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How to Edit Your Dental Office Medical Clearance Form Online

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To anyone who has caught COVID-19, or knows someone who has, how bad are the symptoms?

In my case the symptoms have not been terribly severe.It started out with a nasal discharge lightly tinged with blood, sometime in the later part of February, 2020; a symptom that lasted about two weeks before anything else happened.Then came about four or five days when I had a sore throat, cough, burning eyes, headache, a steady, slightly elevated temperature of 99 degrees F, and that painful, fatigued feeling that is familiar to anyone who gets flu. It was like a very bad flu at that point.That set of symptoms faded into pneumonia, signified by pain and a feeling of fullness in the chest, with difficulty breathing. This has been the hardest part of the illness, but I got over the most uncomfortably intense part of the pneumonia after a couple of days.Symptom intensity varies from day to day. Most of the time now my energy is okay, but sometimes all I can do is stay in bed. I can take walks and do gardening on good days, but aerobic activity is not possible. A little too much exertion for my lung capacity results in a deep burning sensation in my chest. Sometimes it comes when I am at rest.Being active outside helps to trigger coughing that clears out a portion of the fluid in my lungs, which feels much better. That fluid can be described as slimy saltwater. I can joke that it is the mutant virus taking control of my behavior and forcing me to go out so the viruses can be sent off to other hosts.But they are stupid and cannot see that I cough them out where no potential hosts exist.In the back and forth of symptom intensities, there is a trend toward improvement. If, as some reports have it, that symptoms can take as long as six weeks to clear, then I have one more week of this. But I know full well that results may vary, and it isn’t over until it’s over.I am in the age group considered vulnerable, and with asthma. My inhaler helps. But recent reports have come out that among those in my age group, obesity, hypertension, and diabetes are the strongest risk factors that bring death. Those risk factors don’t pertain to me.Update: 3/28/20 Here it is one week since I wrote the answer above. The pneumonia is gone, but I still feel inflammation in my lungs. I can now breathe deeply, but there is some light soreness around the lungs. I still have some congestion in my throat with a dry cough.I still have body aches and some lack of energy, but I feel much better. Healing is happening, and I no longer fear a downturn with the sudden onset of severe pneumonia.I feel very fortunate to have avoided the more severe possibilities of Covid 19.Update: 4/4/2020 More improvement. About 4 days ago I had half a day with a bad cough. Pain and fatigue come and go. When I feel badly my temperature is elevated, between 99.1 and 99.2 F. As of now, the lungs are clear, with congestion in the trachea, throat, and lightly in the nose with a little blood. There is soreness in my throat, probably from cough irritation. My back and chest get achy when the pain arises. Good news though. Last night I did a fast bike ride for about 3 kilometers as a test of my condition. My lungs handled it easily, and I didn’t even breathe hard. My muscles had all their old strength. It felt really good to move like that. Recovery is very close, but the last symptoms are taking an insanely long time to taper off.Update: 4/7/2020 I woke up this morning with my throat badly congested, and had to do some coughing, but the trachea is now clear, and there is still congestion in the nose, but with no more blood. I don’t often feel achy, but when I do my temperature is up around 99.2 F. The airways in my lungs are still sensitive after all that trauma. Two nights after that wonderful bike ride, I took a 2.5 mile walk at a fast pace, and got an asthma attack. I treated it with albuterol and did deep breathing exercises and continued on. I could feel inflammation in the airways. They need time to heal. Last night I walked more slowly and had no problems. It isn’t over until it is, but I wish it was.Update: 4/11/2020 I think I see why Covid 19 appears to return to some patients after their recovery. I was beginning to think this thing was almost gone, as I was mostly symptom free. Last Thursday I awoke with a very sore throat, and then the coughing began, for hours. I was enveloped with body pain and severe fatigue. Walking around in the yard was very difficult, so I went back to bed and slept. This thing does not behave the way we expect respiratory viruses to behave. On Friday I felt so much better. It has the character of letting a person feel probably well, or almost. And then symptoms come slamming back for another round. It cannot be trusted. After that came the stressful misfortune late Friday of getting a painful abscessed tooth in my lower jaw. With it comes a fever of 101 degrees F and a headache. And on a holiday weekend of course. A relative gave me an unused prescription for amoxicillin, so maybe I’m good until I find a dentist.Update: 4/18/2020 I am thankful for all the upvotes, interest, and supportive comments my ongoing narrative has been getting. It is a silver lining to this experience.The symptoms are still with me. It is mostly soreness in the throat and back of the nose, but at random times there will be headaches and fatigue, and muscle soreness in the legs and upper back. I discover those when I set out to take a walk. Rarely are they