Long night’s journey into day…and then the dentist…

What woke us up was the loud thumping.  It came from the other side of the top floor and it jarred us out of our slumber.  THUNK THUNK STOMP STOMP PHWUMP PHWUMP.  It was in such quick succession that I was bolt upright on the bed as soon as the first THUNK could be heard, and by the time I “landed” from my disorientation, we were on the second STOMP and got to witness firsthand both PHWUMPs.  It was 2:00 a.m.  J was -quite obviously- NOT happy.

During the ensuing tantrum (conducted everywhere from the toilet to the hallway to J’s bed,) Dada and I kept looking at each other and thinking (as we both admitted later) “not again, please.  Not THIS again!”  For all intents and purposes, we were back in the middle of a circa 2010 tantrum, with J howling, growling, gnashing teeth and hitting himself (fist on fist, fist on forehead, fist on knees, fist on feet) with gusto.

A while ago, while having lunch, Dada and I agreed it was all too eerily familiar and all too sad, and that we both felt like crying.  TGG, who had rolled out of bed during the last PHWUMP, had the wide-eyed look of one who is having a scary flashback.  Trying to establish eye contact with J was proving difficult and, no matter which side we approached him from, we were in the line of fire (people have sore fingers and hands in the aftermath) and incapable of establishing a line of communication with J.

When we finally got him to respond to us rather than to his desire to pummel his forehead in with his fists, he used the Proloquo to tell us he was in pain.  Then he told us his ears ached (possibly because that’s where he was feeling it most) and then said his tooth ached, too.

This was the worst news possible, of course, but we were buoyed by the fact that our J, at long last, was putting in an effort to tell us WHY he was so upset.  I don’t think I can properly describe the joy we felt when this happened.  To anyone who has never experienced being constantly locked out of their child’s mind because of Autism, our description would seem excessive, too melodramatic, too…much.

If I tell you that we were walking around, smiling from ear to ear while tripping over ourselves to find something for the pain, and saying “his tooth hurts!  He is in PAIN!” you might understand.  An outsider, someone who has never had to guess why their child (who is far from a baby or pre-verbal toddler) is screaming and kicking and biting and hitting and lashing out because they don’t have WORDS…well, they might not find our joy mingled with concern funny or heartwarming.  People who have never experienced the isolation of silence and Autism will probably peg us for lunatics who are into some sort of dental sadomasochism.

We gave him something for the pain, and J started calming down.  By then it was half-past two.  After a quick search of the dentist’s website, we agreed that at 6 a.m. I would call the bus ladies and tell them J would be skipping school today.  With this thought in mind, we all climbed into our beds and tried to wind down.  (Laughing at people who still hope they will be able to wind down after such an experience is not nice.  The situation IS ridiculous, but laughing is not nice.)

On went the hallway light, and again J was in the bathroom.  Not pounding or screaming or acting out, but awake and alert in ways that are impossible to fathom at that hour.  I got up and found him, calmer, but still agitated in a quiet way.  He insisted that I put away the dosage cup for the medication we’d given him, that I move a towel that had been left on the counter (a complaint I am constantly offering to anyone who will lend an ear,) and generally anxious.  I talked him into going back to bed, and he crawled under the covers and bid me adieu.

No sooner had I settled back into my bed, alert and awake in ways that are just plain wrong for that time of morning, than the light in the hallway went on again.  Once more I fished for the sweater and climbed out of bed.  As I lifted my glasses to my eyes while asking “what’s up, Pumpkin?,” I saw that J was holding the towel he’d been pointing to earlier.  It was wadded up into a ball, and he was going for the laundry basket.  I looked more closely and noticed he’d thrown up on his bed; he didn’t make an obvious mess, but all the water he’d been chugging down since he got up in the middle of the night had come out in a gush.

