Autism Watch: 2007

Posts Tagged ‘sedation

My seven-year-old son is a really bad teeth grinder. He’s always ground his teeth. It’s a noisy sound, a nails-on-the-chalkboard sound that makes me attempt to stick my fingers inside his wired-tight jaws and pop them apart, but it never works and sometimes I get bitten as his teeth snap back together like a gator’s might. Snap. At his dental check-up/cleaning last month, we learned that the dentist was afraid he was wearing down a crown to the point it would require replacement. We hoped it wouldn’t, but learned on Monday that it does.

Next week, he goes in for another root canal, as there’s a definite crack back there and a serious risk of infection. They’ll put a new, non-amalgam-related crown in his mouth. He knows it’s going to happen, and so far, he’s not freaking out about it. But I worry, and not just because of what he might incur during the appointment but because of what happens afterwards: regression.

Almost two years ago, he had three root canals and a couple of fillings. He was a reflux baby, and the enamel was worn off those teeth, so they became problematic early. He also was, as many autistic children are, really averse to brushing his teeth, and it took a lot of effort that wasn’t always successful. The first appointment…well, I will remember it vividly forever. It was the first time one of my children has ever had a tough time in the dentist’s chair, and it was messy. The dentist had to do her work, and help calm him and hold him still, while the assistant also helped hold him still while holding her tools, and I laid in the chair, leaning on him, trying to hold his hands out of the way. We had chosen nitrous, and he hated the hissing sound. By the end of the appointment, he had some rash on his face and neck from all the movement and he was so badly stressed out and frantic, I refused to take him to the next of the three appointments he needed to finish all the work. Dh, out-of-state on a business trip at the time, got a lovely phonecall from me, where I proceeded to tell him that all his traveling for work would have to be on hold long enough for him to do the next appointment. He agreed. Anyway, it took days and days until ds was back to himself, well over a week. He hated the idea of another appointment, and so did I. Yet, dh got him there, and to the next one (rescheduled for first of the day, when the office wasn’t even officially open so no one else would be waiting, listening or needing any help) and the process was completed without the mess of the first one. Was he more used to it? Was dad’s presence better than mine? Who knows, but we won’t push it — dh is doing this appointment next week, too.

We’re lucky — we have a wonderful dentist who has a lot of experience with kids on the spectrum. She has one of her own. When our regular dentist said we needed to find a pediatrics dentist, she was one of the numbers we were given, and I did grill the receptionist heavily, knowing not just any peds. dentist would work. It paid off. Her office is built around children, with flat-panel TVs on the ceiling above the chairs, children get to choose what to watch, and the walls are covered in relaxing but eye-catching murals. After the appointment, they get coins for use in the toy machines, and the goodie bag must cost the dentist office a pretty penny each month with the spinbrushes and other items each includes. So, if your child needs a dentist and you’re iffy about yours, look around. Better ones are out there. Don’t settle for one that makes you uncomfortable or doesn’t listen to your concerns. Ours knows our issue with mercury, and doesn’t hassle us. We’re given a lot of options, and above all, she’s understanding with our son. When he can’t take a routine cleaning because the cleaning gel bugs him, she works with him to find a better solution. (New special gel that’s not gritty and comes in a better flavor.) When a machine is new to him, she lets him play with it so he knows exactly what it is before she puts it in his mouth, and better yet, she does that without us having to suggest it. She knows that approaching him slowly is best, and getting in his face takes advanced warning. When he can’t take the smell, she does what she can to dissipate it. (Last cleaning, a new hygienist was in the room and didn’t seem to be aware of his ‘issues,’ until he bit her and I explained. He was crying, the dentist came in, calmly took over and it was done in minutes. Not many dentists will handle things this way.)

Does that mean I’m okay with just signing him up for more work? No, but I also know that an infection can wreak havoc on his system and make things worse, and an infected tooth will bring a whole lotta pain and still need to be fixed. He won’t wear a mouth-guard, but maybe when he’s older he’ll be more willing. Right now, we’re just thrilled that he’s actually sleeping in his own bed…for almost 14 days now!

Know your dentist. Ask questions. Research and if your current dentist doesn’t like it, find a new one.  Dental work is too important to put off yet you don’t want a child who is so afraid to ever return. (And all this coming from me, a major wimp at the dentist’s office, particularly after a root-canal tool broke IN my mouth and had to be surgically removed. But I’m still up-to-date on my appointments, so if I can do it after what I call The Fiasco, so can you!) 

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You know what I’m talking about. That vacant look a child with autism gets when they have reach the point of extreme overstimulation.

