Dr Lagos – advise on visiting
by L.M. Lalko
First, his site: http://biologicaldent.com. His fees page should be updated a bit, some things are replaced. His estimates will be accurate.
Second, qualifications. I was asked by many, both sides of the border, why Dr. Lagos. Yes there was a better price and I’m broke so that was significant, but that doesn’t mean see Dr. Lagos, it means find a cheaper dentist. Lagos is a Huggins dentist, personally trained by Huggins. I happen to think Huggins was on to the truth and prefer that orientation. I believe root canals are an abomination and if you have one it should be removed. I do not believe implants are healthy. I am oriented their way. With a Huggins dentist I don’t have to fight these battles.
Third, recommendations. I would be very reluctant to see any dentist I could not get either a lot of written on a website or a few word-of-mouth recommendations for. Ditto doctors. His were excellent. On this site: Mary Ellen Halpin, Vivian Vera, and Alan Downey had seem him and loved him and were generous with answering questions and relating their experiences. Since I saw him, discovered Olive Kaiser was also a patient of his; again strong recommendation from her.
Also he had complete, useful info, which went beyond the essential dental info to include a recommended hotel (Dali Suites. Far nicer than most budget motels in the States. Reasonable price. I was comfortable and happy at this no-smoking anywhere facility reasonably close to Dr. Lagos’ office. And a transportation service which avoided the nightmare of having to get out at the border and find another way to finish the trip.) He made it possible to coordinate everything and get it done.
Experience 25-28 April 2016
Day One I managed to get lost, but did arrive on time. You need to ring the bell to get in. Adam, Dr. Lagos’ assistant is very friendly, considerate, and competent. He’s a pleasure. Nice little waiting room. Free wifi in there as well. Dr. Lagos is a charming, warm, compassionate man. I like him the best of any dentist I have ever seen. I have massive dental phobia and had some butchers, but most of my dentists in all honesty were good. A couple were very kind. He is the best from a technical point of view as well as being compassionate.
I opted for conscious sedation. That meant that I had an anesthesiologist who works at the hospital there. He was there the entire procedure. He put an IV port in my arm so that they would not need to stick me each day. I will be honest, he had to try three locations. That was not a lack of skill on his part. I am sicker than I talk about and when hospitalized it usually takes three different people to get an IV going and often to even do blood draws. I have veins that roll and collapse often. They did it again. The cocktail this anesthesiologist uses is: Propofol, Fentanil, Midazolan, and Presedex. I have no idea if you would have the same anesthesiologist if you opt for conscious sedation or if he would use the same cocktail. (Cocktail is just slang, it’s a mix of drugs injected into the IV line; there is no drinking of anything.) I had not asked Dr. Lagos about his local anesthetic, but he told me. I believe it was Septocaine, but I am not sure. Your vital signs are monitored. I did not go fully under so was in and out during Day One.
Also of note, they do put a disposable surgical cap on your head to cover your hair and there is a thin blanket on you during the procedure. Your things are stored on a bookshelf in the recovery area, so your contamination exposure is minimized. They do use a dam. They also use a “block” which holds your mouth open for the procedure. A nasal canula is placed so you have Oxygen throughout the procedure. There is a suction device with air hose where the vapor is captured in the area being worked on and vented out of the room.
I was also told to eat nothing past 8 p.m. the night before the procedure (this is because of anesthesia). I was told in the morning to have not more than 5 oz. of water. I recommend really guzzling water the night before.
I was told in advance to NOT take any Vitamin C supplements for 2 days before the procedure because it inactivates local anesthetics. Please note anesthetics, not anesthesia (which is the IV med requiring the anesthesiologist to administer properly because the dentist is otherwise busy.) This is something that Dr. Hal Huggins discovered. He did not share the mechanism involved that causes this. Clearly there is something involved with using the stomach to process the C. We have two members on site who can attest to the truth of it because one had C before a procedure and experienced great pain; another took C after a procedure before the numbing wore off and experienced great pain. Because I have other issues (gastroparesis being one—a stomach problem associated with diabetes, which I have—that causes slow, I mean tremendously slow, digestion) I cut off my C 3.5 days in advance of the procedure. I hate pain J It is quite possible to have IV C during the procedure and I did. I received 25 g in a Hartmann solution. Hartmann’s solution is also known as compound sodium lactate (CSL) which is isotonic (means it has the same salt concentration) with blood. The line that is used to establish the IV is where the anesthesiologist injects medications.
