My osteoporosis

Contribution to doctors and dentists.

Flavio Musa de Freitas Guimarães
6 min readApr 12, 2024

I moved from a city in the interior of São Paulo to one in the interior of a distant state from São Paulo.

In December 2022, my upper left incisor was hurting and throbbing.

From my experience of having three bridges implanted by my dentist more than fifteen years ago when I lived in São Paulo, one of two teeth, one of three in the upper jaw, and one of four teeth in the lower jaw. All of them, to this day, April 2024, are perfect, I decided that my incisor be ripped out and replaced by an implant.

I consulted several people I already knew about the dentists with whom they were treated; I received suggestions from excellent professionals from the same city, and some were from nearby cities.

I sent messages to those in my city asking about the amount they would charge for the implant of an incisor.

One was very expensive, and only came to this city once a week; I would not have, as I would not have today, resources to do so.

Of the others, I used the indications of the acquaintances who had lived the longest time here; I consulted, at Google, their references.

I went to the one that most of the nominations I received, had good references on Google. It was not the cheapest, but the amount, in instalments, was in my budget.

By X-ray, he saw that the nerve had already been extirpated, extracted the tooth, and cleaned the channel.

From the description I made of my previous treatments, the X-ray and personal verification, he saw that the bone structure of the jaw was perfect and compact. He made the mould; a week later put in a temporary tooth; two months later he made the implant.

It was a perfect prosthesis, the porcelain smooth and bright as the teeth of my previous implants. He prescribed me Amoxylin three times a day for seven days.

A week or ten days later, the implant was soft. I came back, the dentist removed it, cleared the cavity, and replaced it; after another week of Amoxylin, the same result: the implant was not fixed.

Another consultation, same procedures. This time, when removing the prosthesis, the canine beside it went off as well. I was prescribed a week of Amoxylin followed by eight days of Levofloxacino 750.

After two weeks, again I had to go back.

He said he didn’t understand, and asked me if I didn’t take calcium.

I said yes, I take a Sodium Alendronate tablet every morning.

Sodium alendronate? He ran to his file, sought and found the file of a client who had the same problem, at that time consulted medical doctors, and found that her problem was this. She stopped taking this drug and everything was resolved.

That I had to stay four months without taking Alendronate. He gave me the implant and asked me to keep it.

Before four months I had to come to Sao Paulo, as I explain below.

On September 1, 2011, I had a diverticulum that burst. Crazy in pain, by mistake, a friend who lived in the same building called, I could hardly talk, she took me to the nearest Ambulatory Medical Assistance (AMA), where I was registered “For Immediate Service”. The dwell and corruption of staff and nurses made me wait for more than 20 minutes until I was attending.

I would have died, were it not to be taken to the University of São Paulo’s University Hospital, of Excellence at that time.

I registered my calvary of suffering and hallucinations in “Traveling on morphinesis[1]; the Initial Note explains my Calvary; the rest tells of my wonderful hallucinations.

On January three, 2023, I had the consultation I asked for, with the gastroenterologist here. A great doctor! He meticulously examined me carefully; at the end gave me an abdominal tomography request and one for bone densitometry.

In May 2023 I had to go to Sao Paulo, for several reasons, especially for a consultation with a renowned surgeon and gastroenterologist; a brother of mine, knowing what I told him, paid.

I went with the tomography and diagnosis.

Anamnesis done, he looked at the tomo and diagnosis, asked me to lay on the examination bed, auscultate and pressed my abdomen.

Returning to his table, he showed me dark points in the transparency and explained that they were calcium deposits; that I should not take calcium supplements, avoid taking milk and eating eggs.

That no surgery was needed, that what I have is a weakening of peristalsis of the colon, which would be resolved by a medication that would refer me but could only prescribe it after the result of a colonoscopy.

The colonoscopy performed by a doctor from his clinic showed that my colon did not have inflamed diverticula, only three small polyps he had removed, gave me the prescription for Resolor[2], which the doctor had told him that I should take.

