I had planned on a quiet Saturday evening. Aaron was going to be at Origins, I was going to put the girls to bed and watch some great medical reality TV on Discovery Health. And then near bedtime, Cordy and I were playing, and I asked her to let me count her teeth. When I got to the last one, I noticed something didn’t look right.
Hoping it was just a little bit of dinner stuck to her tooth, I gently brushed her teeth, and noticed the molar still looked weird. Grabbing my pen light, I asked her to open her mouth again, and I got a close look (warning, graphic description): a jagged V slice was missing from the middle of her tooth, with the yellow pulp visible.
I couldn’t believe what I was seeing. “Does your tooth hurt?” I asked Cordy.
“No!” she replied with a smile. No way, that’s impossible, I thought. That HAS TO HURT. She had no idea when she did it, or how. I have no idea when she ever ate anything hard enough to crack her molar.
Part of Cordy’s unique character is her reaction to pain. Or maybe that should read lack of reaction. I’ve watched her do things that would make the average child shriek in pain. I saw her tear half of her fingernail off, and the most reaction we got from that was a temporary sad face. She doesn’t process pain the same way most of us do.
I still can’t figure out if she is feeling the sensation of pain and interprets it differently in her brain, or if pain doesn’t register at all. But either way, extreme pain generally doesn’t bother her. (Now, try to pour water on her hair and she screams that it hurts. I don’t fully understand it.)
I called her pediatrician’s on-call service, and the doctor said it was best to take Cordy to Children’s Hospital for a look. Infection was a concern, as was the pain issue. So after spending 20 minutes trying to prep Cordy for what to expect, we left for the hospital.
Cordy was scared. I knew this was likely to end in disaster, but at the same time she seemed to understand what I told her. The doctor wanted to look at her tooth, and they wouldn’t do anything to hurt her. She asked if she would get a new tooth, and I told her they would try to make her tooth all better. She promised she’d be brave if I promised not to leave her.
At the hospital, she was fine as I checked in, and I had hope that she might do better than I expected. Then we walked back into the triage area, and the aide asked her to stand on the scale for her weight. She lost it right there, and her fear slowly built into a full, old-school meltdown. No one could touch her.
I sat on the floor with her in our nook in triage, holding her while she tried to break free to run away, primal screams and repetitions of “Let me go!” coming from deep inside. My own face burned with embarrassment at the stares we got from other parents and staff. I know I should be used to this by now, but it still gets to me. I wanted to scream out, “She has autism! Transitions and new experiences are hard for her!” but instead I focused on calming her down. She finally calmed down right before we were moved to an exam room.
The resident who came in to examine Cordy was young and I had to explain all of Cordy’s quirks to her. Cordy hid under a chair in the exam room, unwilling to show her tooth or let this new stranger near her. She got a history on Cordy, then said she needed to talk to her attending doc to see what steps we’d take next. I was left alone in the room with Cordy. She eventually came up onto the bed with me, and then exhaustion from her meltdown caught up with her. Cordy was overcome with sleep.
When the attending doctor came in, he got to look closely at the tooth, thanks to Cordy’s ability to sleep like the dead. He was amazed that she wasn’t in extreme pain, as it is a very deep break in the tooth. Nothing would be done tonight, he said, but she will need to have something done with that tooth.
Based on her behavior, it was obvious that she will need to be sedated to have her tooth fixed. That’s something they didn’t have the set-up for in the ER, but the dental clinic at Children’s has the ability to do general anesthesia. So the plan was put in place for her to come see the dental surgeon on Monday to determine what to do with that tooth.
Cordy also received a prescription for a heavy-duty pain med that would make drug seekers green with envy. Even though we can’t be sure if she’s hurting or not, the doctor said the only ethical thing to do in this case is assume she is in pain, treat with ibuprofen round-the-clock, and then use the prescription pain med if she shows any signs of pain or says that her tooth hurts.
Even though I’m nearly-a-nurse and know that general anesthesia is safe, I’m still terribly nervous about Monday now. First, I know we’re going to have a replay of everything that happened tonight. But on top of that, they will have to hold her down and sedate her.
And even though she has no allergies that we know of, we’ve also never had to know her allergies. She’s only been on antibiotics twice in her life. She’s never been seriously injured or sick. However, I do know that she reacts strangely to nearly anything she’s given. Pain medications don’t seem to do anything at all, while she has adverse reactions to Benadryl. Hell, even blue food coloring affects her behavior. Nothing about her seems to react the way it should. I worry she’ll be ultra sensitive to the anesthesia or something will go wrong.
I hate seeing her afraid. And I hate having to even think about risking general anesthesia for a tooth problem. At this point I want Monday to come and go quickly and with as little disruption to our lives as normal. But I’ll confess I’m so worried that something might happen to my Amazon warrior princess.
I don’t want to be on this side of things – I want to be the nurse reassuring the parents that everything will be fine, not the worried mother hoping her sensitive child won’t have a bad reaction under anesthesia.