Dentist Appointment

 

Last week, we took Alex to the dentist for his regular six-month cleaning and check-up appointment. Although he usually likes going to the dentist, his recent anxiety about going places had us concerned how he might react this time. Unlike some people who fear going to the dentist, Alex has had good experiences through the years and actually looks forward to his dental visits. The dental hygienist who has cleaned his teeth the past few years is especially sweet and patient with him, and her encouragement and praise make him eager to cooperate with her.

As with all of his appointments, I am careful to schedule a time that works best for Alex. For some doctors, we schedule Alex’s appointments first thing in the morning to avoid having to wait, which is more common in the afternoon. We try to avoid times when he might miss his beloved game shows, The Price Is Right or Jeopardy, and we avoid appointments that might overlap meal times. We also need to schedule around his regular behavioral and music therapy sessions because he doesn’t want to miss them. Working around Alex’s sacred schedule allows small windows of times in the morning and afternoon, but we manage to keep him happy.

For his dentist appointment, he didn’t have to sit in the waiting room but a few minutes before his dental hygienist came to greet him. Immediately, he happily jumped up and followed her back to the room where his teeth would be cleaned and checked—so far, so good. (We were even thrilled that he got into and out of our car without being coaxed.) Once he was seated in the dentist’s chair, his hygienist began putting on the paper bib to protect his clothes as she cleaned his teeth. She warned him that the metal chain that holds the bib might be a little cold on the back of his neck. As soon as he felt the chain against his neck, he decided it was too cold and decided he wanted nothing to do with the bib, pulling it off the chain and handing it to me. I assured him that he didn’t have to wear the bib and assured her that his shirt could be washed if anything spilled on it.

While the hygienist was preparing to clean Alex’s teeth, she chatted with him and tried to make sure he was comfortable, even asking if the light bothered him (probably knowing that the bib did), but he told her the light was fine. However, he was a little shaky, and she gently patted him on the shoulder and asked him if he was okay. Calmly, he admitted he was a little nervous. While Alex used to utilize a series of calm down skills, he now prefers only two options when he’s anxious: sit quietly or talk about his concerns. Consequently, I asked him if he wanted to talk or be quiet. He said he wanted to sit quietly and needed two minutes to calm down. Despite his nerves, he seemed to be in good control of his emotions.

Knowing that Alex literally meant he needed exactly two minutes, I figured this would give his hygienist time to note his medication reductions on his chart, so I gave her a copy of his updated medication dosages. Also, I asked her if she could put on the country music cable channel on the television after asking Alex if he would like some music. Clearly, Alex was regaining his composure in that short amount of time, as he stopped shaking and he visibly relaxed, even starting to sing along softly to the music. At the end of the two minutes, he announced that he was ready to have his teeth cleaned. He knew.

During the cleaning, Alex was calm and cooperative, answering any questions she asked him. Concerned for his comfort and attentive to his needs, she told him each step of the process and gave him choices to make him feel in control of the situation. For example, she asked him if he wanted her to spray his teeth with water or to drink from a cup himself. Usually, he doesn’t mind the water hose and suction, but he asked for a cup of water to rinse instead. Because of his sensory defensiveness, we always have to coax him to open his mouth wider, but he was cooperative, and she was able to clean his teeth successfully. Fortunately, Alex’s good daily dental hygiene habit of faithfully brushing his teeth twice a day with a sonic electric toothbrush pays off in that he had very little plaque that needed to be removed. When she was done, she enthusiastically praised him for doing such a great job. I think she was especially impressed––as was I––that he pulled himself together so nicely even though he started the session with some trepidation.

As we waited for the dentist to come and check Alex’s teeth, his hygienist asked him if he had any questions for her. He immediately asked her if he had any cavities. She told him that she didn’t see any, but the dentist would check that for him. While the dentist checked Alex’s teeth, his hygienist sang Alex’s praises, telling what a good job he did cleaning his teeth daily and how well he had cooperated as she cleaned his teeth. This seemed to make Alex (and certainly his mother) proud. After the dentist examined Alex’s teeth, he stated that everything looked good, there were no cavities, and he would see Alex again in August for his next six-month check-up.

Despite any fears Alex had about going to the dentist, or for that matter, any fears we had about taking him to the dentist, everything went remarkably smoothly. Even though he was a bit anxious, we were proud of the way he handled himself, never getting upset, calmly admitting his nervousness, and quickly calming himself so that he could do what needed to be done. Needless to say, his behavioral therapist, who has taught him many ways to cope with anxiety, was delighted to hear how well he had dealt with his nerves at the dentist. Of course, we were not only pleased with how well Alex coped at the dentist, but also with getting a good report that his teeth are healthy. Once again, we find ourselves grateful to God for the progress Alex continues to make in dealing with anxiety and for the kindhearted people who work with Alex and bring out the best in him. Most of all, we are thankful for Alex’s faith in God that helps him fight his fears, knowing that God watches over him and brings him the calm he needs whenever life overwhelms him.

