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A dental hygienist loses the use of an eye, but finds her purpose

June 14, 2018
A brain tumor robbed her of her ability to practice clinically. But it didn't rob her of her profession.

Lifelong learning through a hygienist’s eyes.That was the title of the first article I wrote for RDH in 2013. I wanted to use my oral health-care experience to educate colleagues and give them permission to challenge what they learned in a classroom so that they could contribute to a new era of prevention.

Ultimately, it was written to share how I viewed our profession and what my vision of dental hygiene was for the future. Little did I know how ironic that title would be five years later.

I never thought that I would lose half of my vision. I am technically not blind. The way I visualize the world is just more complicated than it was in the past. A hemorrhaging benign meningioma bordering the optic nerve and the subsequent surgery left me with a paralyzed eye. This complication, third nerve palsy, puts me in a place that is forever changing my life physically, emotionally, and professionally.

When it reared its head this past summer, the brain tumor was not a surprise. I have known about a mass in my brain since 2004. An MRI prescribed to check the pituitary gland due to hormonal fluctuations led to its discovery. The pituitary gland was fine, but what they found was a 2.5 cm mass abutting my optic nerve.

The consensus of the neurosurgeons consulted was that this mass was a nongrowing lipoma. It was speculated that a hunk of fat had formed in my brain before birth. No biopsy was considered, and no surgery was recommended unless symptoms started to occur. Monitoring for changes became the treatment plan.

Life kept on moving forward. I continued practicing dental hygiene, got my bachelor of science in oral health-care promotion, and became more active in my local hygiene association component. I implemented new products in my practice, and despite opposition within my clinical environment, I brought patient care to its optimum level in my hygiene department. Life had become so full that I eventually forgot about the lump of fat in my head. That was about to change.

One night this past summer, as I was sitting outside a local Italian restaurant, I started to feel the dull ache that preceded every migraine I’ve ever gotten. The pain was subtle, but as dinner progressed, the sunlight became my foe. By the time I got home, the pain was so intense that I knew over-the-counter medication wouldn’t work. Sleep was my only way out.

I chalked the migraine up to the stress from changes in the office. The changeover of front-desk staff and the financial woes of the business were taking their toll. Micromanaging new staff were challenging every decision I made. The migraine I thought was stress related pressed on in varying degrees. Finally, on the tenth day, I sought help.

Arriving at the hospital, I decided to use the brain tumor as an excuse to get through the sea of patients in the ER waiting room. I honestly didn’t think the tumor was the culprit, but the intense throbbing and nausea was like nothing I had ever felt before. I needed relief and would use any excuse to get it. When the medication made the symptoms worse, I was finally admitted.

It took three days in the hospital to get the pain to a tolerable level. The third day also brought a symptom first noticed by my husband. The left eyelid was not at the same level as the right. It had begun to droop. Radiologist and neurologist all agreed that the new MRI didn’t appear any different than previous images, and the eyelid issue could be addressed by an optometrist.

That’s where I was physically. Professionally, an ad for my full-time job was posted online and my livelihood was in jeopardy.

These events made my priorities change. My health became more important than any job I held. Doctor appointments were kept as I searched for the answer to my falling eyelid and the double vision that soon followed.

Two eye specialists and one neurosurgeon later, we discover that the MRI showed a hemorrhage from the brain mass. While it was a blessing to know the cause, it now came time to decide when to remove this life-changing mass. At this time, my eyelid and double vision had resolved, my body reabsorbed the fluid, and pressure was no longer exhibiting itself on the nerve. Surgery now or later was the question.

What made me decide to do the surgery this past summer? Well, the neurosurgeon thought earlier was better, as the younger a patient is, the better recovery can be. The other reason was that my job was no longer mine. I had no idea if it would bleed again and my next job would be lost for the same medical reason that I was losing this one. I decided to be rid of it. I followed my surgeon’s advice.

Just as in dentistry, sometimes surgeries do not go as planned. Complications happen even with the most skilled surgeon. I, thankfully, woke up after surgery but my eye never did. I could feel the eyelid blinking but it didn’t move. Phantom movements, that’s all I felt.

The six months of recovery took me away from the dental world, one I had thought about leaving because of the absence of professional growth. Listening to others trying to dissuade me from my ideas often times kept me from collaborating with others and progressing forward. Despite these feelings, I attended a CE course that would change my perspective on the career I thought was over.

Being surrounded by passionate dental hygienists and listening to the lecture about microbiomes fed the fire had had begun to smolder. I realized during this course that all the clinically challenging moments I had getting patients from disease to health were over. The realization that my clinical skills would no longer be used caused me to leave the CE course during the lecture and have an emotional breakdown.

In the seven months since surgery, I had not cried for my physical and professional losses. I needed this moment to finally realize that my plans and dreams had changed. Allowing the breakdown to turn into a breakthrough was my only way to move forward. It was at that moment that I realized I was stunting my own growth in our field.

Why can’t we help patients from the sidelines? What stops us from educating others? Wasn’t that my original goal when I wrote the article in 2013—to educate hygienists of their potential in our profession?

I now realize that I am a hygienist with limited visibility, not completely blind, but visually impaired. My hands work. My dental knowledge is the same. The passion I always had for dentistry and patient care is still present.

We have potential outside the clinical setting to make a difference. My new goal is to continue writing and to search for a dental hygiene position in which I can bring what I’ve learned in my career to other hygienists. I will listen to them, teach them, and let them teach me. We don’t need to have a setback to stop us from moving forward.

This is now what I see through my hygienist’s eye.

Christa Crilley McConaghy, RDH, PHDHP, has been an RDH for over 20 years and received her BS in oral healthcare promotion from O’Hehir University in 2013. She is currently a trainer for Perioprotect and a presenter for the Healthy Teeth Healthy Children program, a medical/dental partnership that works to increase dental access to children. Her career goals are to improve oral health care by implementing disease prevention programs into offices and helping hygienists and dentists realize the potential their dental hygiene department has on their practice and their patient's systemic health.