Frightened for dm and don’t know what to do

[JustBloodyListen]

My dm started having a bit of a niggling toothache on Friday and decided to leave it until Monday morning before phoning the dentist. By this point her face had swollen right up on one side. She saw a dentist midday on Monday and it’s an abscess but it is too inflamed for her to have anaesthetic injected so he prescribed AB’s and booked an appointment for the following Monday.

This morning she woke up with her face so swollen that he right eye is completely shut. She has a fever and is shivery and said she couldn’t hold her cup of tea because she was so shaky. She phoned the dentist who told her to phone her GP as she may need intravenous AB’s or have the tooth out under GA if the swelling isn’t going down.

DM phoned GP who tells her to phone the emergency dental number. She does this, is told she urgently needs to see a dentist but as she has a dentist she needs to phone him. So she calls her dentist back, she gets another appointment and the dentist explains that he can’t prescribe any other AB’s and he can’t remove the tooth as he cannot inject anaesthetic as it is so swollen. He tells her to relay this to the GP. She speaks to GP again who tells her that he can’t do anything as it’s dental but due to her clearly having an infection she should go to A and E at the hospital.

She gets the bus over to A and E, waits 3 hours to be seen and is finally taken in to see a doctor who tells her to call the emergency dental line (who she already spoke to and who told her to go to her dentist who told her to go to the GP). At this point my dm bursts out crying, explains it all and the doctor tells her to go back into the waiting room and he’ll see what he can do.

Another 90 minutes later and a doctor tells her that it’s likely she’ll need it out under general anaesthetic. Her local hospital doesn’t have a maxillo facial department so he’s made an appointment for tomorrow morning at the hospital 2 hours away from her house.

She is now at home with a clear infection, fever of 40 degrees and sounds barely conscious when I call her. I’ve phoned for an ambulance for her but they said it almost certainly wouldn’t arrive until the morning. She is a 5 hour drive away from me and I have children who I’d have to take with me if I left now. I don’t even have a key for her house so I don’t know what I’d do when I get there if she’s asleep/ unconscious.

What should I do? Am I overreacting? I keep looking at Google and there are so many things saying how dangerous a tooth abscess can be if untreated.

I think in these circumstances I would throw some clothes in the car and head off to your mums, let the kids fall asleep in the car. Tell your mum so maybe she can leave a spare key under the matt for you in case she falls asleep

Thank you so much for all the offers of help and advice 💐

Hope your mum is ok OP and she is getting treatment. Shocking!

It's fairly standard atm tbh
Seriously...People have no clue how bad it is
I spent 20 hours with my mum in a&e 3 weeks ago. She had sepsis. I knew she had sepsis. She was sat on a hard chair with no fluids and only got pain relief because I insisted.
3 day wait for a bed on a ward.
You are really not over reacting at all op
Get her seen ASAP
I agree the dentist has been totally negligent

Does your sister have a friend that could help?

Firstly OP don't panic, I am a maxfax dr and it is rare for someone to become properly septic from a dental abscess. The majority of our patients who turn up like this are fine after IV antibiotics, but she does need to be seen.

Secondly A&E will know to look out for sepsis. They will not send her home if her obs arent stable. It sounds like they have spoken to maxfax snd she will be known to them. Has she had bloods taken?

I would advise her to get a taxi to the hospital she is due to attend tomorrow and present to ED, say she is due to see maxfax tomorrow but is feeling more unwell. ED should then contact maxfax, they will not want to reassess her and will want her to be seen quickly by maxfax. She may still need to see ED as well but should get IV antibiotics, fluids going and bloodwork checked if not already

Oh OP. I hope she is OK. How frightening and the ambulance situation is disgraceful.

What a sorry state we're in. An ambulance in the morning.

Glad you've got her a taxi. Try ringing A & E and explaining.

Make sure she goes to the hospital she is due to attend tomorrow OP not her local ED, and say she is a maxfax patient with worsening infection.

Thank you @Squidwall thats really helpful. I’d booked her a taxi to the hospital without MaxFax as that is the closest one but I can get another one to take her onto the other hospital if need be. I hadn’t really thought it through, I just wanted her to be at a hospital.

my sister almost certainly has someone who would help. She’s abroad at the moment though and isn’t picking up her phone as yet so I haven’t been able to speak to her to find out who I should contact.

Tell the ambulance service she has a known infection, a fever of over 40, and is confused which is not normal for her (if this is true). That should trigger a higher category of response from them.

Secondly I would complain to the dentist. This has been completely mismanaged and has resulted in your mum being unwell

Firstly dental abscesses need treatment. Either drainage or extraction. Most of the time anaesthesia can be achieved to at least get some drainage of the abscess. It is lalazand incompetent dentistry to just send patients away with antibiotics with a large abscess

When your mum re presented with clearly worsening infection what the fuck did the dentist think the GP was going to do? It is absolutely ridiculous to repeatedly refer a patient to the GP, there is nothing a Gp can offer for dental infection that a dentist can't.

Abscesses are managed by dentists. If they are beyond what a dentist can manage then they need to be managed by maxfax. The dentist is more than capable of picking up the phone and referring the patient to maxfax. Actually both the GP and the dentist could have referred your mum to maxfax to get her seen. If the dentist was or some unknown reason incapable of phoning then they should have directed your mum to the appropriate ED (the hospital with maxfax) with a letter. It is not ideal but it is better than calling the GP

Get her to the hospital with MaxFax dept. They are the specialists she needs

@dane8 that is true. I'm not sure where she is in Kent but it's it's fairly urgent situation and would be the best option to get her care. If too much to get to the maxfax hospital the local ED should be covered by a maxfax unit even if not onsite (think it's Ashford in Kent but maybe a London hospital), and at least will still get IV abx and fluids and can be transferred

@LadyGardenersQuestionTime i told them this and they still said it would likely be tomorrow and that I should try and get her to hospital another way

How will she get into the taxi if she sounds barely conscious, I would call the ambulance again. The taxi driver may not be able to get into the house or have the knowledge or experience to take an elderly unwell person to hospital.

Quite often there are voluntary medicar groups in towns
Can you post on her local fb page and ask?
They can take her usually for a donation

@JustBloodyListen

Find the local Facebook group for your mums community and look for the moderators etc or any posts about community help.

Where we are there's a local charity group connected to our surgery and they have a team of volunteers that would help with exactly this sort of thing.

I'm so sorry your in this situation your poor mum and you must be so worried

People are literally left to fester right now in this country it's bloody frightening and not acceptable

Your mum may have sepsis which is life-threatening. Call the emergency services, explain and tell them the words "triggering red flag for sepsis". Do it now.

Really wishing your mum all the best for a swift recovery.

The dentist was outrageous to try and palm this off to a GP. It is their job to manage issues with teeth and they should have referred directly to a hospital with a max fax unit. No one else has anything to offer here.

She’s in the taxi and headed to the hospital at Ashford. She attended the hospital in Margate earlier and was told that she’d need to go to Ashford as they had a MaxFax department. Having looked online it looks like the Margate one also has that department so I don’t know why she has to go to Ashford for it. Maybe they’re closed at the moment or something.

I’m now worried that they’ll send her back to Margate if she turns up at Ashford. She hasn’t got a letter or anything for her appointment tomorrow, it’s literally the time and department written on a post it note from what shes said.

Whereabouts in Kent is your Mum? I am in Kent!