The second most powerful call of alarm in this household is “he threw up!”  Bodies emerge from under blankets, corners, rocks; people come armed with our beloved “barf bowl,” baby wipes, laundry baskets.  J, unprompted and calmly, had set in motion the protocol for the situation at hand.  It was 3 a.m. by the time we had a load of laundry going, J’s bed freshly made and a bag of ice (ok, a ziploc bag with ice inside an old, but clean, sock) on the area that was hurting.  While one of us manned the bag of ice, the other called the dental emergency line.  It was best to wait until the urgent dental care opened in the morning because at the ER all they would do was give him pain medication.  This didn’t sound like a viable alternative for us so we sent TGG to bed and sat up with J.

Little by little, J started calming down and relaxing.  At first he asked for us to give him something for the pain, but we explained that we could not give him anything more, that one doesn’t take more simply because one vomited what was given earlier.  The ice, we explained, was to help with the discomfort.  Grumbling, but he accepted this dictum and we settled down on his bed for an uncomfortable wait until 6 a.m.

A pattern for comfort was soon established: J would wait until Dada and I had nestled in around him (one holding the ice bag, the other rubbing his leg to soothe him,) and then he would ask to go to the bathroom (because he did have an upset stomach that we are attributing to the anxiety caused by the pain,) then he’d wash his hands, climb back into bed, ask for a drink of water, get the ice pack in the right position, nearly doze off and start all over again.  By the time six a.m. rolled around, J was doing this with an ear-to-ear smile and a giggle.

The wait at the urgent dental care clinic was more of an ordeal than all the preceding hours.  I think the anxiety J felt, the children running around uncontrollably and all the toothless people surrounding us made for an excruciating hour or so.  J asked to go to the bathroom six times, to drink water three and to leave for home at least 20.  We told him he had to wait for the doctor to look at his tooth.

The quarters into which we were led were extremely cramped, and we had to have X-rays taken twice.  The news was not good, and we were given three options: do nothing (which they are required by law to mention,) a root canal and crown, and extraction.  Doing nothing, obviously, was not a viable option.  So we asked about the root canal and the extraction.  The root canal would be ONE appointment, and the crown ANOTHER.  It would have added to about four hours of treatment.  The extraction would be done by a surgeon (not a student, thank goodness,) and would be quick.  The questions we had to ask ourselves were not quite simple: could J live without the molar in the farthest recesses of his mouth or could J live with having to have treatment possibly repeated a few months down the line.

Looking at J’s anxious face, the decision was simple: in the cramped quarters of the urgent dental care unit at a teaching hospital was not the most comfortable or soothing place for him.  Having to repeat the same treatment several times over before extraction became necessary, all Dada and I could agree with was that extraction was the best course for our dentist-phobic son.

From the small room (in which we felt like sardines and J kept asking to be sent home,) we were sent to the oral and maxillofacial surgery unit.  I skipped out to call J’s court-appointed attorney to explain that J’s treatment was necessary and that, in the absence of guardianship, we thought it was still the best thing to make this particular determination.  She agreed and said she knew we were thinking of J, and to let her know what happened.  As soon as I turned back towards the waiting room, J and Dada had disappeared into the recesses of the surgical office.  I cursed the crappy cell phone signal acquired through our dinky pay-as-you-go cell phone, and dashed back into the office.

Being the person waiting outside for news is not fun at all.  When J had his dental treatment done in hospital as an outpatient, both Dada and I had to wait.  The clock moves so slowly when news is expected!  I ended up waiting half an hour, and the verdict was simple: antibiotics until the morning of the 28th when the tooth will be extracted.  Dada tells me that they could’ve done it then and there, but they didn’t want to poke and probe too much with the infection in full swing.  J, in spite of his misgivings, had behaved beautifully.

And here we are, mid-afternoon on a Friday, watching a thin snowfall gathering half-heartedly outside the windows.  We are all tired.  We are all anxious.  We all know the map points to a long tunnel with an end to it, and we’re ready to head that way.  The antibiotic is disgusting; the liquid acetaminophen is worse.  Not much else we can do for now, just clear the path for the bulldozers, I guess.

What do we know now that we didn’t know a little over 12 hours ago?  That J really, really, really wants to let us know what he’s feeling.  He’s not just responding to the availability of a shiny new toy; he’s actually trying to tell us “hey!  I’m in HERE, and I have something to say…and I don’t need to scream anymore!!!”

It feels good…damn good, in fact.

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