“For the Lord your God is living among you. He is a mighty savior. He will take delight in you with gladness. With His love, He will calm all your fears. He will rejoice over you with joyful songs.” Zephaniah 3:17

In Thy Light

 

On Monday, Alex had a dentist appointment to fill a small cavity between his two front teeth and to replace a small old filling in a back tooth. Even though the dentist had assured us that there was no hurry to fix these teeth, we didn’t want to wait and risk having the problem teeth get any worse. Besides, after two very successful times of having our family dentist fill cavities for Alex, we felt fairly confident that he would handle the situation well, and we knew that the dentist and his staff would handle Alex very well.

When the dental assistant summoned us back to the room, I realized that she had not worked on Alex before. Invoking my usual introduction to explain and reassure, I told her, “This is Alex. He has autism, but he’s usually very cooperative. We’ll be glad to help in any way we can.” With that I said a prayer that the procedure would go smoothly and hoped that he would live up to the build-up I had given him.

Thankfully, Alex came through the numbing, drilling, and filling like a trouper. Not only did he cooperate, but he also showed good social skills by answering their questions and using his manners. Moreover, he was totally relaxed, all six feet of him stretching the entire length of the dentist’s chair. Because they have always treated him with gentle kindness, he trusted them and had no fears. As our dentist patted Alex on the shoulder and told him what a good job he had done, we couldn’t help but feel pride in our son. When we thanked the dental assistant, she enthusiastically praised Alex, and he rewarded her with a big smile, showing the beautiful work she had done on his front teeth.

Although I’m probably biased as Alex’s mom, when he smiles, a light radiates from him that brings forth joy. However, I must not be the only one who sees that in him because other people have commented on what a great smile he has: his support team, people who wait on him in restaurants, family, friends, and others who have been treated to a smile from Alex. Alex’s smile is so infectious, when he grins broadly and shows his dimple, his behavioral therapist often giggles, delighted to share in his happiness. Seeing Alex smile is a treat, and we can’t help but smile with him.

Yesterday, we took Alex to the last home game of the season for the Valparaiso University women’s basketball team. Even though the team has won just nine games and lost twenty, sometimes losing by double-digit figures, Alex has remained a steadfast fan, only missing one home game. In fact, he plans his entire week looking forward to going to the games, repeatedly checking the basketball schedule and the calendar to make sure nothing will interfere with cheering on his team.

Unlike the men’s basketball games, which he also enjoys attending, the women’s games are subdued with few fans in attendance and a nearly empty student section. At times, the gym is remarkably quiet, more like a library than an athletic facility. Nonetheless, Alex settles into his seat on the bleachers, armed with two orange Gatorades and a small bag of Fritos, ready to follow two hours of basketball. No matter what the score is, Alex smiles through it all, just happy to be in a place that brings him joy. The team may be defeated, but Alex never is, ever hopeful that they will win the next game. Win or lose, he proclaims every game that he liked it “one hundred percent.”

In the last home game, Alex’s beloved Crusaders basketball team enjoyed victory in a game that was never close, winning 72 to 63. Although the players probably never noticed a young man sitting with his parents in the bleachers behind the team bench and always wearing a Valparaiso University sweatshirt, he has been their biggest fan who believed that they could win. As they scored each point, his face lit up with joy, revealed by his big smile and twinkling eyes. After a rather dismal home season, the team rewarded that ever-hopeful fan with a resounding victory, and he was delighted, standing and reading the words to the Valparaiso University fight song as the pep band played at the end of the game.

The motto of Valparaiso University focuses upon light, symbolized by a torch present in the school logo. The motto, “In luce tua videmus lucem,” or “In Thy light we see light” reflects the religious foundation of the university, focusing on the light of God that enlightens us. As the son of a Valparaiso University graduate and a Valparaiso University professor, Alex has grown up seeing that phrase in various places he has visited on campus over the years. Yet, I would venture that few people sense “Thy light” as keenly as Alex does in his abundant faith. Moreover, Alex seems to reflect that light, finding joy in unexpected places, even the dentist’s chair and the bleachers at a basketball game. How blessed we are that God shines his light through Alex, reminding us of His presence in our everyday lives and His promises for eternal life!

“Light shines on the godly, and joy on those whose hearts are right.” Psalm 97:11

Filling a Need

 

Some people get it. When they do, we realize that God has put them in our path to fill a need; their presence in our lives is no coincidence. Finding the right professionals to work with our children who have autism is an important task we autism parents face. Over the years, we have been fortunate to find some outstanding individuals to work with Alex while others have been less impressive. At times we have stayed with some professionals longer than we probably should have, not ready to make a change. Sometimes God has to push me out of my comfort zone with both hands so that I know that it’s time to do something new. That happened last fall, and my full understanding of the need for change was clearly reinforced this past week.

