Dental Visit and the Hello Kitty Alarm Clock

Our Munchkin cat, Wiggles.

The dental appointment went well. The dentist was pleased at how well Dear Son's teeth looked. His teeth looked great under the light, plus there wasn't any plaque near the gums and his gums were healthy. One concern we had was his gum overgrowth and the thickness of the roof of his mouth. It seemed to have gotten progressively worse since he was hospitalized with the swine flu. Dear Son hasn't been on Dilantin in years, which frequently causes gum overgrowth. He said that the gum overgrowth and thickness is somewhat typical of the seizure kids he sees (The dental office is for special needs patients.) and I don't have to worry.

While the outside of his teeth looked great, I was conerned because I have not been able to clean the tops and bottoms of Dear Son's teeth (where they meet) very well since he's had the swine flu. Once he got out of the hospital at the end of November, he had these thick mucous plugs that he would cough up. His scopolamine patch dried up secretions so it essentially dried up the mucous and he'd cough it up or it would dry right on the roof of his mouth. I had to go in there with a toothbrush and dislodge it off the roof of his mouth. As a result, he got very defensive and didn't want me to go in his mouth for regular tooth brushing so I have only been able to brush the outsides of his teeth and on occasion, the inner parts even though I try every day. The dentist was able to check his teeth and Dear Son didn't have any cavities but did have some plaque on the molars however he wasn't concerned. He said it was minimal and because Dear Son feeds via a g tube, it's highly unlikely he would get a cavity.

We also talked about Dear Son's risks for sedation. In 2008, we had his teeth cleaned and sealants put on under sedation however with Dear Son's current health issues, sedation presents two huge risks: respiratory depression and aspiration. In light of this, the dentist was able to clean Dear Son's teeth while we talked. Dear Son was quiet and sat back in his wheelchair while we talked. The good news is that we don't have to come back for a year and the teeth cleaning is done!

The next day, he went to school for "Fun Friday." Last Friday he cried on the bus and the CNA asked him what was wrong then told him he was going to have a fun day and he stopped crying. He's never cried going to school. So this Friday, I had a substitute nurse for the bus. I explained what happened last week and told her if he cried, she may have to tell him he was going to have a great day and things should be fine. We had a good laugh over that.

Dear Son did have a great day. For the first time since October, he was able to sit in a rocking chair at school (they secure him in there and have someone next to him) and push his feet to rock himself. He had lost his ability to move his feet and legs after the swine flu. This was a very good thing. They also had a little action at school; some senior high school student pushed the fire alarm so they had a false alarm. Dear Son thought it was pretty fun though, when they had to run through the halls pushing him in his wheelchair. He likes a little chaos.

My Hello Kitty Alarm Clock

On a different note, our cat is confused with Dear Son's school schedule. Dear Son goes to school two half days a week, on Tuesday and on Friday. Our cat however remembers the old school schedule. Back in October, I'd get up early to start Dear Son's g tube feeding then go back to bed for a few hours until it was time to get him ready for school. The cat knew the time and if I overslept, he would wake me up by standing near my face and meowing. Well, once the cat gets wind that Dear Son is going to school, he then assumes that Dear Son will go to school every day so he now wakes me up the following day, thinking it's a school day. So every Wednesday and every Saturday he starts meowing very early to let me know that it's time to get up for school. He starts by meowing, then runs around a bit, then comes back and meows some more. Then if I don't say anything, he stands in front of my face and meows loudly. When I open my eyes, he's like two inches from my face. Today, he kept meowing even though I told him Dear Son did not have school today. Finally, he bit me and ran away. Honestly, it's just too funny. It's great that he can tell time, lol, but now I need to teach him the days of the week.

The Make a Wish Trip itinerary arrived today! Our trip is only a few weeks away!

Suction Machine Update & Dental Visit Tomorrow

The home healthcare agency came out today and replaced the suction machine. The one I had was defective. I did have it set up properly though so that was good. The new machine works great.

Prior to coming, I told Dear Son that they were coming out to fix his machine. I told him that when he was choking I could take the tube and go "bzzt" and get the saliva out for him. He smiled when I told him that. I have to try to create some excitement when we get new equipment so he'll let me use it on him.

After the tech left, I tried it out on Dear Son. He was a little startled by the noise however he did let me in his mouth enough to get out some saliva.

We'll see if he is as eager to let me in his mouth after I take him for his dental check up tomorrow. He seems to have a lot more gum overgrowth, along with extensive growth on the roof of his mouth since his hospitalization last November. He is not on any medication that should cause this, so we'll see what they say.

We see a dental group that is affiliated with a big city hospital. They take care of mostly Medicaid children and poor adults with multiple mental and physical disabilities. It took a while to find a dentist who could see a child like Dear Son but I found this group over ten years ago. I had tried three other dentists but none were able to care for Dear Son. It is amazing to go there. Every patient has significant impairments and that is the only type of patient the dentists see all day. Can you imagine that? It's quite impressive. They have dental students there as well since it's a dental school. What's great too is that it's right across the street from the hospital. This is important since if the patient ran into issues during a procedure, they could wheel him across the street for an emergency. Something to think about when you have a special needs patient.

The dental school is very well run however. They group their days by visit type so one day a week they do all cleanings, another day all fillings, etc. Some special needs patients have to wait several months to get a cavity filled because this is one of the few places that know how to take care of people with severe disabilities. The average dentist can't manage a patient like Dear Son even if they say they take children:) It's also tough because many of these patients don't have dental coverage or their families or caregivers never took them to a dentist. Unfortunately, dental health falls to the wayside for some families in light of the patient's more pressing issues.

We go for a visit tomorrow and then after that, they'll set up a teeth cleaning for Dear Son. To get a teeth cleaning, there is typically a six month waiting list and they won't see the patient until they have a preliminary appointment like we do tomorrow.

To clean Dear Son's teeth, they typically put him under a bit. It's very challenging because they clamp the mouth open and won't allow the patient to close their mouth until they are done. It's pretty uncomfortable and I don't know that he can do that anymore. The last time he was crying out while they did it and it was very hard on me to sit in the waiting room and listen to him cry. (They also typically tie the patients hands down and I don't allow that. After all, I wouldn't want it done for me and I don't allow people to do any procedure to a special needs child that they wouldn't do to a normal child.) When you or I go to the dentist for a cleaning, they don't clamp our mouth open. When we go, they'll take out the suction device and allow us to swallow or to reposition ourselves but for the special needs kids, they keep them clamped open since it's too hard to get them re-clamped again. I don't like that part really and find it enormously stressful. Dear Son's never had a cavity in eighteen years though. We had an appointment last year and had to cancel due to his hospitalizations.

Aside from the clamp, they do a great job cleaning the teeth. The anesthesiologist is pretty good too. I felt really confident when I met him since he wasn't fazed at all by the number of medications Dear Son was on. After all, most of their special needs patients are on a lot of meds. I was able to have his teeth cleaned previously and had sealants put on all his teeth.

Thank you for all of your comments on the suction post. I really appreciated your support.