The personnel are all nice and competent and efficient. You won’t be twiddling your thumbs waiting for things to happen. Everyone’s English is fine. Everyone looks out for you. There is no waiting room full of patients. He seems to do one intensive patient a day; I am sure there are other days he sees multiple folks, but when it is a TDR (Total Dental Revision) you have signed up for he allots the full amount of time that the procedure COULD take, including if things go wrong (like rolling veins). Oh at that meeting the first day, he introduced me to his partner. Dr. Veronica Gonzales (sp?). He said that she would do the extractions and cavitations on Day Three.
That day 5 amalgams were removed and replaced with resin composites that my biocompatibility test had said I should not react to and I have not. I am not sure how many hours I was there; I would guess they worked on me for around 4 that day. After it was done, I was assisted out to a recovery area (there is a proper waiting room; this is similar but you are not with folks just walking in off the street, but back in the procedure room area.) My adrenals were complaining so I was cold. I had a blanket. The acupressure lady, Laura, showed up. She noticed that I was still cold and brought a heavy blanket out and proceeded to work on me. I noted my neck was actually sorest and she worked on that in particular. She has known Dr. Lagos for over 20 years. She’s worked with him for at least 16. When I was ready to go, I used the restroom and Dr. Lagos actually drove me back to the Dali Suites and saw I got into the gate safely. (He is also a good driver.) He offered to pick me up the next morning at 8:30. Now I want to note a couple of things here. I require a cane to walk. He also knows my real age and medical issues. My point is: I would not assume that Dr. Lagos is going to provide driving service to all of his patients. I believe my age, disabilities, and fact I was nice to him all factored in to his extraordinary generosity. You are told to get yourself there and back and you should assume that is what you will do.
I believe he crossed the midline on that day, but am not sure. He did tell me which teeth he did; some were uppers, so I could not see that work and I don’t really think in tooth numbers. In any case, what I found interesting was that though a significant amount of work had been done, the soreness I had was where the lower amalgams remained. The areas worked on were perhaps a wee bit noticeable, but not painful. It was a remarkable day. I had great difficulty sleeping but that is the norm for me.
Day Two. Adam arrived to pick me up and take me to the Clinic. He was a cab driver in Tijuana for ten years. He has nerves of steel (I repeat myself) and knows his way around. He is an extremely nice man who is clearly madly in love with his wife and adores his two daughters. He is open and easy to talk to. An absolute delight. I did ask him when there if I could get the receipt for the work done as I had not the day before when I paid. He said that would come the day the work was completed because the bill might be adjusted: more work could need to be done and if I used fewer anesthesia hours, those charges would be refunded. Please re-read that sentence. You don’t have to ask; you don’t have to beg; they just do the right thing automatically. BTW, jumping ahead, on Day Four, there were charges that had not been planned on (cavitations) and fewer hours of anesthesia used. I received a net rebate. Dr. Lagos himself stood there with his wallet offering to pay the difference in cash. I said I preferred a check as I am not comfortable carrying significant cash around. He said he could not make it to the bank before Saturday and I said I trusted him. He could mail it to me. Yes, I am confident he will do so.
This time all the usual was done (and the tape which had protected the IV port in my arm was removed. Today would involve more amalgams being removed and dealing with the crown. I found that I was not as sedated as the day before, but it was not painful. Afterwards, I was a bit sore in the mouth, particularly in the crown area. Oh yes, before the procedure started I did ask Dr. Lagos if he could take a bite wing of the crown tooth when all the amalgam was out before the temporary crown was placed. He said it would be a bit difficult and asked why I wanted that. I said, Because if I have trouble with chelation everyone will say: What if there is hidden amalgam under the crown? So this way I know. He smiled and said my temporary was opaque so the final x-ray I had requested (a panoramic) would show that tooth.) Problem solved! The whole day was short and uneventful. Yes acupressure again. Adam drove me back to the Suites and said he’d be there the next morning at 8:30 and was.