severe enough to stop me, but it happens. If I can walk through it those symptoms diminish with movement. `Other times it gets hard to breathe, feeling more like asthma than pneumonia. Sometimes there is a neurological seeming issue in which my sense of balance is off, and I tend to lean over to my left as I walk, which makes me stagger a bit as if drunk. I don’t like that one, but it does not last long.I feel troubled. I’ve had 9 weeks of symptoms now, if my time keeping still works. Is this infection chronic? It is not just a respiratory infection. What does it do to the other body organs? Information is coming in that it could well be a whole body infection. This entire last week, aside from the tooth abscess, has been a week of no change in symptoms, mostly just the same stuff, with variations in intensity. It has reached a steady state. I’m not as ill as I was in the beginning, and with interspersed rest breaks I am able to stay active, but in solitude.Update: 4/25/2020 I took a walk last Thursday evening, and the muscles in my legs felt as if were climbing a steep hill, painful and stiff. It eased up some as I continued. And I was coughing too. The portion of airway in my neck is sore and congested.I found out that the dry cough can be made more productive with good hydration.But that was the beginning of an inflammatory reaction that continues to the present moment. On Friday I was surprised at all the pain in the muscles and joints in my hands and arms as I used a garden hose to do some watering in the yard. There was intense fatigue also. I did not do much more that day. My temperature that day fluctuated from 99.2 F to a brief high of 101.2, but mostly in the 99s.I could take a walk that evening, but it was shorter than usual.Today I felt better, but it was like Friday to a lesser intensity. It is harder to think too. Sometimes I felt a kind of lightheadedness that was similar to what I went through 8 years ago when recovering from sepsis. I do not feel like walking tonight.I also had some episodes these past three days when I had to deal with asthma, most likely provoked by this inflammatory immune reaction. I can usually sense the stuff in the air that brings me asthma, and the air seems okay.I guess I am just going to have to put up with this stuff until I don’t anymore. It is hard to know what is going on. I’m not so sick as I used to be, but can’t say I’m well either. Symptoms rise and fall as they linger. Some kind of antiviral medication might put an end to this, but I’ll pass on UV radiation and disinfectants.The pain in my hands as I write this is such a new experience. I see a dentist on Monday, and Monday a week ago I was tested for Covid with a nasal swab, which came out negative. It might have worked out better when there was blood in there, or if taken during the second week in March when the infection was at its worst. The thought of putting a swab down my sore throat where viruses may still lurk is enough to make me gag. I’ll see what an antibody test shows, if a reliable one is created.Update: 5/3/2020 Symptoms have diminished a lot. They always had a rising and falling quality to them, but now when they rise it sometimes gets difficult to be sure they are Covid 19 symptoms.I had a dental appointment for that abscess on April 30, resulting in another appointment that will be done after the infection is gone. I did not notice that they forgot to return my ID until I got home. Rather than take a chance of a fine for driving without my license, I decided to ride my bike over there the next day. It was an ordeal, but I was strong enough to do it without any physical setbacks. It was a 5 mile ride to the office, but a portion of it involved traveling on a very busy multilane highway that crossed over an Interstate highway, not the kind of ride I’ve ever done done before. I was doing a lot of coughing for the first three miles, then things stabilized. The last few miles back my arms were just burning with fatigue. The day after felt no worse than what some over-exertion brings. I believe I’m mostly over this thing now, not quite, but mostly. Sometimes my throat is sore and my lungs burn, and congestion clogs my throat, and fatigue intervenes at times, but none of it interferes anymore in living my life. I still don’t know if I’m contagious, so I behave as if I am. It has been such a long time getting to this point, but I’m reasonably confident of no more relapsing surprises.Update: 5/13/2020 It just won’t go away. There is congestion in the throat, which generates coughing from time to time, at infrequent intervals. There is a lot of muscle pain, in the back, arms, and legs.Fatigue hits me over and over, but it isn’t constant, so that allows for some activity, followed by rest periods.Headaches sometimes come for a visit, but they don’t last long.The symptom I wrote of on April 18, that balance problem that tends to cause me to lean to the left, has eased somewhat, but now my left ear has developed tinitis and it is much more difficult to understand speech.I have not taken any long walks lately due to pain and fatigue.Much of the time it is difficult for me to think or read anything dense. Writing this update was too difficult to do when I wanted to write it a few days ago.Along with these cognitive difficulties, in the background of my mind there is a bit of free-floating anxiety.At this time, symptoms can erupt and put a stop to whatever I want to do, but they also recede, and life goes forward. It is perplexing that this thing has stayed with me so long.Update: 5/17/2020 I’ve been doing okay most of the time over the last few days, but