care and handling

Yesterday, I posted the following on Facebook:

IMG_6704

Three years ago when Brooke needed to have a couple of baby teeth pulled, we were told (and agreed) that the only way to do that would be in a hospital, under general anesthesia. That was what we did. Last month, we were told that she needed to have an adult tooth pulled. Her orthodontist referred us to her surgeon. This time, however, things were radically different. Thanks to myriad factors which I swear I’ll get into in detail in a full post tomorrow, we believed that she would be able to do this. We were right. As we left the dentist’s office just now, one tooth lighter, Brooke texted Luau. “I’ve been a rock star,” she wrote. “I am proud of me.”

#RockStarIndeed

#ShoutYourPrideFromTheMountaintopsGirl

{image is a photo of Brooke in the waiting area at the dentist’s  office before her appointment.}

I can’t tell you how proud I am of my girl, nor how grateful I am for the people who helped us to create the environment in which this was possible. Here’s the story of how that happened …

In November of 2011, we checked Brooke into Boston Children’s hospital for outpatient surgery. She needed a total of four baby teeth pulled, and it was clear to all involved that pulling them would not be possible with her awake. Her anxiety was unmanageable and there was simply no way that she would allow a dentist, or at least any dentist we’d yet met, the time they would need in her mouth.

The procedure was traumatic. She was under general anesthesia. It took hours for her to come out of it. It was necessary, but it was a hell of a lot for her to handle both physically and emotionally.

A year later, we would come to learn that orthodontia would be unavoidable. We were terrified at the prospect of braces. How on Earth could the kid who had to be asleep for any substantive dental work survive braces?

We brought her to Katie’s orthodontist to strategize. He saw her once and told us that he couldn’t accommodate her needs. He didn’t phrase it that way. He couldn’t “handle her,” is what he said. He didn’t deserve her was what I thought.

We asked around. Another mom told us where we had to go. It wasn’t close to home. We didn’t care.

Dr Mahdavi was a whole different animal. Gone was the assembly line feel of every other office – in, out, pay your bill and go. He was in no rush. “Whatever she can handle,” he said. The irony of his wording wasn’t lost on us.

One appointment was broken into three. Sitting in the chair. Getting comfortable. Meeting the assistants. They worked their way — slowly, patiently, gently, up to taking a mold of her mouth. She let them.

They told her what they were doing every step of the way. They told her how it would feel from her perspective: they let her see the instruments, told her how anything going into her mouth might taste, smell, feel. “This might be cold for a second,” they’d say. “This might feel funny on your tongue, but only for a minute.”

They gave her a handheld mirror so that she could see what they were doing. They never approached her from behind or overhead without telling her they were there. When she made it clear – no matter how – that she needed to stop, they stopped. They respected her. In return, she trusted them.

Eventually, she got her braces on. They haven’t been without their challenges, but she’s done it. They’d hoped to avoid pulling teeth, but last month it became clear that there would be no choice. Dr Mahdavi referred us to her surgeon.

This time, I pushed back. “I think she can do it if we do it here,” I said. “She’s comfortable here. If we can go step by step, I really believe she can do this.”

Dr Mahdavi smiled. “I do too,” he said.

Luau scheduled an appointment for Brooke to meet Dr Nancy. To make the connection, to get comfortable. And then we set up an appointment to do the extraction.

Brooke was nervous, but ready. She told Luau that the Tooth Fairy would come. And that she’d come with a new Playmobil friend. He didn’t argue. She asked me to take her. I didn’t argue either.

On the way to the office, I told her that I was going to tell Dr Nancy a few things when we got there. I told her that I would tell her that it’s important to Brooke to know what’s about to happen. I asked her if that was okay. She said it was. I asked if she wanted to tell Dr Nancy anything. She said, “You will.” I told her that if I said anything that didn’t sound right, she needed to say so. She said she would.

When Dr Nancy walked in, I told her that Brooke and I had talked about some things in the car that she wanted her to know. I told her that she needed to know what to expect – not too much lead time, just enough to avoid surprises. I told her that we needed to take things slowly. I asked if they could give her a mirror to hold so that she could see the nitrous oxide mask. “She will be less anxious about it if she can see what it looks like on her,” I said. They were happy to oblige.

Brooke asked me to hold her foot. I did. She asked me to hold it tighter. I did.