Last August, when we took Alex to the pediatric dentist he had been seeing for nearly ten years, we were told that his upper twelve-year molars were badly decayed and would need to be removed. This came as a shock to us because his teeth had been fine when we had taken him six months earlier for a check-up. What was even more frustrating was that we were told this could wait unless the pain became so severe it kept Alex awake at night, which struck us as negligent. In addition, the dentist left this rather important news to a hygienist to relay to me instead of talking to me himself. This was the same dentist who had condescendingly dismissed me repeatedly anytime I had asked about Alex’s wisdom teeth, telling me that we weren’t going to worry about them.

Unsatisfied with the information they had given, I decided to make an appointment with my family dentist, whose judgment and skill I completely trust. He wisely had a panoramic x-ray taken of Alex’s teeth, which revealed that his wisdom teeth were badly impacted and likely damaging the roots of his twelve-year molars, which probably accounted for their decay. He recommended removing the twelve-year molars and the wisdom teeth at the same time and referred us to an experienced oral surgeon. As I explained in my November 9, 2014, blog entry “Healing,” Alex came through the surgery to remove his molars and wisdom teeth­­––as well as the recovery afterward––amazingly well, and we were thankful to have this procedure done by such a skillful doctor.

After this experience, I began to question the pediatric dentist’s decision to ignore my concerns as a parent regarding Alex’s wisdom teeth. Perhaps if he had taken my questions more seriously, Alex would not have lost his twelve-year molars due to the damage by the wisdom teeth. Moreover, I was not happy with his dismissive attitude toward me and insistence that any dental procedures done on Alex be performed under general anesthesia, which carries its own risks. Consequently, I decided it was time for a change. For his next regular dental appointment in February, we took Alex back to our family dentist. Encouraged by the kindness and compassion shown by both the hygienist and the dentist, Alex complied beautifully with having his teeth cleaned and checked, and we felt this was a sign we had made the right decision to change dentists.

When we took him again a few weeks ago for his six-month appointment to have his teeth cleaned and checked, we were pleased that Alex was quite calm and comfortable at the new dentist’s office while they worked on his teeth. However, we were a little disappointed to discover that he had a small cavity. Nonetheless, our dentist felt confident that Alex could handle having the cavity filled because he had been so good during the cleaning and check-up appointments. In addition, we were able to schedule an appointment to have the tooth filled the next day, which meant that we could get this procedure done before I had to go back to school the following week. Or so we thought.

The next day, the appointment began with putting numbing cream on a cotton roll as preparation for the numbing shots. As the numb began to spread through Alex’s mouth, he started to panic at the strange sensation he’d never felt before. (When he’d had his first two cavities filled two years earlier, he had been under general anesthesia instead of a local anesthesia.) He also wasn’t very happy about having the wad of cotton under his upper lip and complained that he had a fat lip. Although he never really escalated, he was anxious and kept grabbing my hands, seeking reassurance. Even though we tried explaining to him that this was temporary and that his lip wasn’t really fat, he was still unnerved (pun intended) by the situation.

Fortunately, our compassionate dentist understood Alex’s anxiety and offered an excellent idea. He gave us a tube of numbing cream and long handled cotton swabs to practice at home with Alex so that he could get used to the sensation of numbness and realize that the feeling does wear off in time. Additionally, he reassured us that Alex’s tooth could wait a few weeks without worrying about further damage, so we could reschedule the appointment when we felt Alex was ready to handle it. Most importantly, he emphasized to us that he didn’t want Alex to be scared, and he didn’t act a bit inconvenienced that Alex wasn’t up to having his tooth filled that day.

After practicing with the numbing cream at home, Alex became comfortable with the sensation of having his mouth numb, and I went ahead and made another appointment to have his tooth filled. Truthfully, I had a lot of trepidation about whether he could handle the numbing shots, the drill, and everything else involved in repairing the tooth. Nonetheless, we prayed that he would not get upset and put our trust in God and our dentist that everything would be okay.

Last Thursday, I scheduled a noon appointment: after lunch, between The Price Is Right and Jeopardy!, and at a time when he is usually fairly mellow. The dental assistant took us back to a large private room where Ed and I could also stay with him comfortably and where they could close the door so that he wouldn’t hear noises from the other procedure rooms. After turning on the television to a baseball game that provided a welcome distraction, our dentist and his assistant compassionately and calmly took care of Alex’s tooth, preparing him for every step of the process by explaining what would happen and praising him for being so cooperative. Thankfully, Alex was remarkably calm and didn’t seem bothered a bit by anything they did to his mouth. He appeared completely comfortable and relaxed the entire time he was in the dentist’s chair, which was a blessing. The dentist did everything possible to reassure Alex, and Alex trusted him completely.

In fact, things went so well that with our approval, the dentist also sealed another tooth to prevent decay since Alex was already numb, and the assistant smoothed a tooth that had been chipped a while ago so that it would not bother his lip and would look better. Not only did Alex sail through the planned procedure, but he also handled the extras added at the last minute quite well. Of course, Ed and I were extremely relieved that things went smoothly, and we were especially proud that Alex handled perfectly a new situation that many people find difficult. We also truly appreciated the understanding and wisdom of our dentist, who knew what Alex needed to feel safe and comfortable and waited until he was ready.