needing frequent rest breaks and pain meds. Right now I’m hurting quite badly in my back, limbs and joints. There is another symptom I’ve been having for some time over the last few weeks that I’ve overlooked reporting because I did not know that it was a symptom of this. It is mild chest pain, sometimes with palpitations, especially at night. Other people report having the same thing, so I shouldn’t discount it.Also, I came across an article that describes my more recent experiences with this, so I thought it relevant to share here: 'Weird as hell’: the Covid-19 patients who have symptoms for months It closely tracks what I’ve been going through.UPDATE PLEASE! Hoping this finds you well as its been a few weeks. Praying for you from Portland Oregonian.Update: 6/12/2020Most of what I experience now is generalized inflammation. Everywhere that bone meets cartilage has been painful. Nothing severe, and its intensity varies over time, with different places on their own schedules.There were times when I was walking that it felt like my feet were bags of bones. I never felt all the joints moving in my feet before. The joints in my hands hurt, as well as my knees and ankles and the spaces between the vertebrae in my upper back. And then there are the achy muscles, in my legs, arms and back, and sometimes my face. When the pain is up, so is the fatigue, and I must rest, although that pain is going to limit my activity in its own ways.This not a comfortable existence, but at least I get intermittent breaks. Then I go about my life and try to catch up on my projects. I was able to take a leisurely 9 mile bike ride last week, and felt fine the next day. Often I have times when I cannot think clearly, and I even get tired from reading, which is unusual for me. There is one little spot in my trachea that is still sore, and can at times bring on coughing, but the sore throat is long gone. I feel crappy and have to live much more slowly for now, with no idea at all how much longer this is going to last.I went to an oral surgeon for some dental work, and they did all this interviewing to find out if I might have Covid 19. I told them they really had nothing to worry about because I caught it already in late February or early March, and tested negative for it in April. Big mistake. I got the leper treatment. First they wanted my medical clearance from the hospital. Eyes went wide when I explained that I did not need hospitilization and stayed home to avoid spreading it. Then they insisted I get a medical clearance from my doctor, who I did not see for this because there is no treatment for cases like mine. I humored them and got the doctor to make them feel safe, but I’ll be more discreet from here on. I don’t like the stigma that gets me treated like a leper.Update: 7/11/2020Most symptoms have quit returning. Cognitive difficulties perplex me though. I did some online shopping, and apparently ordered the wrong sizes and amounts of the things wanted. I also went to a store for some grass seed, and when I was ready to plant it, it was only after I opened the bag that I discovered that I had instead purchased lawn fertilizer. It was alarming, annoying, and funny at the same time. I really need to take special care when I buy stuff.There is a tiny spot in my trachea that seems inflamed, and if it gets irritated I go through an intense spell of coughing.I have several periods during the day when I feel generally distributed pain, accompanied by fatigue, which takes over and forces me to rest. After an hour or so I can resume activity. I have not been able to exercise as frequently as I could before the virus came my way. The trend is one of slow improvement. So far, I cannot detect any permanent damage.Update: 7/25/2020 It seems like it’s been months since my last update. Some kind of inflammatory process has ruled my life since then, with increased pain in my muscles and joints, life disrupting fatigue, and time distorting problems with memory and concentration. I get breaks from these issues at unpredictable intervals, and have been feeling much better over the last three days. I was given an antibody test on blood drawn July 2, which came out negative. That suggests a couple of possibilities to me. The test might have a higher than optimal tendency to yield false negatives, or perhaps the antibodies fade away four and a half months after infection. That second possibility brings me to wonder how safe I could be from getting another infection. I had been feeling confident of some immunity until now.I get monthly infusions of immune globulin over two consecutive days to treat chronic inflammatory demyelinating polyneuropathy, and the blood drawn for that antibody test may have given scewed results because it was drawn about an hour after my IG infusion for the second day.I’m glad enough to be feeling better today, and well aware of how badly this ordeal could have gone, but fortunately didn’t.Update: 8/9/2020 Two days ago I had a morning in which my trachea was irritated, I was coughing again, and I had a runny nose. My joints and muscles were in deep pain, and fatigue kept me resting. I wondered if maybe this had to a cold. But probably not, because by afternoon most of those symptoms had vanished. Since then I have not felt terribly bad, but not great either. This situation is difficult to understand. I also wonder, if viruses can be detected leaving people’s bodies when they talk, sing, cough or sneeze, is it not possible to test for viruses by having people cough into some kind of receptacle? My recent coughing two days ago left me wondering if I were still contageous.

