My oldest daughter Hallee had her wisdom teeth out on Thursday. She was due to have them out back in June, but because she’s autistic, her oral surgeon decided that taking them out under general anesthesia at St. Joe’s here in Bangor would be the safer and less stressful option for her. There was quite a long wait to get scheduled, so I’m very thankful that they didn’t turn ugly on her before we got her in there.
I’ve been worried (massive understatement) for months about how she would handle the procedure. Despite being 18 years old, she’s never had surgery, never had a cavity, never really been hurt other than your typical kid bumps and scrapes. We’ve read stories, watched YouTube videos, you name it to prepare her, but with nothing to really reference it with, I wasn’t sure how much any of it would help her with what was coming.
So Thursday morning, we were up at o-dark-thirty and found ourselves driving the wet, black streets of pre-dawn Bangor headed towards Saint Joseph’s. Hallee was super agitated, as I knew she would be. Everything we were doing was screwing up her routine and she wasn’t happy about it. Once we got there, the staff in the outpatient surgery center were wonderful. Sue and Robin made us feel very welcome and were ready ahead of our arrival to get Hallee to a private room as quickly as possible to avoid the stress of a waiting room full of strangers.
Once we were settled into our room, our nurse got Hal changed and in bed and did her best to get Hallee’s information from me over the constant stims and questions. The anesthesiologist was wonderful. I was allowed to walk with Hallee into the OR and stay with her until she was under and they waited until she was asleep to place any IV’s.
Her oral surgeon came to find me the minute she was done and said it had gone very well, all 4 teeth (including one impacted) had come out smoothly and she’d be awake shortly. He said if there were any issues at all, to call him at home or on his cell (pretty amazing) and otherwise he’d see us in 2 weeks for a follow-up appointment.
Within a few minutes, a recovery room nurse came out to get me and took me to Hal. Half of me wanted to whip out my camera and document my very-drugged kiddo, but I resisted. She had one eye open, a mouthful of bloody gauze and looked like she had been on a 3 day bender. She’d look around the room, sit up straight, look me in the eyes and yell, “MOM!”. I’d answer her and tell her I was right there only to have a few seconds go by and she’d notice I was there again and yell, “MOM!”. Despite my concerns for her pain levels and the surgery in general, it was pretty funny. She’d forget I was there entirely until she saw me again.
Then we got taken back to a room to have her wake up bit more and be checked out one last time and then we were being wheeled out the door. It was over. The drive home was punctuated by the occasional, “MOM!”.
Once at home I shuttled her straight back into her pajamas and into bed. There was quite a bit of bleeding, even with sutures and we were changing gauze every half an hour for a good bit until it slowed and then finally stopped a few hours later. I started her in on her pain meds (hellooooo loopy kid!) at lunchtime, alternating with an antibiotic and keeping cold packs on her face. For an autistic person with sensory issues, the ice packs would probably have been impossible without her being on drugs. Even though she slept well that night, I was up every couple of hours to check on her, worrying that she’d be in pain.
Today, 48 hours post-surgery, she’s swollen a bit, but nothing terrible. No bleeding, the sutures look clean and tight. She’s rinsing with warm salt water (again, this is a struggle for her and has caused more than one bout of tears, but she’s doing it) and I’m trying to gauge the need for heavy meds -vs- ibuprofen and Tylenol.
Now here’s the thing….the after-wisdom-teeth diet. Obviously, nothing but soft foods for at least 3 days, maybe longer depending on how the person is healing. Hallee’s had textural issues since she was a toddler. One of her autism “quirks” is that she’s unable to palate soft foods. That’s a nice way of saying that she’d gag and throw it back up. The closest thing she’s eaten that you might consider soft food in the last 16 years would be a small banana here and there during the week. She literally hasn’t had ice cream, yogurt, soup or pudding since she was 2. TWO. No smoothies, no milkshakes, no Jell-o…and yes, she’s always had vitamins and an extra calcium supplement. So what am I supposed to feed my kid this weekend??
That first day, all food was out. She was just too drugged up and snoozy to want food. On Friday, I started trying to get just one spoonful of yogurt or chocolate pudding into her..with little success. She’d drink water or juice, but no milk. Today, Saturday…she’s hungry. She understands that she can’t have regular food yet, and I think she was starting to get that it was soft food or nothing. She ate half a banana today, several bites of chocolate pudding, (she turned her nose up at strawberry/banana Yoplait, even though she loves strawberries and bananas, ditto the chocolate milk), a popsicle and at dinner time, I set a tiny bowl of mashed potatoes with butter in front of her without saying a word and BY GOD THE KID ATE SOME. It was a win for every autism mom the world over, although I wish had been for any other reason than oral surgery.
I’m watching her like a hawk for signs of the dreaded dry socket. I’ve lectured repeatedly about no blowing her nose, no touching with hands or tongue, no straws, etc. If we did run into trouble, we’d be up the proverbial sh*t creek without a paddle, since she’d very likely never be able to sit still in the dental chair to let him open the sutures and pack the socket, which is the usual treatment for dry socket. We’d likely end up back in the OR for what would otherwise be a 5 minute office procedure. So if you’re the praying sort, please offer up a prayer that her recovery continues forward with no issues.
Here’s what I’ve taken away from this so far and this goes for either yourself or your child, special needs or not.
Prepare as much as you can. Have prescriptions filled and waiting so your kiddo isn’t at home with anesthetics wearing off while you’re running from pharmacy to pharmacy looking for one that carries what you need. I called Rite Aid a week ahead with a heads up and they said that it’s typically takes 4 days lead-time to order in what they don’t have in stock. In our case it was liquid meds since Hallee can’t swallow pills.
Have an oral surgeon that you trust and can have an open dialogue with. Not all professionals are great with special needs kids and the extra challenges that can come with having them as patients. Ours (Jeffrey Fister) was very understanding that Hallee would need specialized and possibly out of routine care and couldn’t have been more open to her needs.
Be prepared to have several down days while your child is healing. Some folks bounce back from this in a day and some need a week or more to feel like themselves. Don’t rush if you can avoid it at all. I kept Hallee home on Friday and depending on how she does tomorrow, I have no problem keeping her home Monday as well, especially if she still needs the heavy duty stuff for pain. We haven’t been able to do more than make a brief run out to the store today without her being tired and fuzzy. Plan on some down time with tv, books or puzzles. Low-key is key while you’re healing.
Stock up on soft foods, even if you have a child like mine who may not eat them. Eventually they’re going to eat something, even if it’s one or two bites. Puddings, yogurt, potatoes, soup, eggs, cooked squash, soft pastas and smoothies. Avoid spices..ouch!
The fancy gel packs that I bought for her facial swelling don’t stay cold very long..a bag of frozen peas or corn inside a thin towel or pillow case works just as well and stays cold longer.
Prop your head up in bed with extra pillows to prevent swelling. Laying flat means easier blood flow to the head and more swelling.
The big no-no’s:
No using a straw. It can dislodge the blood clots in the sockets which will lead you to a world of hurt….dry socket.
No blowing your nose..wipe…same reason.
No vigorous mouth swishing.
No smoking..huge factor in getting dry socket as an adult.
No crunchy, chewy or hard foods until the holes have healed. As a 10 year old my mother had to turn the car around and drive back to the oral surgeon an hour after I had a tooth pulled because I immediately got a piece of peanut stuck in an open socket. Not fun for anyone involved. In my defense, my mother said I could have whatever I wanted as a treat and I wanted a Dairy Queen sundae with nuts. Thanks, Mom.