Consequently, we know that God has led us to change dentists to one who can provide what Alex needs. We need someone whom we can trust to take care of Alex and not only make him feel comfortable in a new situation but also provided a good first experience that will make him not afraid to face similar situations in the future. As Alex now ends his nightly prayers, “God bless Dr. Lyzak.”

“He will once again fill your mouth with laughter and your lips with shouts of joy.” Job 8:21

Healing

 

Last week began in trepidation and ended in celebration. Last evening as the three of us had a snack at one of our favorite restaurants with Alex happily downing fries and orange drink, Ed commented that we never would have guessed that he would be doing so well three days after oral surgery. Despite having eight teeth—four wisdom teeth and four twelve-year molars—removed on Wednesday morning, Alex has been remarkably congenial and energetic. Prior to the surgery, Ed and I thought that, at best, Alex would want to lie in bed for several days to recuperate. Our greater fear, though, was that he would be in such pain that he would be nasty and possibly even aggressive, angry that we had put him through a procedure that made him suffer. However, God watched over us, brought Alex safely through the surgery, and spared Alex and us pain, a true blessing. Moreover, with the removal of those damaged and impacted teeth, we are seeing significant improvements that we never anticipated.

Although Alex has never complained about his back teeth bothering him, his dentist told us in August that he needed to have the upper twelve-year molars removed because they were decayed. When we took him to our dentist for a second opinion, x-rays indicated that his impacted wisdom teeth were damaging the roots of the twelve-year molars. Consequently, our dentist recommended removing all eight of those back teeth at the same time, and he referred us to an experienced oral surgeon, who concurred with that treatment plan. The removal of the twelve-year molars created openings to remove the wisdom teeth, which were totally “bone impacted.” In addition, he felt this oral surgery should be done at an outpatient surgery center with an anesthesiologist putting Alex under general anesthesia. While we felt bad that Alex would have to undergo this procedure, we agreed that it must be done and moved forward to schedule the surgery. As Alex pointed out to me, this was his first surgery, which shows how well God has protected him in his nearly twenty-three years.

After reading through all the possible complications and things that could go wrong during the oral surgery (including pain, bleeding, infection, jaw fracture, permanent numbness, and even death), I signed the consent forms as Alex’s legal health care representative and prayed that none of these potential problems would occur. However, I also remembered my own wisdom teeth removal when I was in my teens as a rather unpleasant experience with pain, swelling, and generally not feeling well for about a week, none of which I shared with Alex, not wanting to incite his anxiety. Because Alex has had positive experiences with doctors and dentists and lab work, he views them as a grand adventure, and this was no different. Even having to get up in the middle of the night, since we had to leave at 4:00 A.M to register at 4:30 A.M. for his 5:30 A.M. surgery, didn’t faze him. He simply told me to wake him up at 3:30 A.M. by reminding him, “It’s twelve hours to Jeopardy!” When I fulfilled his request, he rolled over, gave me a sleepy grin, and awakened without any complaints. We were off to a good start.

In the pre-operation room, two sweet nurses helped us prepare him for surgery and even let him weigh himself when he asked if they had a scale. When he had an IV inserted, he calmly handled the procedure and watched as the nurse put the IV in place. When she injected medication to numb his hand—the worst part of the process, she warned him—he began to wince, and I told him to pretend he was blowing out birthday candles, a trick I learned along the way to distract him and ease pain. He complied, and all was well. The nurse commented that he was an excellent patient, which made us quite proud, but we were even prouder of how calmly Alex was handling himself before surgery.

As Ed and I sat in the waiting room during the hour-long surgery, I alternated between praying and trying to read and distract myself from worrying about Alex. At one point, I looked across the room of the Catholic hospital to see a plaque with a cross that read, “God always keeps his promises.” This reminder comforted me and gave me hope that Alex would, indeed, be safe in God’s hands. I also remembered that many family members and friends were praying for us. Thankfully, Alex came through the surgery beautifully with no complications, and we were glad to find out that Alex was calm both before and after the surgery. When we went to see him in the recovery room, he had gauze stuffed in his mouth and was sleepy, but his coloring looked quite good, and he seemed no worse for the wear. In fact, he kept trying to tell us something. The nurse, who kept commenting on what a sweet boy Alex was, said that he kept repeating some phrase that she couldn’t decipher with all that gauze packed in his mouth. Because of his articulation issues, Alex’s speech isn’t always clear on good days, but the swollen mouth and gauze made understanding him even trickier. The kind nurse, Ed, and I kept trying to figure out what Alex was telling us with no success. Fortunately, he wasn’t upset that we didn’t understand, and when we were wrong in our guesses, he just calmly repeated the mumbled phrase again. Finally, I figured out what he wanted. “Bologna and Thousand Island dressing?” I asked. He nodded and grinned as much as that gauze allowed. After having all those teeth removed, he was thinking about a strange food combination, probably because he was hungry from pre-surgery fasting. I told him we’d have to wait and see how he was feeling before he could eat anything, and that satisfied him.

