Wednesday, March 7, 2012

Adventures in Dentalwork, Billy Edition

Before Smile:

Wow. What a long day. I'd rather have surgery myself than do that again. Literally.

As a mom, you realize that you would gladly walk through fire for your child. You'd rather have the surgery than to watch your "baby" go through it and not be able to help. And, just like a mother, you feel guilty for the whole durn thing because we all know that no matter what, it is always all your fault.

Today my six-year-old son had major dental work done. Nine teeth pulled, three crowns, two fillings, and a therapeutic pulpotomy (whatever that is).

I've known Billy had teeth problems for a while now. Here's where the guilt part comes in. I was a tired mom of three and I let Billy go to bed with a sippy cup even though I knew better. He has not been an easy child, so in order to keep him calm and save my sanity, I caved. My husband says I cave any time Billy is involved, but I am trying to be better. In the beginning, I didn't get his teeth fixed because I didn't have the money. Then, I hoped that the baby teeth would come out on their own. But, since he seems to be slow at most everything, he didn't lose his first baby tooth until a couple of weeks ago, two months before his 7th birthday. His teeth got worse, he started having pain, and we found out he had three abscesses. It was time to get it done.

The financing was something else altogether. The cost of this was astronomical and I tried calling insurance companies and other dentists and oral surgeons to find another option. But, the long and the short of it is that dental insurance doesn't cover general anesthetic and medical insurance will only cover dental expenses if there is an injury. With Billy's special needs, there was no way we could do this extensive work without general anesthesia. He would never have allowed them to come near him with a needle, let alone all the work they needed to do.

They originally scheduled him for noon, but changed it to 1:30pm. He was not allowed to eat anything after midnight--a long time for a little boy. He could have sips of water until 9:30am. I had to give him about half a spoonful of yogurt in the morning to take his meds with, since he can't swallow them whole. The dentist's office called in the morning and said they were running behind, so he was pushed to 2pm.

We had decided not to tell him about the surgery until the day of the surgery. We weren't sure if he could handle hearing all that. We didn't want him freaking out for two weeks. So, the night before, I told him he wasn't going to school, that he was going to the dentist to get his teeth fixed. He asked if they were going to pull them out and I said yes, some of them, but that they were going to give him medicine to make him go to sleep while they did it. He seemed to take it well.

We got to the dentist's office a little before two. Since this is a pediatric dentist, they had a couple of video games in the waiting room and Billy amused himself with that for a while. He brought one of his little stuffed bears and had fun dropping it from a little window at the top of a climbing/slide play area. We waited for a long time. It occurred to us that we were not going to get done in time to pick the girls up from school, so I called the school to arrange for them to stay at the after-school daycare.

Eventually, the anesthesia nurse came out and gave him some medicine to drink to make him sleepy, got his weight, and filled out paperwork and went over the risks with us. She kept checking on him because he was thumping around like boys do and she was afraid he was hitting the floor. She asked him if he was sleepy yet and he kept saying no. We finally asked him to come sit by us because we didn't want him to fall. He sat on my lap and played games on my phone. I started noticing that he was wobbling and he almost fell off my lap. I asked if he was tired and he said, "No, this medicine doesn't work. I'm dizzy, but not sleepy." Scott put him on his lap, but he wanted mama back. Then he protested being held, period. He did not think he was incapacitated and didn't understand why we wouldn't let him get up. I put him in the chair next to me, but he jumped up and tried to run. He stumbled and bumped into a tiki statue (their decor is jungle), jumped up before I could reach him and ran again. He stumbled again and this time, he went head first into the wall and started screaming and crying. He'd hit his face and ear and now has a light bruise under his eye.

He couldn't be consoled after that. Not only had he hurt himself, but he still didn't understand that he couldn't get up. He fought being held and we wrestled him. He kept screaming that he wouldn't hurt himself again, that he was okay. He argued, "I AM in control of myself!" Then he started talking funny, not finishing his sentences. He was still fighting us, but he could barely talk. The dentist came back out and heard what was going on and felt so sorry for him since he had hurt himself. The anesthesiologist came out and basically told us the same stuff his nurse had said. It was a good thing he didn't say anything new because I could barely hear him over Billy's wails.

Scott carried him back and as soon as he was laid on the chair, he was quiet. He had a hold of his bear and they had Rio on the TV above his head. They put a monitor on his toe and put a mask over his nose and mouth. They had him inhaling nitrous and an inhaled anesthetic. I held his hand and the anesthesiologist talked to him as he drifted off and let go of my hand. It was very hard for me as a mother. I have been under numerous times, but this was the first time I have watched this done. Usually it's done behind O. R. doors or if I'm the patient, I am asleep and have no idea what is going on. But, watching my baby laying there limp and hooked to machines was awful. I don't know how parents of sick children do it. This was just dental work and I was near tears and nauseous. The anesthesiologist was basically breathing for him, squeezing the bag to try to get him through the second stage of the anesthesia as quickly as possible. Apparently in that phase, the vocal cords can slam shut and cause him to not be able to breathe. I was worried that this would be a problem since he was crying so long, the mucous can cause this. It was frightening to me to see his chest rising and falling, his cheeks inflating with every squeeze of the bag. But even more frightening when the anesthesiologist took the mask away to gesture as he "talked shop" with my paramedic husband or to squirt nasal spray into his nose. He seemed to POUR that spray into his nose three times. Overreacting mom felt like they were drowning her baby.

