Oral Surgery Ordeal

 

 Preamble:   After much deliberation, the companion finally decides that a visit to the oral surgeon is necessary. Yes those wisdom teeth must be removed for several reasons: a. we now know that good oral hygiene is going to be an ever present issue - so we probably should remove anything that is hard to reach and probably won't get cleaned most of the time

 

2. The wisdom teeth are pressing against the other teeth, which is making for nasty cavities that are not easy for the regular dentist to deal with.

 

3. there are those behaviors - that seem to have no basis in anything - the scream/jump phenomena that could be related to pain - we know that pain in not necessarily where the hitting occurs - but the self-abusive behaviors are bad and???? What if the impacted teeth are painful?? Where would this individual exhibit this pain? Could this be the reason for the head banging? The hip banging? The chest banging? We don't know - but after careful consideration this seems like a reasonable issue to eliminate - even though we know the process may be extremely difficult in the short run.  

 

Visit 1:   After consulting with the parent to parent list serve and numerous people at various meetings, we finally find an oral surgeon that takes Medicaid. We call to make the appointment. We preview this appointment with the ONE, making sure that he understands that the person will be looking at his teeth, poking at him and that we will most likely be doing X-Rays that will make a noxious noise and require him to be very still. We find the address - which is downtown - and finally a place to park - it is all confusing for both of us. We get in the building and go up the elevator to what we think is the right floor. We walk around and determine that this isn't the right floor - our anxiety increases - we are going to be late. We go down in the elevator - the self-abuse begins and the hitting of the companion ensues. We consult the directory and figure out that the place we are looking for doesn't exist in this building. As we are dodging hits to every entity within reach, we finally realize there is another building close by with the same name. We head for that building with grunts and screams. Everyone is looking at us. We find the elevator for the other building and go up to the floor we think is the correct location. It isn't. As one of us is hammering his fist into the walls, some kind construction worker asks if he can help. We communicate the name of the illusive Dental group and he tells us we need to go one floor up - they have moved. We maneuver our way back to the elevator, head-banging and hitting our companion along the way and manage to get to the right floor in the right building in the right suite. Now we need to do paperwork, and deal with the embarrassment of being late. As they are looking us up on the computer, more hitting of self and others occurs. With mild restraint, the companion is treated with the best of all expressions of frustrations, the head-butt. Everyone in the office is staring. No one knows what to do. The companion knows that she is going to cry. The desk person hands them a clip board and they maneuver to the far side of the room - away from the babies crying. While the companion fills out the forms, she is treated to a barrage of elbow jabs, hits to the shoulder and feral screams. After several minutes of deep breathing by both parties, the forms are returned to the desk. We wait. The appointment goes smoothly and we are told to return for another consult with the surgeon.  

 

Visit 2: We know where we are going! Or at least we think so! It is Saturday, and they are paving the parking lot - we hesitate - we stop sharply and the construction workers yell at us. We yell back that we are trying to understand their cones and barriers, but they are not clear. We finally find a place to park, and guess what - we are barraged with hitting and anxiety, AND we are late again! We see the doctor and take a deep breath explaining clearly and plainly about what is to be done. "See - look at the picture! These are the teeth they are going to take out. They will put a needle in your arm and give you some medicine so you will go to sleep. The teeth are too much for your mouth - we can't keep them clean - they are pushing your other teeth into bad places - do you understand? Then sign here. We schedule the next appointment.  

 

Visit 3: This is the big one. The companion has worked hard to make sure that all of the other companions know what is going on and what needs to be done to support the ONE in his after surgery care. Buses have been cancelled. Instructions have been posted, all straws have been hidden. The ONE has been previewed of the coming events - several times - in and calm and secure manner - we have the schedule timed out to the second - no food or drink for 8 hours prior - keep the ONE up and encourage food and drink to the last minute - careful bedtime routine - preview the next day without a smidge of anxiety. The companion awakes early to secure a few moments of peace. Carefully at the required hour she wakes the ONE to bathe and relax for the day. She prompts the ONE to bathe in the appointed time frame - being ever careful not to prompt too much, so that the ONE doesn't get angry, or anxious. However, it is going slower than planned for. The water is not the right temperature, so the ONE keeps letting the water out to put better temperature water in. The prompts increase - with calm demeanor - always stay calm - don't rock the boat - we have to get an IV in - we have to travel through traffic - don't make him escalate. Finally he is out of the bath. The companion has each piece of clothing laid out for ease and speed. The ONE is slow - he is worried about a lost watch. The companion stays cool and calm - the dressing is done - we forget the tooth brushing and the shaving - after several false starts as he tries for breakfast, we are out the door and into the van. Whew! Very little traffic - we will only be a little late. We get to the appointment in record time and are told to wait. The companion reviews what is to come one last time. She forgets that it against the rules to use contractions and is punished with hitting upon the arms and shoulders. Everyone in the waiting room is staring. We are called to the front desk. Our appointment has been cancelled because we were late - we will have to reschedule. The companion is shocked - she knows she will cry if she stays in the room one more minute. The ONE is heading back to the surgery - his name has been called - he has been previewed of what is to come - the companion grabs him to bring him back. Hitting and screaming occurs as the companion explains the cancellation. We were 15 minutes late. So we are failures and must do this again another day.  

 

Later that morning:   When we call to reschedule we are told that the oral surgeon is the only surgeon in the area that takes Medicaid and that his time is valuable. He won't reschedule a missed Medicaid appointment. The companion replies that we were only a little late. It doesn't matter - the surgeon's time is valuable. Obviously - ours is not.   Carol - who called and begged the doctor for another appointment - to be continued.  

Later -

Ok my friends, I'm counting on your thoughts and prayers to help me get through the next few days. We're doing the wisdom teeth tomorrow. I have done the Social Story, I have hidden all the straws, I have continuously fed him to shore up the blood sugar, I have re-trained all the caregivers, I have read all the literature, I have bought pudding and jello and instant breakfast and refried beans, we have been to all the appointments, I've told them that we have to be in the room before he wakes up several times to several people, I have signed all the papers, I have garaged the car so it won't have snow on it in the morning... and I'm worried. Think lovely thoughts.. Carol   The surgery went well as did the anesthesia (no rages in the recovery room - whew!). Now we are trying to keep him from putting his fingers in his mouth. For some reason if something hurts, he thinks that area should be poked or hit really hard. The Vicodin just made him sick yesterday so we switched to Ibuprofen - but that didn't help much. This morning I am getting beat up for saying that we can't put the teeth back in.   It is going to be a long recovery. I hope the bruises will be gone by the time we have our party at Denver and Nora's home. I'll come anyway - you guys understand.   Thanks for all your good thoughts and prayers! - Carol