before I had to make a final decision on whether or not to trust myself to that hospital’s care and, luckily, found another side of the healthcare in Kerala.
The hospital down the road from our little lane was private and didn’t perform abortions. They were more than happy, though, to take care of a women in the middle of miscarrying, including sending me for imaging and doing a D&C. While the expectations would have been wildly difficult to figure out without some of James’ friends knowing the system (things like they don’t feed the patients because families want to take care of that), the level of expertise and care was impressive. The facility was not sparkly-new in the recovery areas but it was far improved over the public hospital.
Only a couple of weeks after going home, I was back for the one and only elective surgery I can imagine I’ll ever get in my life: tubal ligation. No way was I chancing another pregnancy, between the not-wanting-kids and my previously-undiagnosed bicornate uterus which ensured I would never carry to term anyway. I trusted the doctor and her staff, and the price was right.
So there we were in Annapolis looking forward to a six-month break between ending the season at the marina and coming back to restart work. James clearly needed a paradigm shift in his mouth, not just a slow ejecting of teeth one by one. And the rhetoric around dental implants was in full swing.
So, we put the boat to bed at Watergate Point Marina for free, asked our friends at Bacon to keep an eye on her and flew back to India to get me (James again) a brand new mouth.
A friend of ours, whom we met the first time we lived in Trivandrum, had a condo there but lived in Bangalore. He offered us the condo for the duration of our stay. It was a bit out of the town-central but not so far that we couldn’t make due in our new locale. The place was a bit of a wreck but it was free so we weren’t complaining. We just got to cleaning and buying a more comfortable mattress.
We walked around for the first week or so looking for oral surgeons and hit a couple of genuine losers before landing on a business called Trivandrum Smiles that really won us over. Dr. Pradeesh was young, professional, spoke English very well and was genuinely concerned about my health. I was getting a bit desperate so we decided to go with him. Unfortunately Dr. Pradeesh wasn’t qualified to do implant surgery so he brought in a colleague, Dr. Allen (fucking asshole), to do the work. Dr. Allen was always late (without exception and once by almost two hours), his bedside manner totally sucked and his work only lasted a few years before it started coming apart in my head. But we went to work immediately on the process removing old teeth and implanting the new denture.
Only six implants can hold an entire top denture! Implants reverse bone loss! It’s the closest thing to having your youthful teeth back…if it’s done right. First they had to get my old teeth out which was a seven surgery process that took a total of about twelve painful hours because of how broken up and infected my original teeth were. Then Dr. Allen fitted me with a temporary removable denture so I could eat while he was installing bone grafts and the hardware into my deteriorating upper jaw over another three surgeries. After that he did the measurements, took an imprint and went to work building the new permanent denture while I heal up from all that sticking and cutting.
I healed up rather quickly because South Indian food is the best food in the world and we aren’t really the sedentary types.
By mid March of 2017 I had a new set of teeth in my mouth and for the first time in almost two decades I could actually eat an apple without weeping from pain. Everything in my life had changed but that change was soon to be proven short lived.
For two years after the surgeries I had little to no issues with my new mouth but the denture slowly started to loosen with time. By the time we took off on our electric circumnavigation I was back to eating as much soft foods as I could and staying awake on my off watches with pain.
By the time we made landfall in Mindelo my mouth was once again full of infection and I could hardly speak from the pain so we (and I do mean Dena because by that time I was almost useless) found a dentist once again in a strange new place. The place is right here in Mindelo and it’s called SmileMed. The Doctor’s name is Joianne Melicio and so far she’s been awesome. She took us in off the street without an appointment and did everything she could to make me comfortable and safe in her care. But make no mistake about it, there was very little she could do with my situation until she could get the infection out of my oral cavity. She gave me a prescription for a heavy dose of antibiotics and after some failed triage sent me on my merry.
The next day I took one of the antibiotic pills and, about forty-five minutes later, the entire denture fell out of my head, hardware and all!
The little bolts went through the denture and threaded into the hollow side of the big bolts, which were threaded into the bone and nova-bone-graft material in my skull. Two of the big bolts are still in there while I shake this infection.
…And this is what has been stabbing me in the gums for the past couple of years!
So here’s the thing…Today I’m no longer in pain and because I actually have a tooth, a single molar, left in my upper jaw I can eat stuff. I mean, it takes a lot of concentration to move the food around in my head and I’m not going to any fancy restaurants anytime soon but the pain is gone, I’m on the mend and we have a path for my complete recovery over the next 4-6 weeks.
So hey, it’s all just another part of the adventure.