What process do I have to go through to get a general anesthesia at the dentist?

First let me say, that on an outpatient basis, patients are frequently provided some level of sedation during a dental procedure. The spectrum extends from wide awake, to mildly sedated (with nitrous oxide or oral or intravenous drugs), to moderate and deep sedation, to general anesthesia.In the United States, there are relatively strict requirements regarding the ability of dentists to administer conscious sedation or general anesthesia. There are some State variations, but trivial.In many States, the provision of general anesthesia requires at least two providers, wherein one is performing the anesthesia. For the lighter levels of sedation, often only the dentist is required to have the necessary qualifications. Also, the dentist’s office and staff may require special equipment and training.Provided you meet certain physical requirements (e.g. ASA 1 or ASA 2) (Look up American Society of Anesthesiology classifications), you may be a candidate. Your dentist may require you to see your physician beforehand to provide medical clearance to undergo the anesthesia/sedation.Pre-operative requirements often include being NPO (nothing by mouth) for up to 8 hours prior too the anesthesia, and you must be accompanied by a responsible adult who will take you home AND be with you for care for a period of time determined by the dentist/anesthesiologist.

Why is it so difficult to volunteer overseas?

Probably because organizations that coordinate volunteer efforts have a lot of experience with people who say they want to volunteer, but flake out once the going gets tough.The Peace Corps, for example, only extends invitations to serve to about one in six people who apply. A big problem they have is that a great many applicants are recent college graduates who have never held down a job for a year, so it’s hard to tell if they have the tenacity to stick with a difficult project that takes a long time to show results. I was rare in that I had more than 20 years of a career built up when I applied. I had started my own business and ran it independently for seven years before selling it, then worked for the buyer as a manager for three years after that.In late 2019, they offered me an assignment to train elementary school teachers in The Gambia in western Africa. I had no experience working in elementary education, but they assured me that my training would make up for it. I would be placed in a remote village where I would be the only non-Gambian in town. I’d be off the electric grid, so the only electricity would come from a small solar panel. There wouldn’t be running water; I’d have to get all the water I use for drinking, cooking and bathing from a pump in the middle of the village and carry it home. I would get around mostly by bicycle and should expect to ride 10 kilometers a day. I accepted this invitation and was told to plan to depart in June of 2020.I then had to go through legal and medical clearance. Legal was pretty simple; the local police took my fingerprints, which were mailed to Washington so the FBI could check them, presumably to make sure I wasn’t on the run from the law. Medical was tougher; I had to get a physical exam that was so thorough that the doctor was amazed as how many things he needed to check. I had to get dental work done, though in fairness I should have done that earlier.Volunteer labor isn’t free. If the Peace Corps were to double the number of volunteer slots, that would double the workload of the Office of Medical Services that analyzes those medical and dental records for clearance and deals with volunteers’ health care needs while in service. That means they’d need to hire more nurses, dentists and physicians. It would double the cost of flying volunteers to and from their countries of service. It would double the workload of country directors, so they’d have to hire more host country nationals to help them deal with it.And all of the above is during normal times. I’m facing special difficulty with COVID-19. In March 2020, the Peace Corps recalled all of its volunteers worldwide because of the pandemic. Initially they told me to continue preparing for a June 2020 departure but to understand that it might be delayed. Then they said it was being delayed for months with no rescheduled date specified. Eventually they said to plan to leave in June 2021. Then, in December 2020, they told me my service was being delayed even more and asked me to consider an assignment in another country. So I’m still in limbo.

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