Once we got home, he seemed remarkably alert and pleasant, even though he had been awakened in the middle of the night, had been under anesthesia, and was given medicine to numb his jaw. We thought he would sleep most of the day, but he wanted to stay awake and talk to us. Again, the gauze packs muffled his speech, so I made him a chart with the letters of the alphabet, numbers from 0-9, and a happy face and sad face to let us know how he was feeling. His flying fingers quickly spelled out what he wanted to tell us, and it was hard for us to keep up with him. At one point, he noted that his voice was raspy, and I explained that they had put a breathing tube down his throat when he was asleep. He grinned and told me in that raspy voice that he sounded “like Bob Dylan.” Nonetheless, he was chatty all day and never once pointed to the sad face when we asked him how he was doing. We were amazed and grateful he was doing so well and was so cooperative about keeping the ice packs on his cheeks and the gauze packs in his mouth.

While we thought he might be more swollen and less pleasant the following day, he surprised us by looking quite good and acting as though nothing had happened, even though the pain medications had worn off. Although he never complained about feeling bad, we gave him over-the-counter pain medicine to keep him comfortable along with the antibiotics the doctor had prescribed. Apparently, his mouth didn’t bother him too much because his appetite was excellent. Besides looking and acting as though he felt fine, Alex was unusually chatty. Moreover, his speech suddenly seems much better and clearer. Even though Alex never complained about those teeth, maybe they have bothered him for a while and made talking more difficult. Perhaps this surgery that we feared would make him temporarily worse has been the turning point to making him permanently better. Perhaps, this is the beginning of the healing that we have prayed for God to give Alex. After seeing how well Alex has come through a rather difficult procedure, we are thankful that God has spared him pain and that Alex is recovering amazingly well, even better than we could have ever hoped or imagined. Certainly, as I was reminded this week, God keeps his promises.

“Heal me, O Lord, and I will be healed. Rescue me, and I will be rescued. You are the one I praise.” Jeremiah 17:14

Like Pulling Teeth

 

A couple of weeks ago, we took Alex to his pediatric dentist who also sees adults with special needs for his regular six-month cleaning and check-up.  As I have mentioned in previous blog entries, Alex has always had good experiences at the dentist, and he eagerly looks forward to going, unlike most people. Moreover, he has been quite fortunate that he hasn’t needed any dental work other than to have two teeth filled under anesthesia last summer when he was twenty-one years old. Although we had thought this appointment would be uneventful, since his check-ups always are, we were wrong.

First of all, Alex looks forward to seeing his beloved hygienist Laura, who shows him great kindness and calls him “Sweetie” in her sultry deep voice that he likes. This time, another hygienist cleaned his teeth instead. Alex’s disappointment was obvious as he asked the new hygienist, “Where’s Laura?” I’m not certain why this change was made, as we saw Laura there that morning, but for some reason she didn’t work on Alex this time. After his teeth were cleaned, the new hygienist went over how Alex’s teeth are doing. Many times, the dentist comes and gives me a report about Alex’s teeth, but lately he seems to be unavailable for these consultations. While I appreciate the good job they have done taking care of Alex’s teeth the past several years, I don’t appreciate that he doesn’t take a few minutes to talk with me. In ways he reminds me of the character of the Wizard of Oz: “Nobody gets in to see the Wizard. Not nobody. Not no how.” Instead, the new hygienist had the task of breaking bad news, which wasn’t fair to her or me.

Since Alex has never had much problem with decay, I was stunned when she told me that his upper back molars needed to be extracted because they are “deteriorating.” I asked her if she meant his wisdom teeth or twelve-year molars, and she seemed a bit rattled by the question. Next I asked her if his wisdom teeth have erupted, which seemed to rattle her even more. She began flipping through his chart, looking for information, even though she had just examined Alex. Then she told me that it was his twelve-year molars that were deteriorating and needed to be removed and that his wisdom teeth had not erupted but were lying sideways. As if to smooth over the situation, she tried to reassure me that nothing needed to be done before we came back for his next check-up in six months. Since things didn’t seem that imminent, I asked her if those teeth could be saved by having them filled, and she flatly told me they were too far gone. Then she told me that if Alex were in a lot of pain or having trouble sleeping, we should call their office to get a referral to an oral surgeon to have them removed right away.

At that point, I was a bit overwhelmed thinking of how nasty Alex could be if he were in so much pain he couldn’t sleep. I simply thanked her, and we took Alex, who was in the waiting room with Ed and oblivious to this discussion, home. In the car, I thought of all the questions I should have asked her and felt frustrated that the dentist had not explained all the issues and had left a new staff person to go over a fairly serious matter. Once I got home and got my thoughts together, I called the office and asked to speak to her to try and address my unanswered questions. Yes, his upper twelve-year molars needed to be removed, but they most likely could wait at least six months. After she had a brief consultation with the “Great and Powerful Wizard of Oz,” the dentist, she said that if we wanted to be proactive, we could consult an oral surgeon and have the teeth removed before they caused him any pain. That sounded like a plan to me.

