Friday, November 5, 2010

NaBloPoMo 5/30: Oral surgery

As I reported yesterday, Carter had oral surgery scheduled for this morning to put crowns on his 4 chipped front teeth, and do a few other things. We had to be at Dell Children's Hospital at 5:45 for our 7:00 appointment. Luckily, traffic is nonexistent that time of day, so it was an easy drive in.

They got us all checked in, and Carter enjoyed playing in the waiting area.

They took us back to a pre-op waiting room, where lots of different nurses came back to talk to us and do paperwork. They have the kids wear special PJs instead of hospital gowns:

Carter was very patient during all of this, and mostly played with the iphone. Before he had to go back to the OR, the anesthesiologist came to give him a dose of a sedative (it's what they normally put in your IV right before they take you back for surgery, in an oral suspension form for kids), for which I was really grateful, because I knew he would have been really freaked out otherwise. The sedative made him very relaxed in about two minutes, and completely loopy within 10 minutes. He was slurring his words, floppy, and staring off into space. It was strange to see him like that, but I was relieved he wouldn't have to be upset before the surgery.

They had me carry him back to the OR, which was actually really difficult since he was so floppy. I didn't realize how much he actually helps me carry him! He was still trying to talk when we got back there, and said, "Dentist" once very clearly, so I knew he was still aware, though drugged up. I put him on the table, and they put a mask on with the anesthesia gas, and he was out very quickly. I headed back to the waiting area then, and was glad I got to be there until he went under.

Since they were working in his mouth, they had to put a tube down his nose for the anesthesia gas, and they also had to put an IV in. Happily, he missed all of that. He has three punctures on his hand, so they clearly had a hard time getting the IV in.

The main reason for the surgery was to crown those four chipped teeth, but the dentist said they would take care of anything else they found, and also put a sealant on his teeth. They cleaned his teeth well, did x-rays, and found two small cavities in his back teeth, which they filled. The whole thing took a little over an hour.

I hung out in the waiting room, trying in vain to get on the hospital's wireless network. Doug later pointed out how ironic this was at a hospital named after Dell (of computer fame). I had a weird moment when I washed my hands in the bathroom -- the soap smelled exactly the same as the soap at the hospital in Greensboro where Carter was in the NICU. That was the only moment where I felt unsettled at all; it took me right back to the NICU in a really powerful way. The strongest emotion that lingers from the NICU days is that of powerlessness, of not being able to take care of your own baby. That smell brought it all back for an instant.

When Carter's surgery was done, they called me back to a consultation room, and the doctor came in to tell me how it all went. While I was waiting for him, I could hear other parents being told much more serious things in other rooms down the hall, and I felt so thankful that Carter has been so healthy. Things could have turned out so much worse for him, and I'm so thankful that he is only in the hospital for things like this!

Carter stayed in recovery for about half an hour, and when he was starting to come around they came back to get me. Unfortunately, he was screaming and crying when I got there. He wasn't in pain -- he was still pretty drugged up. I think he was just completely terrified! After all, the last thing he remembered was sitting in my lap, and the next thing he knew he was waking up in a strange room with all these tubes and things attached to him, surrounded by strangers. He clung to me when he saw me, but didn't stop crying. He pulled at the IV and the tubes and kept saying, "Take it off!"

The main problem we had at that point was that the anesthesia had triggered his reactive airway, and his oxygen saturation was in the 80s. They had already tried to give him oxygen, but that only freaked him out more. The doctor came by and decided we needed to do a breathing treatment, which I knew would not be fun. He hates the mask, and he fought it the whole time, still screaming and crying. And of course, screaming and crying does nothing for the oxygen level in one's blood, so his sats were not coming up. The staff were starting to talk about keeping us longer and what to do next. The nurse was trying to reason with Carter to get him to calm down. I'm surprised that a pediatric nurse wouldn't know that you really can't talk with young children while they're that upset -- their language processing centers in their brain shut down, and they just don't hear what you're saying. I finally told her to back off and let me handle it, because she was actually making it worse.

As soon as the breathing treatment was over, I pulled up my shirt and nursed Carter. It was actually pretty funny to see how quickly the nurses jumped up and pulled the curtains around us. They were all, "She's breastfeeding!" and whipped those curtains closed. At that point, I honestly wouldn't have cared if we were sitting on the side of the highway; this was what my baby needed and I whipped out a boob! And of course, it worked. He calmed right down, his heart rate came down, and his oxygen saturation went up. Needless to say, they were all impressed. :-)

We were soon moved to a post-op waiting room, where Carter nursed to sleep in my arms, and stayed asleep while they took out his IVs and got us ready to go. I put him in the stroller still asleep, and he didn't wake up until I put him in the car.

And that was it! We got home and he had a few popsicles and some jello, and grudgingly let me give him some ibuprofen, and then he was ready to hit the sandbox. He seems completely fine, and so far hasn't seemed to be in any pain.

Here is a "before" picture. You can see that the four top front teeth are all chipped, and that the lateral incisor on the right was pretty far gone. That one chipped off halfway, and no amount of brushing or fluoride treatments helped it.


And here is the after picture. The crowns do look a little fake, but they'll look better when the swelling in his gums goes down. They're tooth-colored in front, and metal in the back. The dentist said he always puts these super-strong crowns on little boys so they won't chip them again!


So no more chip-toothed smile! Just in time for our holiday card pictures, too.

Thanks for all the messages of support on Facebook today. Even though the procedure was no big deal, it was nice to know everyone was thinking of us!

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