Rotten

Just a post for me to look back on in 10 years to remind me that I predicted Aitch would need $10K in orthodontia work…

Over this past summer break, Aitch would come to me complaining of a headache or toothache. I would offer a washcloth to bite on or if she was particularly clingy, a baby aspirin. Where she pointed in her mouth led me to believe that her 6-year molars were coming in, because, well…she’s six. But other times, she would point more to the frontish-side-ish and so I imagined baby teeth were getting ready to be ousted. I shrugged it off while encouraging her to suck it up until her bi-annual dental exam on July 24.

At the exam, I was informed that she had pretty extensive decay on all four primary (baby) first molars. Worse, there was no waiting for the baby teeth to fall out as they normally don’t until sometime around age 8 to 12. Her dentist recommended fillings at the least; pulpotomies (a root canal on baby teeth) at the worst. Due to procedures being necessitated in all four quadrants of her mouth, he suggested doing it under general anesthesia. The other option was to do the procedures in his office, but if we chose that route, we’d have at least two, possibly three more office visits since he wouldn’t/couldn’t do them all in one.

I was devastated. Rather, I was embarrassed that my perfect snowflake (said with some sarcasm) had nasty teeth. I regretted every soda I shared with her; every glass of orange juice I poured; every pint of cherry tomatoes she ever polished off; and every glowing review I gave to her post-brushing when I’d “Oooh!” and “Aaaah!”  when in reality all she was doing was rubbing the brush across the front of her teeth as she grimaced into the bathroom mirror.

Working for an oral surgeon had been educational on the long-term effects of ondontophobia (dental anxiety). If the first appointment involved work on the most painful tooth (needles, drilling, gagging, grinding), how difficult would it be to get her back for the next appointments? On the other hand? She should suck it up. I should suck it up! General anesthesia is dangerous stuff, especially when I had no idea how she would respond to it, and so young. Not to mention the considerable extra expense!

I chose to have it all done in one fell swoop.

The procedure was scheduled three weeks later. August 12th. A week before she returned to school (as a 1st Grader!). That Sunday before, the pain flared again. When I looked into her mouth (now knowing where specifically to look), I saw the gum surrounding the worst tooth was red and swollen to twice its normal size. Surgery couldn’t come soon enough.

Unicorn, freshly washed and fluffed.

Tuesday morning, we were as ready as we could be. I had made sure to bathe her the night before and gently warned her that she couldn’t have anything to eat or drink, not even a sip or to even brush her teeth. She seemed happy when I told her that she could stay in her jammies and bring along her favorite blanket and stuffed animal (Unicorn). We were scheduled at 9:00 am at the surgery center. By 8:40, we were buckling up in the car when the SC called, “The doctor is just finishing up his last case. Are you on your way?” I assured her that we could be there in 10 minutes. At least he wasn’t behind…

Upon our arrival, I filled out some paperwork and wrote a check. We have a high-deductible plan and while I knew the SC would have to take a write-off, we’d be responsible for a majority of the bill. Within just a few minutes, the prep-nurse brought us back and had Aitch exchange her jammie top for a child’s scrub shirt. She chatted happily with the nurse; her only complaint was that of hunger. The anesthesiologist stopped in, someone I had known for many years through the hospital. She introduced herself to Aitch and said, “You know what? You have your daddy’s eyes.” I didn’t think too much of her observation until later when she was getting our family history, “…even though I know you don’t have her maternal history…” While I knew this woman, I wasn’t friendly enough with her to have ever mentioned Aitch was donor egg in a past conversation. I wondered if a common friend, who did indeed know, had told her.

The CRNA went on to explain quietly what her job would be during the procedure while Aitch seemed to be ignoring her as the stupor of the oral sedative (versed) worked its magic. The plastic syringe brought earlier containing the bright pink medicine frightened her at first as she believed it was a needle. She barely opened her mouth as they dispensed it. I discovered later that she had been paying close enough attention for someone in a drug-induced haze.

Then the performing dentist came in. I told him about the swelling and redness from two days before. He frowned and told me that if that’s the case, the tooth was worse than they had thought and they may have to pull it. With his assurance he would do what they could, I kissed Aitch’s brow good-bye. She weakly reached for me, but her eyes were closed, barely awake.

A sterile, lonely and quiet wait.