However, I was not comfortable taking Alex to an oral surgeon we’d never met before I knew more about what was wrong with his teeth. Consequently, I decided to take him to my dentist whom I like and trust. Fortunately, we were able to get an appointment right away, and Alex was enthusiastic about seeing a new dentist. Since Alex’s dentist never x-rays his teeth, I knew that having x-rays could be tricky because he would have to cooperate and sit still. However, the pleasant dental assistant was very good about explaining to Alex what he needed to do, and the panorama x-ray of his entire mouth went amazingly well because Alex did exactly as he was told. I think he found the rotating machine fascinating and liked that the process would take exactly sixteen—not fifteen or twenty—seconds.

After the x-ray was developed, my dentist carefully examined Alex’s teeth on the image and in his mouth. He also showed me in the dental mirror the decay on the back of Alex’s twelve-year molars that was cause for concern. He was quite understanding as he explained that keeping the back of his back molars clean was difficult and that by removing those teeth, we could take better care of the rest of his teeth. For that reason, he thought removing the bottom two back molars might be a good idea, as well. Additionally, he recommended removing Alex’s impacted wisdom teeth at the same time before they cause him any pain or problems. He explained that when his twelve-year molars are removed, that will allow easier access to the wisdom teeth to remove them, as well. He recommended all eight back teeth be removed under IV anesthesia for Alex’s comfort and felt that doing it all at once would be easier on him in the long run.

After addressing that concern, he checked all of the rest of Alex’s teeth and said that they are in good shape. He asked me if Alex brushed his own teeth, and I explained that his fine motor skill weakness makes it difficult for him to do his own oral hygiene. Therefore, I do most of the brushing of his teeth. He then told me that I “deserve a pat on the back” for the good job I’ve done in keeping his teeth clean and healthy. This was a nice recognition no dentist had given me before and made me feel better about the decay in Alex’s back teeth, which he reassured me was difficult to avoid. Although we aren’t thrilled that Alex needs to have eight teeth removed, we appreciated that we now understood why this would be best in the long run, thanks to my dentist’s gentle and compassionate explanation of how this will help Alex.

Also, he agreed with us that we shouldn’t wait until the teeth cause him problems and should proceed with getting them removed instead of waiting six months, as we had been told we could. He then gave us a referral to a local oral surgeon along with Alex’s x-rays and a written explanation of which teeth need extraction. When we got home, I scheduled an appointment with the recommended oral surgeon for a consultation, and we will wait to see what he says then. Since Alex did well last summer when he had teeth filled under anesthesia, we are hopeful that he will do well with having these teeth removed under anesthesia, but we are concerned about how he’ll react to the discomfort afterwards. Alex, on the other hand, has no worries and is looking forward to the process, seeing it as yet another adventure. I suspect he thinks he has a big payoff coming from the Tooth Fairy in the future. If that makes things easier for him, I’m sure she can fulfill his wish.

“Putting confidence in an unreliable person in times of trouble is like chewing with a broken tooth or walking on a lame foot.” Proverbs 25:19

First Fillings

 

In July, we took Alex to the dentist for his regular cleaning and check-up. Because of his severe anxiety issues the past couple of years, we had not taken him for his six-month appointment in about two years, fearing that at best he would not cooperate, and at worst he might have a meltdown. Although Alex has always liked going to the dentist, we did not think he would be able to handle the sensory overload involved in having his teeth cleaned and checked until recently. Once I made the appointment with the dentist who has taken care of him for the past seven years, Alex eagerly anticipated his appointment. Primarily, he looked forward to seeing his beloved dental hygienist who patiently cleans his teeth, praises him enthusiastically, and calls him “Sweetie.”

While this appointment was the same as others in that Alex happily skipped into the office, excited to be there, this time was also different. For the first time in his life, they discovered that Alex had some decay in his back teeth. While we knew that eventually he would have a cavity someday, we hoped that he would continue his lifelong trend of going cavity-free. Also, we dreaded the thought of needing to have cavities filled. His dentist, who has many patients in his practice with special needs, assured us that the best way to handle this procedure was to have Alex’s teeth filled under general anesthesia in a hospital setting. The idea of putting Alex to sleep, especially since he’s never had anesthesia because he’s managed to avoid surgery the way he’s avoided cavities, made me nervous; however, his dentist told me that he had done over 11,000 hospital dentistry procedures. Consequently, we agreed that this would be the best way to fix Alex’s teeth to prevent him from experiencing needless pain and anxiety.

Before Alex could have the dental work done under anesthesia, he had to be cleared medically with a check-up from a doctor on the hospital staff. Even though Alex had a complete physical examination by his family doctor in June, he is not on the staff of the hospital where the dentist has privileges, so we went to a doctor recommended by the dentist’s office. While the doctor was kind to Alex, he seemed to be more concerned with issues unrelated to the upcoming dental procedures. We understood the need to check Alex’s heart and lungs, but the doctor’s insistence upon checking for hernias and scoliosis seemed unnecessary to us. Moreover, we were surprised that he didn’t order any blood tests. Nonetheless, the examination was completed, and we were anticipating the upcoming dental appointment at the hospital.

