Monday, June 6, 2016

My sons' teeth and lungs

Last Thursday was the last day of school for my boys -- the last day of the Quaker Local School, in fact.  They'll be going back to public school next year.

On Friday, to celebrate their first day of "freedom", they visited the oral surgeon for their long-awaited wisdom tooth extraction.  Woo-hoo, right?  Because what could be better than starting summer vacation with anesthesia and chipmunk cheeks?

N-son went first, because his teeth were the worst.  We'd had the x-rays confirming it for years; his wisdom teeth were coming "in" sideways, pointing at his other teeth, not up or down.  Yuckers.  The oral surgeons knocked him out, got out their jackhammers and TNT, and opened up new spaces in his jaw.

N-son is no stranger to orthodontic intervention.  Even before he had braces, his orthodontist had me choose between nightly headgear and a more substantial (scary looking) piece of equipment called a "Herbst Appliance".   We chose the Herbst Appliance, mostly because I knew my son's propensity for breaking things, and I knew the headgear didn't stand a chance of lasting.  The Herbst gets bolted to the inside of your (kid's) mouth, and is virtually unbreakable.  Which is why N-son only broke it three or so times, each time much to the bewilderment of his orthodontists.  Yeah.

So when N-son had the oral surgeons digging foxholes in his jaw, they warned us he'd be in some pretty significant post-operative pain.  Fortunately, we discovered that a kid who can crumple Herbst appliances in a single bound (to mix metaphors) has a fairly high pain threshold.  He was on Vicodin (generic) for a day and a half, but since then he's been on nothing stronger than tylenol (also generic).   So, all went much more smoothly than expected.

J-son, with the much more straightforward extraction, was second.  The anesthesiologist put him out, numbed his mouth, . . . and then woke him back up as fast as they could without touching his mouth.  Because apparently his oxygen level had plummeted to disturbingly low levels.  (Actual description to my husband:  "If this had been an emergency, we would have put him in an ambulance, but it wasn't yet an emergency."  This was delivered to my husband over J-son's catatonic, drooling body, and was not particularly comforting at the time.)

Apparently, J-son reacted to the anesthesia like a morbidly obese patient or like an extremely elderly patient.  The oral surgeon said, "his general level of high fitness might be masking the fact that he has a serious medical problem."  He hinted at sickle cell anemia, at the same time noting that it didn't fit with the rest of J-son's profile.  (I looked it up:  pain and lethargy.  No, "lethargy" doesn't describe this kid at all.)  After a weekend of waiting for the test results, we were greeted with an old, familiar diagnosis:  weak lungs.  We knew about this when we adopted J-son, and we thought he'd outgrown this.  But apparently he's just out-exercised his apparent need for his inhaler, and not the underlying condition.  He's back on his albuterol inhaler twice a day now, possibly moving to a non-steroid inhaler in the future.

So, we'll reschedule the oral surgery, with a different kind of anesthesia, once J-son has been on the inhaler for about a week.  Do we need a medical warning bracelet?  Or notes in his medical file?  We don't know; those are the next questions we'll get to ask.

In the meanwhile, J-son is still boxing, training harder than ever, and looking amazingly good. Who'd  have thought that J-son would have the harder time with his teeth, or that N-son's tooth removal (dreaded for several years now) would go so smoothly?

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