Day Three. This was the one I dreaded. Who wants to lose any teeth? But they were RC, root canal, teeth and from day one of those I had complained that I felt pain, infection, etc. American dentists scoffed and I was miserable for 2 solid years with chronic sinusitis to boot. The other doctor was there, but so was Dr. Lagos who said he would be in the room during most of the procedure. This was the day they would also administer PRP. That is platelet-rich plasma. They draw your blood that day, spin it down, and you are reinjected with plasma that contains several growth factors and cytokines that stimulate healing. This works for both bone and soft tissue. This has replaced the PZI injection that may still be on his Fees page. I did ask if they’d be so kind as to snap a photo or two of that, as well as the RC teeth, because I figured you’d be interested. I have yet to look at the photos. I still have dental phobia so didn’t want to be nauseated with visuals while trying to give comprehensive notes. They did do that. Again, can’t stress how nice his staff are. The PRP is injected to the extraction sites. The sites are also cleaned: the ligament is removed (that is another Huggins thing); the bone is scraped; ozonated water is used to clean the site; it is closed with dissolving sutures. I had additional cavitations, I believe, from the sites of my wisdom teeth removal long ago. I did say to the anesthesiologist that I hoped he was going to actually put me to sleep for this. He smiled. Again, I am hooked up to the IV C and he administers medications via that line. This day did not go so well for me.
Again, I am sicker than I like to talk about. I am admitting to this now because I know we have a lot of sick folks on here and now is the time to share some of the pertinent info so you can evaluate what is likely to be your situation. There were problems from the get-go. My oxygen levels dropped significantly. My BP rose dramatically. I was in distress. The anesthesiologist would only go so far for an elective dental procedure. Clearly someone getting a heart transplant has to be completely out, but that is a life and death situation. Many people have teeth extracted without being anesthetized. The maximum amount of locals was injected. I was conscious throughout. There was pain at times and it was also quite unpleasant to feel pressure while teeth were removed, sutures, injections (including the PRPs), etc. It was not as bad as it could have been or the nightmares I’d had about it at times, but it was not a good experience at all. I was gesturing to the anesthesiologist: Sleep! But no L So I had to embrace the suck. Dr. Gonzales is technically proficient and fast. I imagine that work would have taken many dentists at least 25% longer to do. When it was over (still not fast enough for me), my vitals were still not good. I remained on the chair for some time. Dr. Gonzales spoke to me a bit, but I really wanted Dr. Lagos and he came back in and comforted me. I was in a lot of pain. Because my stupid vitals were still bad, Laura came in and did acupressure on me in the room. As I never had my glasses on during work, I asked her what my BP was. This is after a good deal of time to recover and some final analgesic in the IV line: 153/98. It had been significantly higher earlier, but she would not know those numbers and I never asked about them. She finished. Dr. Lagos assisted me to a chair (he always put me in the rolling chair he uses in the procedure room and would roll me to the recliner. This time I said I really needed to use the restroom first and he rolled me up to the door which is as far as I needed him to take me. Came out in a couple of minutes and he rolled me to the recliner and my adrenals crashed. I was not just shivering; I was shaking. My teeth were chattering so hard (great after what I’d just been through). I was weak. I felt spent. I felt a lot of horrible things physically and emotionally. When your adrenals rebel, it is bad news. I would imagine I was there in that chair for over an hour before Dr. Lagos felt I was stable enough to leave. He kept checking on me and would speak a bit—looking for responsiveness.
I would like to add a personal observation. In the States there is TOO MUCH relying on freaking machines and lab tests for everything and frankly it’s not just cold, but too often inaccurate. Actually really observing and interacting with a patient is a better measure of how they ARE. When needed, the machinery can be used again to check the BP, O2, whatever, but the usual: let them sit alone hooked up to machines that go ping (yes I love Monty Python and Yes Graham Chapman was a physician) and go about to the other people you’ve stacked like cordwood to work on at the same time is NOT a good practice. This is something we need to be doing in the States. Yes, I know ALL about the “extra cost” and needing trained personnel to actually, the HORROR!, interact with a patient instead of using the more cost-effective machines. Stupid! It’s also a reason more people sue. FACT: if your practitioner is one you like, even if he messes up badly, the odds you will sue are dramatically less than if you don’t like the little robot who maybe was not even that bad of a doctor/dentist/whatever and caused less harm.
He also gave me instructions on cleaning my mouth, saying how important it was to keep the blood clots over the extraction sites. He gave me gauze; he gave me a special salt (not bogus table salt), and a cup to use and told me how to clean the mouth.
