Keep Smiling

Today, Adam had dental surgery. He has soft teeth and bad bacteria that tooth brushing, flossing and flouride treatments just couldn't beat. We arrived, and experience a little from last year's ear tube implants, I must say the hospital staff accomodated us beautifully. A little bit of advocating for Adam's special needs really went a long way....

Adam has gained, quite justifiably, an incredible fear of doctors and their gadgets. Forget the dentist. He won't have anything to do with him anymore. Last week's visit to his pediatrician resulted in screaming, tearing out my hair, and yelling to the doctor "go away" repetitively. All of these events lead us to decide that it was better to give Adam general anaesthesia to get a lot of needed work done, than to subject him to a series of dental appointements.

To prepare, I called the anaesthesiologist a week in advance. I asked to be in the O.R., and that Adam be given a light sedative so that he wouldn't panic once he had to have the mask. I asked that I be in recovery before he awoke so that he wouldn't panic and scream like the last time -- I don't know how he perceives things when he wakes up. At first, when I advocated for Adam, there was some hesitancy. I needed to tell the woman that Adam was autistic and recently developed a severe fear of doctors. Subsequent questions proceeded -- was he "high or low functioning?" she asked nicely.

I said he was autistic and there was no such thing as high or low functioning -- I felt that I needed to stay with the facts that I knew: that he could talk a little but in a circumstance like this may not talk at all, that he would scream if they tried to pin him down, that he would resist everything and would need extra time, and require sedative before anasthesia. I asked that the crew talk softy to Adam and not raise their voices if Adam resisted. I mentioned that Adam panicked the last time he was in the recovery room and that it would be best if he could see my face when he awoke.

"It's scarry for all kids," she said.

"I'm sure it is, but we can't honestly say that we know how he perceives the experience and if he is extra disoriented," I replied. "I feel it is important to support him and make sure he gets the accomodations he needs."

After half an hour of requesting, the very pleasant woman said she would do everything she could and even came to the waiting rooms to meet us today. I had a chance to recap all of these with the head anaesthetist. All of our requests for Adam were honoured and respected, and as a result, this surgery, which took two hours, was much less traumatic than his last one. One might even say, smooth.


Just before surgery 

In contrast, I saw another autistic older boy today. He was non verbal but made noises. He kept "regarding" lego pieces, his body hovered into a ball on the floor, after the pre-operative examination -- he moaned in terror and the legos calmed him. He tried to resist as they made him transition from this room to the O.R. waiting room. There were more legos to regard when I saw them there, but I wondered why the same accomodation wasn't made for this child who could not advocate for himself? At one point, his mother grabbed him aggressively by the arm and forced him to put the legos away. I was shocked. These were the obvious means by which he was soothing himself. She looked visibly annoyed with him, but I couldn't tell if she was just scarred herself. You know that feeling when you want to burst into tears, but instead you literally swallow them? Well...

Later, that same boy came out earlier than Adam from surgery, walking with his father, but moaning and making sounds like a wounded animal. The distress was clear enough communication for me. His moans became mixed with cries when they passed the doorway, I could see the son try to burrow his head in his father's chest. The father kept talking to him firmly, "shhhhh, shhhhh," moving his own body away from his desperate son's. Now, all of these observations and judgements are mine, I know. But I never felt so sad in my life for a child. There was a coldness there and I simply couldn't relate.

Adam slept most of the day today and when he woke up, came to and later laughed a little, I was shocked. All of his back teeth -- upper and lower -- are silver capped. He looks like that guy from James Bond with all the silver sharp teeth!! I knew they were capped afterward -- the dentist told me. He also had two "baby" root canals. Apparently, his teeth are deteriorating quickly -- tightly jammed teeth and this lactobacillic bacteria that don't give his little teeth much of a chance. Thankfully, his front teeth are still white, but let me tell you, Adam's smile is very different when he laughs. I thank God that these are just baby teeth and they will fall out. The silver will likely dull with time and mastication. Yet, I know his smile will keep on shining, even if a little brighter than before.