Wednesday, July 14th, 2010

My parents haven't been looking forward to this day - it was time for my dental surgery. It was just a little less than a year ago (7/24/09) that I had several root canals, crowns and extractions. Mommy and I met up with Aunt Kristin who took the day off to be with us. While Mommy and I checked in, Aunt Kristin ran to get some much needed coffee. I had a super fun time playing with all the toys until they called me back to an exam room. They started off with a height and weight and I knew I was in for some trouble. Once in the exam room, I had a bunch of visitors. First was the nurse who took my blood pressure (which was very high due to the tantrum I was throwing) and my temperature. The dentist who was doing my surgery came by as well to discuss the plan. Then we met the anesthesiologist who ordered several medications - Pulmicort due to my previous reactive airway issues (see my previous hospitalizations for the common cold), antibiotics (possible infection from dental surgery is not good with a heart condition) and Versed to calm me before they took me away. Aunt Kristin had brought me some new toys to keep me entertained and it helped keep me occupied during the breathing treatment and eventually the Versed kicked in. Mommy rocked me and once I was good and loopy she handed me off to the nurse without a fight.

As Mommy has said in the past - my mouth is the perfect storm for dental decay. It is small to begin with and then when you add my ankylosis, it is nearly impossible to open my mouth wide enough to do any real good tooth brushing. To make matters worse, my bottom jaw sits so much farther back from my upper jaw now that when I clench my mouth closed during tooth brushing, my bottom teeth are hidden by my top teeth. As if the anatomy issues were not enough - then I have a few other contributing factors. Because of the trach and g tube, I don't use my mouth for breathing and eating like most folks which means my mouth is open to the air all the time and I don't have a lot of saliva production which means that any bacteria isn't washed away by the saliva when I swallow - not good! As if I wasn't already a dental nightmare - add on my diet. The only foods I like are refined sugars and carbohydrates - the worst bacteria producers. And in addition, I graze all day which means the bacteria is constantly being produced. So there you have it - the perfect storm. So when the dentist came out to speak with Mommy 2 1/2 hours later she shouldn't have been surprised to hear the bad news. Well she heard the bad news but she also saw the bad news when he handed her a biohazard cup with my teeth in it. Drum roll please - I lost 7 teeth and had 5 teeth crowned! There were four teeth that needed to be extracted but three of the four were fused which resulted in seven extractions in total. The one extraction that was a single tooth was actually a root canal/crown from the last dental surgery that developed an abscess. Now as the dentist explained it, 90% of the time a root canal followed by a crown will take care of the tooth for good - but as you know, I would have to be the 10%! Because of my heart condition and not wanting to chance an infection travelling to my heart, the dentist said he was more agressive then he might normally be which resulted in more extractions then crowns. About this time, Aunt Kristin walked in to hear the update and got to witness Mommy breaking out crying - can you say embarassing! Mommy usually does a pretty good job of keeping it together but seeing the proof of all my little teeth in the cup was just too much - she felt like a horrible parent.

As Mommy mopped up the tears, she was able to come back to visit me in recovery and Aunt Kristin joined her shortly after. I had woken up a few minutes before Mommy arrived to see me and I was fighting! The nurses had put pillows all around the crib to keep me from huring myself. They had given me some anti nausea meds which have the side effect of knocking me out so I was down for the count. After watching me sleep for a good hour, Aunt Kristin went home and Mommy kept watch. Now apparently most children gradually wake up after anesthesia but not me. Out of nowhere, I sat straight up in bed and was ready to go. No grogginess or whining - just wanted to get dressed and leave. And about five minutes later that is just what we did. Mommy called Daddy on the phone on the ride home and I was laughing from the car seat as if I had just spent a day playing at the park - not having serious dental work! I got home and was content to watch Caillou in between irritating the dogs before Daddy got home. I hadn't had much time to say hi before Aunt Kristin, Uncle Lonnie and Jackson came to check on me. Jackson and I spent the next few hours chasing each other around the house, climibing the stairs and jumping on the bed - Mommy never knew children's Tylenol was so good - she might have to have some herself! After all that exercise, it still took me quite a while to fall asleep but I finally did. Mommy and Daddy will keep up the pain meds every 3 hours through the night to keep my pain under control. And tomorrow they will get back on the horse and start brushing my teeth again. None of us like this nightly ritual because I cry and fight and have to be held down but brush they will. I don't have many baby teeth left so here's hoping I keep the rest of them for awhile.

Peyton Nicole Smith