I had a lot of pain from this procedure and it just grew as the IV meds wore off. Normally Dr. Lagos has a wafer magnet deal he uses to help with pain. His order had NOT come in; I will receive one in the mail at some point. As I usually am in pain somewhere, I will comment later on how that seems to work. Dr. Lagos said he could offer me something comparable to Motrin, which I am allergic to, and was hoping I would take the Percocet I had brought with me. I did not. Why? Because every day I had already needed a suppository because even less than general anesthesia can cause problems with elimination especially when you already have a variety of medical problems that cause that sort of problem anyway. I knew I was HEALING and I had had that lovely IV C so was confident it was progressing as fast as it could with my body. Dr. Lagos did tell me when I was back to the Suites to use the Keflex I had brought (I asked him about that long before I came. I have no one to send to a pharmacy for me, etc. Why not go prepared?). He said every 12 hours to just give my body a bit of a boost. I had been very badly infected everywhere I thought I felt infection. He thought three days would do it. I slept way less that night. Oh and because I had been so unstable, Dr. Lagos himself drove me to the Suites. It has a one-way street with a school across from it and it just was not passable. I was going to get out and walk the half block and he said no. He backed up that half block (also has nerves of steel) and went around. No luck from the other approach. So he went to the closest safe area to park and personally walked me back to the Suites, pointing out a spot where the sidewalk dropped off. He went ahead at that point and took my hands so I would not fall. We got to the gate which I had the key to open and I thanked him for his care. He said, “I will walk you to your room,” and did, seeing I could get the door open. Then he left. I have NEVER in my life heard of an American dentist who does anything like that.
Day Four: the exam day. I had also asked him to do a panoramic x-ray. He did. He went over it with me. I have two printed versions, but I am waiting for the emailed one and will post that so you can see a mercury-free mouth J. Because I have a massive problem with my teeth, he kindly used a different attachment for the pano (you are supposed to bite something and hold the position while the machine whirs around your head and gets that fuller shot we have seen.) I don’t know there is a name for what has happened to my mouth over the last few years. I have an open bite (front teeth do not close. I can stick a large portion of my tongue out it is that bad). But it goes beyond that. I asked him how he would describe it. He said it is not his area but he wonders how I chew as only ONE top and ONE bottom tooth meet. I am suspecting I have a dislocated jaw, but don’t know for sure. No, I was not in a car wreck and I didn’t get into a fight with someone. I have a lot of joint and muscle issues. Body parts go out on their own regularly.
I apparently need an oral surgeon. I have been aware of this problem for a long time. The dentists here have scoffed or say “you’re a tongue thruster and pushed some teeth.” That is false and also tends to be a lifelong issue, not one you develop after 40, which is when the problem started. But what are you going to do with the “experts.” Worse yet after I had the pano that I sent to Dr. Lagos I had my PCP write for a few skull shots and the radiologist happily declared that there was NO infection anywhere and my mouth was in perfect alignment. I shared that with Dr. Lagos. He looked like I had said something insane and asked me to repeat what I had just said. I did. He sat there, searching for words, and said, “You had massive infection in several areas. Only one tooth on top meets with one on the bottom. A radiologist said your mouth is fine?” Yes.
I wonder if the radiologist bothered to read the x-rays or just slapped that down. I’ve seen debatable x-rays; I don’t believe mine could be—there is just too much damage. Anyway, my PCP will hear about this and we will see what can be done. I am in a bad position on this because to be blunt: I don’t know who would fix it if I need surgery. Dr. Lagos doesn’t do the surgery. He would clearly be my first choice. I am leery of American dentists. I’ve had several who claim I’m OK. Really? But I’ll cross that bridge after a discussion with my PCP. Though he does NOT normally do this, Dr. Lagos is going to try to describe what he sees and send that to my PCP so I can get help. He was concerned that my PCP would discount the information because he said, “Doctors don’t like to listen to dentists. Doctors don’t want to hear from dentists from a different country.” I told him I know he speaks the truth but don’t think my PCP is quite that foolish. He better not be. I suspect a good deal of my constant headaches are from the dislocation.