 Our weekend started with an open house here with at least 30 kids playing upstairs in the playroom at various times. HIS playroom. He had been prepped all week that this would happen, but after an hour or so, he started to come unglued. He had a few tantrums and meltdowns over different things, then it progressed to him going into the ‘forbidden zone,’ our bedroom. We had the door shut and didn’t want the kids in there (ours, anyones) because not only is it our bedroom, but it was the room we used to store some of the things we didn’t want the kids playing with — the new pool table/air hockey set, the pile of birthday gifts from his party the weekend before, my computers, etc. Yet, by 8:00pm or so, he’d climbed into our bed…with food. I guess I can’t blame him for wanting to retreat, but the room was ransacked, as was the playroom, and he then was unhappy because all his stuff was scattered. (But thankfully, we did go on an intensive search for all the pieces to his new Torpedo game, and found everything!)

Saturday comes around, and we had two more parties to go to. We went to the first one late, left early, yet ds ate a bunch of sweets. He had a couple of meltdowns there, and then got so hyper, even the most patient of kids were getting frustrated with his inability to calm down. One thing to keep in mind, before someone thinks we dragged him places he didn’t want to go, is that he loves both of these families who hosted the parties. They both have animals he enjoys playing with, and they are very understanding with him, so we didn’t have to drag him — he wanted to go, which says something itself.

After party number one, we went home to give him time to decompress. We cuddled, he ate his latest obsession, Club Crackers, and he watched some Christmas TV. Then off to another party at 7:35. He loves going to this house, they are family to us, and they also have a slew of pets to play with, including a teeny chihuahua and a very spirited husky, both who are very tolerant of his energy level…though by 10pm, the husky was huddled in her kennel, like I’ve never seen, worn out from ds’s playing with her. He had a couple of meltdowns there, but not too bad. He wasn’t surrounded by nearly as many other children, and he feels more at home here than most places. After 11:15pm, we headed home, though to his credit, he wanted to stay. He was supposed to sing with the children at church on Sunday, for Christmas, and we wanted him to at least get his 8 hours of sleep. (And that alone is a feat.)

Sunday morning, he did really well singing, though I think a whole lot of lip syncing was going on. He behaved good the whole time, as far as we could tell, though he didn’t want to sing and again told his teacher that. (She’s a good friend of ours, and she’s just an amazing person anyway, so he was in excellent hands and she got him to sing anyway.) Heading to the car, things were good…until we mentioned we were going home for a couple of hours before his sister had a Christmas piano and vocal recital. All heck broke loose.

Fast forward two hours later, dh and I took dd to the recital, leaving ds with our 19 yod, with the agreement that when she left for work, she’d drop him off at the recital. Fine, right? Dh and I get to the recital, “Dh, do you have your phone with you? You probably should, on vibe, just in case there’s a problem.” He realizes, only after we’re trying to figure out why they’re not there yet, that ds refused to leave the house and ds had been calling and calling. She got him into the truck, and dropped him off, but he refused to come inside. Worrying that this would happen, I’d already alerted the music instructor that as soon as dd was done with her vocal performance in the second half, we’d be leaving. Ds sat on a little table right outside the door of the recital room, with dh watching while I video’d dd. We scooted out quietly, having enjoyed a slew of snacks at the break, and ds was excited to know we were heading home. No amount of ‘just peek! that’s your sister singing!’ would get him anywhere near that front door, and we didn’t want to push the issue. When he’s had enough, he’s had enough, and enough probably started Saturday around 3pm.

In the end, he did well, all things considered. He even survived a quick stop at Henry’s so I could run in and grab more probiotics and almond milk, though, in  his words, it took “too long.” We’d gotten a boost earlier in the day when dd had shown us her college final project in which she showed pictures of ds before and after biomedical intervention, and the change in his smile and eye contact is unmistakable. Slipping backwards for a couple of days because social events get in the way isn’t a goal, but I know that a year ago, we wouldn’t have been able to do that. He’s come a long way.

In the evening, he found his beloved Santa hat dripping wet on the bathroom counter. Major meltdown, took a while to calm him down though it ended up being him that had put it in the shower. It’s now drying and hopefully is completely there before he returns from school. He was convinced last night that it would never be the same.

Tonight he sees the dentist, so she can determine if his nightly teeth grinding has damaged a crown (over a root-canal’d tooth) to the point where the risk for infection is too high and the crown must be replaced. Dental work of that level=sedation, so I really hope that she says it’s not necessary, but it wasn’t looking too positive last time. I already got the ground work in place though for no metal, only porcelain, in his mouth, though she feels metal is okay but respects our feelings that it isn’t. Pray and think happy thoughts that we can escape more dental work for the little dude, he doesn’t need more to deal with.

When I sent him to school this morning, the vacant look was improving. He wasn’t pulling at his eyelashes this morning, as he had been all weekend. He still wasn’t himself, but that’s okay. One thing at a time, and any improvement is good improvement.


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