As my gal gets older we hit all sorts of new challenges...first there was puberty (it's own book of stories, really) and now we've come to the wisdom teeth issue. Her extraction is scheduled for Friday, just two days away, and already my anxiety is at full throttle.
We tried the procedure in the office. Yes, I was well aware that this was not going to work but apparently insurance companies do not like to pay for procedures to occur in the hospital that can occur in an office. Let's just say that when she shot up from the chair and ran down the hall screaming "NOOOOO" we knew our next step would be an outpatient procedure. Thanks to a wonderful fellow autism mom, I was able to get her into the local Children's Hospital here even though she is twenty and technically an adult. That's the good news.
There are challenges.
We have the "Before-the Procedure-Challenges." She cannot eat after midnight or drink clear fluids once she is four hours from the procedure. Since RJC is not one of those all night sleepers it means taking her out on Thursday night and staying up late in the hopes that she'll sleep until morning and I will not have to fight with her when she wants a snack at 2 am.
Then we have the "Day-of-Procedure-Challenges." First, she is not an easy girl to knock out. The little drink they give her doesn't affect her in the slightest. Of course I tell them this at the hospital but they insist they know better and give it to her anyway. When this doesn't work, they try to get her to walk with them to the OR so they can put the mask on. Again, not happening. Next step is the idea of putting in an IV. That's what previously caused her to run down the hall screaming when we were at the office so...no. Last time we had a procedure done we went through all of these options (again, I tried to tell them...) and were holding up the OR schedule by about an hour and a half. Finally a guy came running across the room, totally took her by surprise and jabbed her with a needle. Creepy when her eyes started to roll back and she was moving in slow motion but effective. Looks like this is the plan this time as well and I'm not looking forward to it. I can only hope that they will forgo all of the other options so as not to prolong the inevitable. Second, RJC does not come out of anesthesia well. She basically freaks out. Stands on the little stretcher and screams, ripping at all of the stuff attached to her. Last time it took six people to get her back to lying down safely and in order to do that they grudgingly took out all of the various monitors and needles attached. She will also not be the least cooperative if she wakes up with gauze in her mouth. I'm working with the hospital staff now to avoid these issues, but so far there is no actual plan in place. We will talk about it when we get there, I suppose, but I'd be so much more happy if we could make a plan. Now. As in...not Friday. Sigh.
Still to go, the "Many-Days-After-the-Procedure-Challenges." Her most favorite go-to food? Popcorn. The one specifically mentioned food she cannot have for ten days? Popcorn. Feel my pain, here? She should also rinse with salt water (um...yeah) and hold an ice pack on her mouth (sensory issues abound in my gal). No straws can be used for the first few days. We can probably get around that one but she won't be happy. There are lots more "no" things on the list that will be a problem: nothing hot the first day (soup - an everyday food), nothing acidic the first few days (OJ - another everyday food, mutliple times a day) and nothing crunchy for a while (bye bye crackers).
I'm working hard to see if we can get something to ease her anxiety and keep her sleepy the first two days. Not that I'm a fan of a medicated child, but in this situation I think it's best for her to be able to sleep alot the first few days. She will not do this on her own. We've used valium and ativan in the past for other situations though they barely touch her, especially when her adrenaline kicks in. Telling her to sit and relax is a foreign concept. I'm still working on this and I have two days. The oral surgeon doesn't want to prescribe anything like this because they don't know her. Same with the hospital staff. So I'm working through our pedicatrician. Fingers crossed.
RJC does not know she's going into the hospital. She would obsess and her anxiety would go through the roof. I have been telling her the story of her previous times there so she is remembering some of her previous experiences. Interestingly, she has wonderful memories of her previous times there and is always asking to go back. I'm hoping that Friday morning she'll feel the same way. In the meantime, I am up in the middle of the night trying to picture this being successful. There are so many steps along the way where I need other people to understand that RJC is...well...different. Not just different from a typical twenty year old but different from many kids on the spectrum. I have found that often medical professionals lump all kids on the spectrum in a category with no concept of the idea that it is called a spectrum for a reason. I then need these professionals to work with me to help them work with her (did you follow that)?. That takes a special type of "professional" since often the whole "work with the mom" thing is not what comes naturally.
So...the countdown to Friday begins. I know that if we can just get through the first few days we should be ok. I chose this date to do the extraction because it gives her time to heal before school starts. Please don't send me your horror stories, but any words of encouragement or success stories are welcome. Make that...needed.
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