I took a seat in the lobby. For an hour I read my Kindle in solitude. I didn’t start to worry until the 60 minute mark, again thinking about her age and general anesthesia and the complications. The next 30 minutes dragged, the 15 after that were unbearable. In that time, I realized I must have a nervous bladder; I had gone to pee three times. Finally another nurse came to get me and escorted me to the family consulting room. There I waited several more minutes before the doctor came in. Aitch was recovering and they were cleaning her up. Unfortunately, he said, the tooth (upper left) that had been so painful and inflamed, was too decayed to save and was extracted. In fact, the bacteria had spread to the adjacent molar tooth and so a filling was applied.

The right upper first molar was also bad, but he thinks the pulpotomy and a silver crown (porcelain would have been too brittle) was applied. The two lower molars, right and left as well, only had to have fillings. I sent Sparring Partner a quick text with the news and I nearly cried. It must have been the combination of relief, tinged with so much regret (for all the things I had pointed out earlier plus letting a good part of me not believe the pain she had experienced was as bad as it must have been).

Holy Hole-in-a-Tooth, Batman!

A nurse came then and led me to where I could see Aitch, awake and dazed. A couple of nurses were trying to get her to bite on a small wad of gauze to try to control some minor bleeding of the socket. She brushed weakly away their efforts until she noticed the IV in her arm. They attempted again to place the gauze, which was now tinted with saliva and blood. To top things off, a biohazard Ziploc bag was on her lap. In it was the tooth. A nasty-looking black hole from the caries bored nearly to the center; three prongs of roots sprouted from the end. She looked at that, and then she looked at me, and then started to cry.

I stood next to her and brushed the hair from her face and assured her that everything was OK. She calmed down soon enough, but remained fascinated by the gauze in her mouth. The nurse gave us an “elephant’s trunk” emesis bag, which she kept spitting into. However, the nurse observed that she showed signs of possibly being sick so she gave her another round of Zofran through the IV. We were then told that once Aitch was able to drink or eat a little bit of flavored slush, we could go home. I was surprised to discover that she wouldn’t have to worry about any after-affects of novacaine. The nurse mouthed silently to me “it makes kids c-r-a-z-y!” over the gurney.

The rough part: post-anesthesia.

She still looked like a crushed flower in the bed, droopy and spent. It was with the announcement that she could pick out a movie to watch until she felt better that she actually brightened a bit. A TV and a media cart were rolled to the foot of her bed and a large binder full of movie title photo-copies was given for us to select from. She finally settled on Sleeping Beauty. The movie was started and a cup of crushed orange ice was handed to her, and she eased back into the pillow and snuggled up with the blanket we had brought from home.

We were the last case of the morning so everything was quiet. She looked more alert and color was starting to come back around. She had also stopped trying to spit out blood and had asked for a refill of ice. The IV was removed at which time the nurse remarked they must have tried at least twice in the OR. About fifteen minutes later we were OKd to go. Aitch was given a ride in a wheelchair to our car and a short drive later, we were home. The first thing she asked for was some food. Not just any food, but a bowl of chili. It seemed an odd first meal request, but soft enough.

Latex allergy?? Unknown.

For the rest of the day, she played and acted as if nothing had happened. No aches or fatigue. The tooth was deemed “cool!” and a bargain was made to not give the tooth to the Tooth Fairy and instead I would take her to get the next edition of the My Little Pony comic book. By 7:00 that night, she and Doodicus were outside playing hoops. I was only concerned to see she had a slight reaction to where the staff had placed the adhesive patches from her chest and taped her eyes, but by the next day, the rash was barely visible. At her post-op, the dentist didn’t think it was a latex allergy, but he made a note in her chart.

I wouldn’t have done it any differently. She has had no more pain and only describes the area where the tooth is gone as being “ticklish” when food touches it. Selfishly I was happy to see that unless her head is tilted back and her mouth is wide open that neither the empty socket nor silver crown is noticeable. I now watch her brush to make sure she’s getting to the back, and upon the suggestion of her dentist, I picked up some fluoridated mouth rinse. The total monetary cost was $4400: $2.7k for the surgery center and anesthesiologist; $1.7k for the dentist to prepare three fillings, the pulpotomy, crown and extraction, as well as their “hospital fee” (which I know is an utterly bogus fee).

So as I said, I only decided to update here in case I needed to refer back to it someday. In fact, I was just looking over my Disney World posts from a couple of years ago. We didn’t take a family vacation this year and maybe we’ll go again in February 2015. Three years will have passed by then, and frankly that seems impossible the kids have aged that much since that memorable trip.