Sunday, July 19, 2015

Extreme Dental Visit


James has been seeing a pediatric dentist regularly since he was 3.  For several years, his teeth would get cleaned and checked. While James does not like sugary foods or sodas, he also won't brush or floss properly without an assist. We don't always make sure he does a thorough job, as we are usually exhausted by day's end.

This caught up with James last year: a cavity was discovered. Because it is difficult to get James to sit still for a cleaning and impossible to get him to sit still for x-rays, his dentist recommended sedation dentistry. Because he screams and freaks out over needles and whirring noises by his ears, she recommended general anesthesia (GA) - quote for which was $800, which we don't have.

Turns out there is a special program for kids with issues like James'. We could get it from his health care HMO. Catch: they only offer this in a service area that is over an hour away.

So I did phone consults and health histories. The day before his procedure his Dad took him to the pre-op physical at a facility an hour+ away. I spoke with four different people about GA and James. The week of the procedure, I worked 10-hour days so I could take a day to accompany him to the almost 2-hour away hospital without losing pay. He started fasting 12 hours before his procedure.

We got there early and signed in. James got his wrist bracelet and a number code, so I could track his progress on the Outpatient Surgery Board. We've been here before. What was different this time was that James' number showed no status - not even that of "waiting room," which some others showed. I was concerned about this because (1) James has a history of wandering and (2) I wanted to make sure they knew he was here so they didn't give his slot away as a no-show. It took a few minutes, but I was able to talk with someone who could not find him in the system, even though he'd checked in. Yikes!

Within 5 minutes we were called back to the prep area. I noticed that James' number now showed a proper status and I was assured we were not only on time, we were an hour early. The nurses, staff, and surgeon were all super nice. We had James changed into a hospital gown and up in a gurney in no time. He had his blankets and found Nick Jr., which kept him busy for most of our 2-hour wait.

I had a final GA consult and got some expert help from a nurse to get James to take the initial oral sedation. I checked all the procedures he was going to get with the nurses: tooth cleaning, first dental x-rays. at least one cavity filled and dental sealants. They would also take blood for several lab tests that had been postponed due to James' fear of needles. I gave James an overview of the procedures and told him I would be there with him until he went to sleep and when he woke up.

It was a long afternoon. I had some lunch, read a book, and took some walks up and down the hospital corridors. At last it showed he was being taken to recovery. It took a while, but he started waking up. And he wasn't happy. While the type of GA used made him less contentious, he  REALLY hated the sore feeling from having the breathing tube in his nose and throat. Despite  warnings to his team, James ripped the IV out of his foot. He really hates needles too.

An hour later, a helpful orderly helped wheel James outside. Fortunately I had been able to park so close to the hospital that could see James the whole time I picked up the car and drove back to pick him up. Then we had a 2 hour ride home with James moaning (and occasionally roaring) in the back seat. It took him a while to realize that a tooth was missing (a loose baby tooth). He didn't like that either. Turns out he had 4 cavities. Luckily none of them were serious, but we do need to step up the oral hygiene. I don't think either of us wants another extreme trip to the dentist any time soon.

1 comment:

Brian Derrick said...

You're right. Aside from the usual checkup and cleaning, the more we can avoid the dentist, the better. And it's pretty intense how he had to be put into sedation so that his teeth can be treated well. It’s a good thing that his cavities weren't as bad as you thought it would be. But it's really best if they weren't there to begin with.

Brian Derrick @ Falls Park Dentistry