Anyway, back to Dr. Lagos. I have partials also known as flippers. He showed them to me, explained them, put them in (Ouch! Just had surgery, am raw there). Said that many times people can return in 3 months to get the permanent ones, but he saw my leg wound and said after looking me over a bit more that I needed to wait 6 months because I heal too slowly. ) So I am planning to get back there and get the permanent crown. I am assuming I will do the partials. I have to wear them awhile before I commit in all honesty. He also kindly allowed me to ask some other questions that apply more to all of us and I will write that up separately. Not everyone wants the detailed blow-by-blow that this is. Oh he also cleaned my mouth with ozonated water and he gave me an injector (looks like a huge syringe) to gently irrigate correctly with salt water. I got my flippers in a case; the two RC teeth in tissue.
Bottom line: I think Dr. Lagos is the best dentist I have ever seen and I have seen good, gentle ones, as well as butchers. I also respect that man: not only is he a superb dentist, but he is truly a GENTLE-MAN, a term too often misapplied. I did also ask him if I had mercury in my RC teeth and fortunately I did not. He did say it can be in RCs. Therefore, I was mercury free Tuesday afternoon. Oh and I know if my Dad were alive to read this, he would say, “I know he didn’t pay you to write this, but it sounds like he did.” My mother would say, “Are you in love with him?” No I wasn’t paid and didn’t get a discount and I am not in love with him either. I would be thrilled if I could count him as a friend because you can never have too many fine quality people in your life, but I don’t know he will even remember me in 6 months. I will remember him always because as I said to him when I left him, “You are my personal Abraham Lincoln. You have freed me.” That is no exaggeration. I know just the removal of those toxins will make me much better; with ACC, I believe ultimately I can be well. I’ve spent a lifetime being very sick. I’d like to live before I die.
I am actually hesitating to put this last bit in because I think this is the point where people will think it’s an incredible tale that can’t be true. When I was ready to leave Day Four, I said in front of Dr. Lagos, Could Adam point me in the right direction to the Walmart? He asked why. I said, I had some soft food with me and I ate it yesterday, but it was really painful and I’m afraid I’m going to dislodge the blood clots. I want to get some baby food. He said he thought that was a good idea. He spoke to Adam in Spanish and they had a brief conversation. I shook Dr. Lagos’ hand and said good-bye. I figured I am no his patient anymore, I have to hoof it to the Walmart. Adam got up holding his keys. “I am taking you to Walmart,” he said. I nearly fainted. So I thanked the doctor again and Adam and I left. BTW, as you probably already think this is ready for a fiction award, he did what he always did—went around and opened the car door for me and closed it. We went to Walmart. I bought 2 bananas which I had not even mentioned; I asked him to help me find the baby food. Once there I knew it would take me too long to figure out what was what so I said if they had chicken and rice that would be great. He found it and said they also had chicken and pasta. He would have translated every bottle, but I said chicken was fine and I could not keep him from his work. He asked what else I wanted and I mentioned hydrocortisone cream. Had to ask a pharmacist. Turns out it is about four times as expensive as the US, so I ended up passing on that. He offered to let me shop in the store (and this was a giant Walmart). I said I could not take advantage of him and the doctor like that, he had plenty of work to do and the doctor was letting me borrow him. So we checked out and he even gave me a good idea of what I was spending in dollars. Drove me to the Suites. Opened the door, helped me out (I still need the cane and now had a backpack and groceries. The backpack had held my laptop so I could put answers to my questions down as my writing is illegible to me and I don’t know if I can tie a pharmacist up long enough to translate what I write.) He also said that if the magnets arrived that day or the next, he would drive them to the Suites. They didn’t come yet, but I know for a fact he was not lying to me. I swear to God this is all true.
Since the mercury removals, I find that I do NOT have to lift the second leg to get into a car. I mean by this that like everyone I stick a leg in the car to sit; however, whether I am the passenger or the driver, for many years, I have had to lift the other leg with my hands to get it into the vehicle. I can now put the leg in the car, passenger or driver side, like everyone else does, OK bangs around a bit more, but it gets in there. The sores on my arms have decreased. I am breathing easier. Though I have definite discomfort in my mouth, I am not in pain for the most part (twinges at times). I don’t feel the infection that I did in the spots where I had it. I feel the sutures! Just had a bit of one break off and was able to get rid of it. Good riddance! I KNOW I am going to get better.
L.M. Lalko
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