Wednesday, October 15, 2008
Site Change in the Dentist Chair.....
Yesterday J.J. had his first dental appointment. I was anxious to see how his teeth were holding up after all the milk/juice he gets in the night to combat lows. Plus, a couple weeks ago, J.J. was eating ice when he came to us saying he had a loose front tooth. When I looked at the tooth it didn't seem like a "normal" loose tooth. Just seemed like the whole root was intact. Well, two days ago the tooth came out. Throughout this whole process there was no blood. Plus none of my children have naturally lost a tooth this young. So I was anxious to see the X-Rays.
Well.....diabetes decided to come to the forefront yesterday. He had been in the 200's the night before. Very odd for him. He was "scheduled" for a site change yesterday morning, but we had squeaked out one extra day on the previous site, so I thought I'd try to at least dose his breakfast and see where he landed. If he was still high I'd have to change his site.
What I wasn't planning on was him going sky-high. We had to pack lunches to eat in the car, and of course J.J. wanted to eat as soon as he got in the car. We weren't quite to the end of our lane when I hear, "MOM, HE'S 376!" WHAT?.......376!!!
Wow!! O.K...here I am about to drive an hour to the dentist and now I've got a potential site change situation. I decided to dose him with the pump and check him when we got to the dentist. As I began to pull out on the highway, I realized I might actually, truly, really have to do a site change at the dentist. I did a quick U-turn, and headed home to get all the supplies I would need.
When we get to the dentist he's 298. Not great, but coming down. I told my daughter, who was there to help, to check him in an hour since I was first to go back to get my teeth cleaned. If he was higher she needed to come back to me. Same or lower she could let it go.
I had really forgotten about the situation, when I felt someone watching. Yep, you guessed it. Then I hear, "Mom, he's 406." I took one look at him, and knew. He looked like he had the flu....I'll never forget those "looks" when he's high. Anyway... the instructor had just shown up to check the hygienist's work....she offered to come back...but I said "no, way...you stay here."(It takes a bit for the instructors to make their rounds, so I didn't want her to leave!) I asked them for a plastic cup and sent J.J. to the bathroom to check ketones. Thankfully they were negative.
After the instructor left. I decided I couldn't trust the site anymore. I dosed for the high with a syringe. Then straddling the dentist chair I used it for my "work table." I changed the site right there. It was actually the most discreet place I could do it, since we were tucked way back in the corner of the room. For some odd reason I remained pretty calm. The only thing was trying to remember it all while being "under pressure". I was somewhat disorganized, and the hygienist seemed a little nervous, but J.J. was taking it all in stride. She told me later that it was cool to see him so calm, like he was saying "Just chill everyone. I do this all the time."
I had my daughter check his blood before it was his turn to get his teeth checked. He had come down to 345 in 45 minutes. It dawned on me then that our insulin was probably at the end of it's potency life. So I really had quite a few things stacked against me. A bad site......old insulin.....and his nervousness of going to the dentist for the first time. What a combination!! Thankfully about dinnertime his numbers were back to normal.....where they've remained until now.
As a side thought in all of this.....I'm coming to realize more and more how misinformed or clueless people are about Type 1 diabetes. I mean I KNOW I was clueless before his diagnosis, so I must learn to be patient. But at the same time, it's a little sad. I wish more people knew.
The hygienist who worked on J.J. read the form I filled out. They had questions like.... has he been treated in the hospital the past 2 years....using any medications.....under the supervision of a doctor.....etc. So I answer he's been diagnosed with type 1, under supervision of an endo, and taking insulin to control his diabetes. The hygienist comes to ask me about these answers, and to get my consent for treatment. It was so apparent she was clueless. She asked me how J.J. took his insulin? I said "He has on insulin pump." She said "Oh, is it in pill form?" I didn't bother to really respond to that....I just stated again that he's on an insulin pump.
Now, by this time I've already changed his site and my hygienist is trying to help me answer the questions, but you could tell J.J.'s hygienist was clueless. She asked how long he would be needing treatment and if he's controlling it, etc. etc. Ummm.....let's see.....today it's not so "controlled", and what exactly does control mean in a type 1'er?.....I mean 400's doesn't seem like control to me, if I were thinking of a non-diabetic, but in the sense that I stopped him from going to the hospital I'd say he was "controlled" today. And the answer to how long.....UNTIL HE DIES!!! Anymore questions????
She walked away......still......
P.S.....If anyone was wondering about that lost tooth....NaTuRaL!!! Although I question the dentist. She only took bitewings....not the front teeth. I really wanted to see the film for those front teeth. If a new tooth doesn't emerge here in the next month I'm thinking this dentist was....