I'm going to rename this blog. The new title is: The Journal of Horrifying Medical Procedures Performed on Small Children. Here at the JHMPPSC office, we have no end of tales involving piercing screams of pain and fear coming from tiny people we love.
I don't know which was more horrifying, though, the spinal tap for two-week-old Elias or the root canal for barely-four-year-old Isaac. I guess they're tied.
How did this happen?
One thing led to another is how…
Going back a bit, I could say that during the long hot summer of high-risk gestation, one of the many things on my list of things I wanted to do but could not do was taking Isaac to the dentist for a six-month check-up. He was due for it in June. But I knew it would not be easy to get him there. I knew I could not lift him and carry him into the place, and that he would not go willingly. And so I just wrung my hands about it a bit, especially since I could see some discoloration on his back teeth. (maybe just stains from his iron supplement…?) But I reasoned that lots of people don’t even take three-year-olds to the dentist at all, let alone do all their check ups right on time, and just added it to the long parade of things I would have to deal with once the baby was born.
When school started, Isaac of course started getting sick time and again. He got a double ear infection and had a round of antibiotics for it. We’re a little more reactive to such things, too, because of his history of asthma and his hospitalization last spring. But he didn’t really seem to get better. He kept having earaches, and then occasionally what seemed to be a really bad toothache also. But, was it referred pain from the sinuses or something? I’ve had that. And now and again this fever that kept popping up out of nowhere. And also, wasn’t he getting paler and paler? When he was in the hospital in March, I noticed that he was white as a sheet despite a high fever and it turned out that he was incredibly anemic. Apparently long-term illness causes anemia. So on Monday night, when I looked at him and noticed that he looked like a Victorian waif (pale and wan with big dark circles under his eyes), I heard that familiar alarm bell go off.
Tuesday morning I brought him in the to doctor, who decided it must be an intractable sinus infection at the heart of it all. He prescribed a really hard-core course of antibiotics. And then suggested that Isaac have all his vaccinations and his flu shot right then and there! I said—“But he’s sick!” Somehow the notion of giving a barrage of vaccinations to a sick child made no sense to me. … But the doctor reasoned that Isaac already feels terrible now, so why not get it over with? He said the immune system has been shown to be able to handle ten thousand times the dose of a normal vaccine. And do you really want to bring him in again in two weeks when he feels great, and THEN ruin his day or two? And do you want to sit in the germy waiting room again with Elias? No. Okay. So I had to break the news to cheerful and bubbly Isaac. And then I had to have him sit on my lap and endure FOUR shots, two in each thigh, during which he screamed and sobbed no end. I can say that at least the nurse was incredibly fast. I think she gave those four shots in about fifteen seconds, total. Then I carried the limp and hot, crying boy out of there, while pushing Elias’s stroller with my spare hand.
Because he had been having this toothache come and go, I had set up a sort of urgent dentist appointment for the next day, Wednesday. His regular dentist was out of town, so we went to see this other lady who was covering for him. I kept Isaac home from school because he was feeling horrible, whether the illness or the vaccinations or both. He was hobbling because both his thighs were so sore.
But Isaac WANTED to go to the dentist, because his tooth was bothering him. He hobbled in calmly, expecting that the dentist would make it all feel better. It was a charming pediatric dentist’s office, with lots of wonderful toys and a fish tank. The little dental chairs were in plain view, so that when you were in the lobby you could pretty much see the dental work going on. Overall a more open, calm environment than his other dentist, who takes the kid into a special room where parents are not allowed to follow. The place was staffed entirely by women, clad in festive jungle-themed smocks.
Like frogs in a pot of cool water that gradually is heated to boiling, Isaac and I felt comfortable at first. I sat beside Isaac and nursed Elias while the dentist lady (who was very nice and good at her job) looked inside his mouth. She carefully told Isaac everything she was doing beforehand. My first inkling of trouble came when she put her fingers inside his mouth and said quietly, “There’s a lot of swelling on this side.” A few minutes later she mentioned, “You mean he’s had break-through pain with all that amoxicillin in his system?” Gradually I came to understand that we were talking about an infection a lot more than we were talking about a cavity.
The dentist wanted x-rays, and while they were setting that up she took me aside. “You understand that this is an infection that is way down into his nerve don’t you?” she asked. No, I didn’t. She showed me a model of a tooth, and demonstrated how the infection was way way down, into the deep root of the tooth and next to the jaw. She said we would know more when we saw the x-rays and then make a plan. She said, “this is not a simple cavity, and it’s going to be bad.” I said, “Do we do general for this?” And she said, “Only in a hospital setting.”
But there was a furtive, hasty tone to this conversation because Isaac was within ear shot. We were speaking in code, quickly, and didn’t have time to really hash the whole thing out.