Dr Nancy and her assistant, Ms Jessica, answered every question that Brooke asked. “What’s your favorite color? Are you married? What’s your son’s name? Have you ever felt anxious? Did you ever lose a tooth? Do you have a middle name? How old are you?” She asked all of those and more and they answered …. Every. Single. One. That matters on so very many levels. They respected the fact that those were important things for her to know. They didn’t shush her or tell her to wait. They never gave the impression that their agenda was more important, nor valid, than hers.

By answering her questions they let her know that she was being heard and that she would be heard during the procedure if need be.

They earned her trust. She gave it to them.

In the end, she handled the entire situation with grace, humor, strength and courage. She made us all laugh and, eventually, once I was alone, cry. Not in sadness, but rather in the utter relief of validation. Validation that my girl really can “handle” anything when SHE is handled with respect, patience and care.

Before we left, I thanked Dr Nancy perhaps just a little too enthusiastically. But she needed to know. To know how much her time and effort and planning and patience mattered.

She didn’t “handle” Brooke. She respected her. And it made all the difference.

 Huge thanks to everyone at Natick Dental Partners. You’re doing it right.

Ed note: I am not affiliated with nor compensated by Natick Dental Partners in any way, shape, or form. Just the grateful mom of a patient. 

IMG_6706

Brooke holding her “loot” in the car: a sparkly ring, two stickers, and a pink box for her tooth, along with the pink dinosaur figurine who kept us company throughout.}

16 thoughts on “care and handling

  1. This makes me so happy to read! I have extreme anxiety and fear of the dentist. So much so that I didn’t go at all between 4th grade and turning 27. My husband spent years convincing me to go. I finally went and cried through the whole cleaning and that was all we did on the first day. They labeled some extractions and a few fillings but said they could wait. I had the first extraction a month later. The office we go to uses IV sedation. I begged for it but they begged me not to because the cost is huge. $400 for sedation for a $60 extraction was too much they thought so we settled on the gas. I made it through but as soon as I got in the car I lost control. All the anxiety came out and I was shaking and bawling. To read others stories of success makes me feel like I can try again.

  2. This is so brilliant. Quite simply, it is all about the people we meet. We just need to find more of those that ‘get it’.

  3. It’s so wonderful that Brooke found someone she’s comfortable with.
    I don’t know how else to contact you but I will be releasing a very public statement today in regards to the worst kind of disability discrimination ever that is currently very common in our state. I am a firm believer in your theory of presuming competence.. but it’s becoming apparent that this is also dangerous for our children.
    There will be more details provided in my full statement which will be directed to every member of our state government, but the basics are that my granddaughter was taken by DCF and they are using my daughter’s receptive language delay as their grounds for terminating my daughter’s parental rights and placing my granddaughter for adoption.
    They won’t support a petition granting me custody because I’m raising my 3 year old autistic grandson.
    Yes… you’re reading this right… the independence we strive for our children to achieve can ultimately hurt them in ways we cannot comprehend.

  4. I am thrilled for our “Rock Star” and so very grateful for Dr Mahdavi, Dr. Nancy and Ms. Jessica for really “seeing” Brooke and understanding her needs.

    Love you,
    Mom

  5. Pingback: » care and handling

  6. Pingback: Care and handling | lovenlearning

  7. Jess, may I add a link to this to a site I’m building (www.autisti-care.com/). The site is intended to offer medical professionals information re. the challenges related to autism and medical care. The focus is on autistic experiences, with input from parents as well (like you) who share the challenges, and solutions when they happen.

    I’m creating a “Dental” page and this would be a great link to include. Thanks!

  8. Jess, this is wonderful. For a very long time I had severe anxiety about going to the dentist. When I was young, I had a dentist that would give you novacaine but would not wait for it to work. He would give the shot and immediately start drilling and not give any more novacaine. I got to the point that I just wouldn’t even let him give me the shot. I didn’t see the point of going through the pain of the shot for him to not wait and let it work anyway. As an adult, I still have that anxiety but I have learned to talk myself down so to speak.
    I’m very proud of Brooke. This is a major accomplishment, and figuring out a way to help her get through it is awesome.

  9. I had such horrible experiences with dentists when I was a kid that I have been to the dentist only once as an adult, and that was because the pain was unbearable. Unfortunately, the experience of that dental visit was also unbearable. (For example, the place I went didn’t have a bathroom, but it was the only dentist available for people on low incomes.) I wish I could find an autism-friendly dentist where I live.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s