When they put the breathing tube down his nose, I couldn't watch. After they did that, they took us to an office they had set up with snacks. We waited rather impatiently and I knitted furiously. Scott went to get us some food since we hadn't eaten all day and it was now about 4:30pm. He hesitated, asking me if I would be okay. I assured him I would be. I called my friend Elizabeth because I knew a fellow mom would understand how I felt better than my medically-minded husband, God love him. About 5:45pm, we figured we were not going to make it in time to get the girls from daycare, which closed at 6pm. Scott didn't want to leave, but I couldn't get a hold of any of my friends to ask them to pick the girls up for us. As Scott was getting ready to reluctantly leave, the dentist came in and told us that they were done. She told us he was doing well and reiterated what they had done. She said they were going to take him to another room to recover and they would come get me to see him.

Scott left to get the girls and a few minutes later, they came and got me to take me to Billy. He was curled up in an exam chair with a Toy Story blanket over him, the nurse keeping the hand with the I.V. under the cover to keep him from pulling it out. He was breathing with his mouth open and the first glance at his bloodied, tooth-deficient mouth was pretty heartbreaking and scary. They had warned me that most children cry coming out of the anesthesia and that some kick and thrash. Boy howdy! I lost count of how many times the nurse and I saved him from hitting the floor. He cried, he whined, he kicked, he thrashed, he rolled, he banged his head into the chair and yet he was still asleep. The nurse and I sat on each side of the chair and kept grabbing the flailing body parts to keep him from hurting himself or us. Occasionally he ended up in my lap. At one point, he flung his arm up over his head and hit me across the face. The anesthesiologist stepped in and said, " are you doing?" At the sound of his name, Billy opened his eyes and turned his head to face the doctor. But, it was obvious he still wasn't awake yet. The doctor left again and we continued our vigil. I talked to him and crooned at him, but he didn't respond. His first words were, "I don't wanna wake up!" Then he started crying, "mama." He also said he was scared several times. He asked for a clock. When I asked why, he said he wanted to see what time it was. He said, "I want Scott!" I told him that Scott would be back soon. He said something about the dentist, but I couldn't make out if he said, "I want to go to the dentist," or "I don't want to go to the dentist." All the while, he is still kicking and fighting. I'm not sure how many injuries the nurse sustained, but I got kicked in the jaw at one point. He tried to pull out his I.V. and we had to stop him from hitting himself in the head with his own fist. Then he said, through tears, "I want to go home now." I told him he could go home as soon as he calmed down. He had said he was thirsty, so we gave him a blue popsicle, which he sucked on a bit. He asked for his socks and shoes. The nurse said he could go, so I asked him if he would promise not to kick me if I put his shoes on. I was getting enough without the shoes. He had been kicking Scott in the waiting room before with those shoes and Scott could attest to the kicks being more forceful with them on.

It wasn't easy juggling him, his popsicle, his bear, his jacket, my purse, and my knitting bag. My phone battery had died, so I asked the receptionist to call Scott, who said he was about ten minutes away. I lugged Billy out of the office, down the elevator, and to some comfy chairs by the front door to wait. By this time, it was about 6:30pm. Billy whimpered a bit and kept asking to go home, but he finished eating his popsicle and laid in my arms.

When Scott and the girls arrived, I tucked him into his carseat. He smelled the McDonald's the girls had and asked for fries. I told him he couldn't chew them but that we would get something when we got home. He fell asleep in the car on the way home. When we got there, Scott carried him in and we laid him on the couch. I gave him half a dose of liquid Lortab and a Pediasure. He tipped it back and drained it! He was thirsty and hungry. I gave him a pudding cup and he scarfed it. We giggled at him because he shoveled it in as fast as he could and had chipmunk cheeks. He also ate some Jell-O and drank some V8 Splash. Then he laid back and watched TV for a little while. After being tucked in, he only got up once, crying that his tummy hurt. He ran to the bathroom, but was nodding off on the toilet, so I tucked him back into bed. Poor little guy! So glad it's all over!

UPDATE: I kept him home from school Thursday, but he seemed so good all day, I wondered if I should have sent him to school after all. In talking to him, he doesn't seem to remember anything between playing games on my phone on my lap and watching TV on the couch.

After Smile (taken the day after surgery, so he looks pretty tired):

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