They put me in a little room with an easy chair and a blanket so I could nurse while they did the x-rays. But in a short time I heard Isaac crying and came out to see what was going on. Seems he wouldn’t let them put the x-ray thingy in his mouth and was getting more and more hysterical at the thought of it. I went in and hugged him and tried to help calm him down, but he wouldn’t have it. He felt that the thing would go down his throat and that he would throw up, and he just couldn’t get calm enough to let them do it. They had a few pictures, but not the one they needed, but the dentist finally decided to bag it and move on to plan B.
At that point, in retrospect, I wish I had said that we should bag the whole plan. Find another way. Get to a hospital setting and get him under general. If he couldn’t handle the x-ray process, how was he going to get through the rest? But I didn’t. I just followed the lead of the dentist who seemed to know what she was doing, and also seemed to feel that the whole thing needed to happen basically NOW, because the infection was so rampant. At one point she mentioned that another boy, just like Isaac, had this same thing, only last week, only a little bit more progressed, and that he’s STILL in the hospital on IV antibiotics. Perhaps the mention of a possible hospitalization cowed me.
We went into the same little room where I had been nursing. There they had a DVD player with many wonderful shows to choose from, and they had the GAS. It really seemed that the combination of nitrous oxide and Bob the Builder would make the whole thing possible. Isaac drifted off into an episode of Bob, the gas hissed into his nose, and his entire body seemed calm and drowsy. They did this and that prepping him, asked him questions which he answered only minimally, and all seemed quite quite well.
Until they did the Novocain. At that point, Isaac broke out of his calm reverie and started screaming. And she was really trying to numb the hell out of him, so kept the needle there for a long time, while Isaac got more and more distraught. Really we never recovered after that, and it was all downhill.
One thing I didn’t know about the gas: it wears off instantly. If you are not breathing it through your nose at that moment, it’s out of your system. And it’s hard to breathe through your nose when you’re screaming full blast through your mouth.
Soon we were in the thick of it: bits of teeth and bloody pulp flying everywhere, Isaac screaming, while I knelt beside him, clutching wailing Elias with one arm and trying to simultaneously soothe and restrain the distraught Isaac. And of course, once we were underway there was no turning back. A lady came and took Elias from my arms and carted him out. That helped. We had a hugging break. Everyone left the room and I held Isaac in my arms and tried to calm him down. He calmed down a little bit, but the reality was that we were not done. I kept trying to convince him that it would be over with sooner—and we could go home!—if he would lie still and cooperate.
No, again another bout. As I watched them scooping shreds of bloody pulp from inside his tooth, I began to WISH that they would send me out, and to LONG for the dentist who did not let parents be in the room. I couldn’t do anything to make it better. Isaac was in an altered state and seemed to not even know I was there. Finally the dentist said that she needed more help and that I should step out. More and more burly-looking ladies in jungle-themed smocks came in. I went out to the waiting room. When I had first come in, the jarring pop music had irritated me. Now I understood the reason: to conceal the screams. Even with the pop music and the closed door down the hall, I could still hear him screaming. And screaming. A deep throaty hoarse scream that went on and on and on.
I nursed Elias. The waiting room filled with kids whose appointments were scheduled and not happening. The secretary lady said that insurance was denying Isaac’s existence (so typical) and I got on the phone to Ben, who raised hell, and soon all was smoothed over financially. But still, the screams. The distant screams went on. I don’t know for how long, but a long, long, horrible time.
Finally it was over. Isaac staggered out sobbing, his shirt soaking wet with sweat, hair completely disheveled. They gave him some prizes, little army guys with parachutes. (Cold comfort.) Then the dentist took me aside and gave me some more bad news: he has five more cavities in there that need attention! I almost burst into tears myself! But why??? I said, “I wish I could understand this. I wish he lived on Kool-Aid and that there were some sort of explanation.” She said, “I can see how clean his teeth are. It’s not that they haven’t been well-cared for. I think his tooth enamel is defective throughout his mouth. It may be due to prematurity.” She also said that if she had planned to do this “pulpectomy” ahead of time, she would have had him on valium and motrin beforehand. I said, “Was this like a root canal?” and she said, “It WAS exactly a root canal.”
But how I wish I had known about all the other cavities at the outset. I really would have pushed hard for doing it in a hospital settling and doing them all at once. How am I going to bring him back to the dentist now? After all that?
She said to give him a whole bottle of Motrin, and just keep it coming for the next two days. We staggered out. We had been there literally three and a half hours.
Amazingly, though, after a short nap in the car, and a very belated lunch, Isaac seemed to bounce back. I kept the Motrin level high all the rest of the day and night and all the next day. I asked him now and then how his teeth felt and he would just click them together and say they were okay.
God—kids ARE resilient.
I asked him yesterday if he would go back to that dentist and he said no, she didn’t do a very good job!! But he seems perfectly happy to go back to his regular dentist. I think it makes sense to confine that experience to the bad place and just never go back there. It seems too that the gas did alter his perceptions somewhat. When asked about his visit to the dentist now, he talks more about his shots. The shots seem worse to him than the ordeal the next day. Okay. So be it. But when we go in for fillings this time in a couple weeks, I’m going to insist on a hefty dose of Valium. Maybe I should take some myself!