The pharmacies I found by Google either do not deliver it to this city, or with an astronomical freight. The pharmacy I always used would have to order it from the Laboratory Jansen; it would arrive for more than 800 reais per box of 28 tablets.

To have a consultation quickly, I paid 250 reais to the hospital maintenance society.

The consultation was held last November April 9.

I handed him the tomography and densitometry and told him why I didn’t have the surgery.

He was terrified of the result of the densitometry; he told me that I could have a broken bone even without falling. Said that I should start taking sodium Ibandronate[3] immediately, explained the care and way to take on every month, that I mark the date rigorously, so as not to delay more than one day the next take.

Instead of Resolor, he gave me a recipe for trimebutil maleate [4](28.85 reais with a discount on the pharmacy; instead of Muvinlax (45 reais with twenty sachets), that I used before for months with no effect, gave me a 30 sachet Polyethylene glycol [5] manipulation formula, that my pharmacy has already asked to manipulate: 110 Reais. As the doctor said that this is more adequate and efficient in my case, am taking it as the doctor prescribed.

I took today, April 10, the first dose of Ibandronate. From what I read from the leaflet I saw that it will help me a lot. But it can never recover all the bone mass I lost.

I took advantage of an appointment with my dentist. I told him the story.

His office is always up to date, including the X-ray appliance that you don’t have to hold on the plate with your finger, you don’t have to wear a lead apron, nor the dentist must hide behind the wall.

On the big screen, he saw the image at various angles, identified -and showed me — a dark mass at the point of junction with the jaw.

The consultation, which should be fast, took almost an hour for him, helped by his great assistant, remove the dough, clean everything with drills, several times with disinfectant, close with cotton (or paste?), he made a porcelain canine and put a provisional. Marked to be back the next day, Saturday, at four in the afternoon, because I had scheduled a trip back here on Sunday, leaving the bus terminal at 23:30.

To put canine and incisive, asked the assistant, to give him the “XY” tool, she told him was over, he asked her to make a note to replace the stock, used the existing tool, with which he squeezed them, removed, changed position, put and squeezed from new. It was firm.

Two or three days after getting home, eating soft food, the piece falls.

I called him; He told me it was because he didn’t have the right tool. I should ask my dentist to put it with the tool such-such the number of the thing and the names and addresses of the dealers that provided it.

Hence, I committed an unworthiness crowned by stupidity: instead of going to the dentist, who is a serious and fair person, would put it with nothing to charge, or charge for something he had to add or change, that would thank the information of the colleague, I went to consult with another here, also with beautiful recommendations and credentials.

This one suggested that, instead of inserting the two prostheses, it would be better and would be more firm, to make one piece, with both teeth.

I agreed. I threw the tooth and implant in the trash.

I had to come back to Sao Paulo urgently. I went to my dentist again, examined the result, and agreed that the solution adopted was better.

The only difference is that it is not with the porcelain as smooth and bright as the one I threw in the trash or those of previous implants.

[1] https://medium.com/@blogflaviomusa/travelling-on-morphinesis-4da3c18b0ad3

[2] https://www.medicines.org.uk/emc/product/586/smpc#gref

[3] https://www.webmd.com/drugs/2/drug-92883/ibandronate-oral/details

[4] https://pubmed.ncbi.nlm.nih.gov/31617696/#:~:text=Trimebutine%20maleate%20has%20been%20used,irritable%20bowel%20syndrome%20(IBS).

[5] https://www.mayoclinic.org/drugs-supplements/polyethylene-glycol-3350-oral-route/description/drg-20523233#:~:text=Polyethylene%20glycol%203350%20is%20used,This%20medicine%20is%20a%20laxative.

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Flavio Musa de Freitas Guimarães

Already watching the eighty-eight turn of the Earth in curtsy around its King, I’m an engineer that became a writer, happy, in perfect health, body and mind.