In the six weeks between Alex’s first appointment with the dentist and the scheduled appointment at the hospital, I had called the dentist’s office a few times with questions about the procedure. They assured me that the hospital would call us to gather pre-registration information a few days ahead of the appointment for the dental work. Since I had not heard from the hospital at all, I called the dentist’s office again and asked them if I needed to call the hospital myself to make sure they had all the needed information to confirm all the arrangements had been made. I was told that I didn’t need to call the hospital, but I could if I wanted to. To ensure everything would be smooth the next day, I decided to call the hospital and check on the arrangements; this was a good idea.

When I called the hospital, I discovered that Alex was not on the schedule for his dental work the next day; apparently someone from the dentist’s office had not notified them. Although my first instinct was to panic, the calm and understanding nurse assured me that she would call the dentist’s office, straighten out the arrangements, and call me right back. As promised, she did make all the necessary calls, made certain that Alex was on the schedule, and called me right back to let me know that everything was ready to go for the next day and answered several questions for me, as well. Things seemed to be set until the dentist’s office called me and asked me why we hadn’t had pre-procedure blood tests done for Alex. A bit taken aback, I told her that the doctor they had sent us to had not ordered any lab tests, or we would have taken care of that already. She told me what lab test needed to be run before Alex could have anesthesia, so I called the hospital nurse who had made the arrangements and asked her what we should do. After discussing options, we agreed the easiest solution would be to have the lab test run when Alex arrived at the hospital for his procedure. Once again, she made arrangements for us, setting up orders for the lab test to be done upon Alex’s arrival. Thanks to her efficiency, we seemed to be ready to go the next day.

With Alex scheduled to check in at 5:15 A.M. for his 7:00 appointment, we had to awaken in the middle of the night to get ready and to drive to the hospital, which is nearly an hour away from our home. Despite having to get up so early, Alex was good natured and enthusiastic about going to a new place. Ed and I were thankful that he wasn’t nervous or scared, which was a blessing to us, because we were a mix of both emotions. At the hospital, we were impressed with how friendly and pleasant we found everyone to be, and Alex was amazingly cooperative. He handled his blood test and the insertion of an IV without flinching or complaining, and we were proud of him for being so brave. He took everything in stride and just seemed to view the experience as an adventure. The fact that the television in his room had a channel devoted to the stock market, one of his interests, helped keep him occupied while he waited was also a blessing. Fortunately, everything ran on time, and his dental work was completed within twenty minutes with no problems. He handled the anesthesia well and came back from the recovery room a bit drowsy but in good spirits. Of course, we were relieved that the dental work was done and that he was fine. However, we were not certain what exactly had been done because his dentist didn’t talk to us before Alex was released, and the nurses were not sure, either. They suggested that we call the dentist’s office to find out exactly what had been done while Alex was there. To be honest, I couldn’t believe that they had filled cavities in the short time he was there and was upset if they had put him under anesthesia just to clean his teeth. However, I planned to call the office to find out for certain.

Yesterday, I called the dentist’s office and discovered that during the procedure they had cleaned Alex’s teeth thoroughly, taken x-rays, and filled two cavities, one upper and one lower. Since he had done well and all the work had been completed, they don’t need to see him for another six months. Apparently, the dental work had been essentially painless because Alex never complained of any mouth discomfort, and he had no problems eating afterward. His only complaint was a slight sore throat and nose from the breathing tube they had inserted, but he handled that well, too. While we hope that Alex can once again go twenty-one years without having any more cavities, we are thankful that the arrangements were straightened out at the last minute and that God took care of him, making everything go smoothly. Moreover, Alex still thinks going to the dentist is fun. If that’s not miraculous, I don’t know what is.

“Your teeth are as white as sheep that are freshly washed. Your smile is flawless, each tooth matched with its twin.” Song of Songs 6:6

What I'm Doing on My Summer Vacation

Yesterday I went for my annual mammogram. As any woman knows who has been through this ritual, this test involves the emotional aspect of putting aside modesty to allow our breasts to be x-rayed along with the physical aspect of having them and our collarbones smashed in machinery to get the best image. Nonetheless, we go through this test to make certain we are healthy or, God forbid, to catch cancer in early stages. As an autism mom, I have to be healthy because my child, probably even more than others, needs me to be healthy to take care of him, even at age 21. I had to remember this yesterday as I endured rather insulting comments regarding my profession as an English teacher from the technician who was doing my mammogram, essentially telling me that teachers are bossy, kids don’t like English, and grammar is boring. Wisely, I knew not to waste time trying to convince her otherwise; raising a child with autism has made me less sensitive to criticism and smart enough not to waste time on those who do not understand. The comment that hit me hardest, however, was when she remarked how nice it must be to have my summer off. She went on to say that when children are smaller, the teacher mom can spend the summer having fun with them, and when the children are older, the teacher mom can relax and do projects around the house. I didn’t bother to mention that my son has autism, nor did I try to explain life with autism to her; she wouldn’t have understood anyway.

