One thing that is increasingly clear in this adventure of raising a heart kiddo is this: nothing is as simple as you think it's going to be. We took Luke in for a routine dental exam three weeks ago, after Luke had complained one night about his molar hurting. This was at our family's dentist and the verdict was two cavities and a crack in the sore molar.
Dr. E. referred us to a pediatric dentist, whom we saw a few days later. This dentist, Dr. O., after examining Luke, felt like that cracked molar actually needed to be pulled as well as the cavities filled. This dentist wanted to be extra cautious, so recommended general anesthesia, which he could do in his office.
Bleh. Through tears, I scheduled that appointment and then put in a call to Dr. Stefanelli, Luke's cardiologist. "No way" was basically his response. No way was he okay with putting Luke under outside of our hospital, without a cardiac anesthesiologist present.
That left us at square one, since Dr. O. does not work out of our local children's hospital, Mary Bridge. We got a referral to another pediatric dentist with privileges at Mary Bridge, Dr. B. Two weeks ago, we went to his office for another exam — yes, that's three already! After looking in Luke's mouth, this doc had a different plan of action in mind. He agreed that Luke should undergo general anesthesia, but didn't think his tooth needed to be pulled. What he wanted to do was put caps on all Luke's molars so that in the next eight years, we wouldn't have to worry about any more cavities in his baby teeth. His thought process was that we don't want Luke under general anesthesia any more than we have to, so let's do this one time and one time only.
Okay. Plan B sounded good to us. We left there with a tentative date in early September for Luke's surgery.
Then, then, we got a phone call from a friend who knew our situation and who also worked in the pediatric dentistry field several years ago. She wanted us to know that she thought we should get a second (actually, third at this point) opinion because she didn't fully trust this Dr. B. Although this complicated matters even more, we felt like we had to get another opinion.
So on to Dr. Beck's office. After examining Luke, he suggested we try to fill the two cavities in office with the help of nitric oxide to relax Luke. This wasn't even on the table at the other's two offices, so we were excited to explore this option. The positive to this plan was — and a big one — that Luke wouldn't have to be under general anesthesia in a hospital O.R. The negative was that if Luke freaked out, we would have to stop the procedure and schedule the O.R. for another date. At this point, we wanted Dr. Stefanelli back in the conversation to help us make the decision. Was nitric oxide safe for Luke? Was this a stable enough environment if Luke were to de-sat?
This is the point in the story where I blather on about how much I love and appreciate Dr. Stefanelli. He understands that with Luke, and many of his patients, it all comes back to the heart. Decisions can't be made apart from a cardiac standpoint. He was completely a part of this decision and I trust him implicitly.
Yesterday, he and Dr. Beck talked. The decision was made to go ahead and get Luke scheduled through the hospital and not even attempt the procedure in-office. A piece of me was disappointed, but of course I want Luke in the safest environment possible, even though it means a day at the hospital.
So I had a little disappointment to work through, but also a little anger. Anger at his heart defect that complicates his little life, that makes things bigger than need be.
But he will be in the best hands at the hospital and he will get his teeth fixed and we will move on, hopefully cavity free!