This week, like many weeks, found me making an assortment of phone calls for Alex, trying to get appointments arranged and checking on various things he needs. For example, on Monday I had to call the pharmacist about one of his medications that seems to be on a different refill schedule than his other medications. Thankfully, she is very helpful and pleasant, and she went back through the records to find the original prescription, confirming that I would need to call his psychiatric nurse practitioner’s office to have her authorize a refill. When I called her office, I also set up an appointment for next month for his six-months check-up. After doing that, I remembered that we already had an appointment scheduled that afternoon with the case manager who oversees his state disability funding and his behavior therapist to work on his annual report for the state to continue services. I called the office again, rescheduled his appointment for the morning instead of the afternoon, thinking that would create a busy, yet workable day.

On Tuesday, his behavioral therapist came for her weekly session, and as usual, I flew around the house making sure it looked presentable for her visit. In addition, I wrote his weekly report for her, updating her on behavioral issues to keep her apprised of his progress and any issues she needs to address with him.  On Wednesday, we took him to the dentist, which is something Alex actually enjoys “one hundred percent,” largely because his dental hygienist is wonderfully sweet and patient with him. Also, we have been blessed that Alex has never had any cavities or any other dental issues, so his visits to the dentist have just involved having his teeth cleaned and checked. Because of his anxiety issues, we hadn’t taken him to the dentist for over a year. Unfortunately, they discovered that he has some cavities in his back teeth that will need to be fixed, and the dentist wants to do this under general anesthesia in the hospital because of Alex’s anxiety and sensory issues. Although we would rather Alex didn’t need to have any work done, we agree with the dentist that this is the best way to handle the situation to avoid upsetting him.

On Wednesday, I received an e-mail from the intake coordinator from the agency where we are on a waiting list trying to get Alex into a day program. She was notifying us that she would be taking a different position within the agency and would be turning over Alex’s file to another intake coordinator. Later that day, she called me to discuss respite care services the agency could provide for us. After not having heard from her in months, I was surprised that she contacted us to offer assistance. Nonetheless, I appreciated that she explained the various services we are eligible to receive, and I was able to remind her that we were most interested in getting Alex involved in the day program, which apparently is still on hold at the moment. Fortunately, we’ve become good about waiting for this after over a year of being on the waiting list.

On Thursday, Alex’s dentist’s office called me to let me know they had set a date for his dental appointment at the hospital next month. In addition, he must see a doctor affiliated with the hospital where the dental work will occur the week prior to that appointment to make sure he is healthy enough for the anesthesia. I appreciated that she had scheduled this for us, as well, but it was the same time as the appointment I had rescheduled with his psychiatric nurse practitioner, which meant calling her office to change his appointment again to the following week. Fortunately, we are able to take care of all these various appointments before Ed and I have to go back to our teaching jobs.

On Friday, Alex decided that he needed to go to the eye doctor, probably because Ed and I have both been to the eye doctor for our annual appointments this month. Even though all evidence shows that Alex has perfect eyesight, he insists that he should have his eyes checked. After he pestered me repeatedly about making an appointment, I called the optometrist, and Alex is delighted that he will see him tomorrow morning. Ed and I are praying that Alex will be cooperative for the eye tests and that his eyes are as healthy as we think they are.

Yesterday, after my mammogram, I spent time researching a new antifungal drug Alex’s doctor has prescribed in yet another attempt to get rid of the thrush infection of his mouth that we have been dealing with for over a year. With all the medications Alex takes to keep him calm, adding anything new to the mix makes me a little nervous and sends me to websites checking for possible drug interactions. Convinced that the new antifungal should be safe, we will start that medication today and pray this will be the magic bullet that finally eradicates the stubborn candida fungus in his mouth.

Aside from my role as Alex’s personal assistant in setting up and coordinating appointments with various professionals who help him, I’m also his social director who comes up with daily outings to keep him entertained and makes sure he has a fun summer. This week, we went to two outdoor band concerts in the park, visited Bass Pro Shop for the first time, had dinner at Taco Bell twice so he could enjoy his favorite Cantina Bowl with rice and beans, took him to an arcade to play video games of Wheel of Fortune and Deal or No Deal, walked with him on the trails of a nearby nature preserve, got him apple chips and a soft drink at the Target Café, and took him to the Indiana Dunes State Park beach where he waded in Lake Michigan. Certainly, we had a busy week, but an enjoyable one, too, even thought it was not the relaxing/home project one suggested by the x-ray technician who did my mammogram. However, this week reminded me that I must be at my best so that I can take care of Alex’s needs, and I’m thankful for my health, even if that means enduring those annoying mammograms.  While I wish my house were more organized and that I had more time to read for enjoyment instead of research, I am grateful to have my summer “off” so that I can devote more time to Alex, making sure that he, too, is healthy and can enjoy life to the fullest.

“Work willingly at whatever you do, as though you were working for the Lord rather than for people. Remember that the Lord will give you an inheritance as your reward, and that the Master you are serving is Christ.” Colossians 3:23-24