James’ Dental Surgery – The Outcomes

It was a day I hadn’t been looking forward to and I was dreading what the outcome would be. I was especially worried that it was going to be tough on James but he coped remarkably well.

It’s always difficult with James when going for appointments because whilst you have to anticipate you may run into traffic on your journey and be mindful of not being late, you also don’t want to arrive too early as then waiting too long can be stressful for him. Having arrived at the hospital in plenty of time though James was happy to look at a book with me while Darryl looked for James’ staff who were meeting us there.

The dental team called me as arranged and came down to take James and his entourage to the day surgery unit. From there it was a case of meeting all the team who were going to be looking after James, including the dentists and the anaesthetist. We had the whole department to ourselves which was great, the special care dental team have this arrangement to make it less stressful for their patients with additional needs and their families.

The anaesthetist wanted to check James over as he had a cough that had developed a few days before. James refused to take his hoodie off but willingly lifted it up for her to listen to his chest. His chest was clear and she wasn’t at all concerned about his cough. Phew!

Would The Sedative Work?

James’ dentist and I had discussed previously that I would bring James’ gastrostomy extension tube and syringes with me so that we could administer some pre-med this way. Having given James his pre-med, a trolley to take him to theatre was brought out with the intention of getting James to lay on it go to sleep. Now call me a sceptic but I wasn’t sure the sedation was even going to work never mind actually getting him to lay on the trolley. Other forms of sedation have failed previously.

James wandered around and when his eyes started to look heavy, we were able to persuade him to sit on the trolley with me and look at a book. He put up very little resistance. Just a few minutes later, as he could barely keep his eyes open, we tried to get him to lay back, he resisted so I laid with him. Sure enough a few minutes later he was fast asleep. So far so good.

Darryl and I went to theatre with James and once they were sure he wasn’t going to wake up they told us to say our goodbyes. Doesn’t matter how many times you do that; it never gets any easier.

It was then a waiting game. A really important part of the process while James was under general anaesthetic was to get bloods taken. I had brought the forms and blood bottles from the GP. Within a very short time they appeared with the bloods done and popped them into the chute that takes them directly to the hospital phlebotomy department.   

An hour and a half later one of the dentists came out to give us an update. Having taken x-rays they were able to see that James had some gum disease, most likely caused by his lack of good dental care (his reluctance to open his mouth is such that the effectiveness of our brushing is very limited). As a result of this 3 teeth needed to be extracted. Fortunately, these were all first teeth so not deeply rooted. Also, they were all at the top and back, 2 on the left and 1 on the right, so extracting these was unlikely to affect James. They had also been able to remove a considerable amount of plaque and much to my relief none of his remaining teeth broke during the process which had been a real concern.

James Was Reluctant To Wake Up

It was another hour before we were called into recovery – James was having a lovely deep sleep. It took some time and a lot of cajoling from us for him to wake up fully. Once the staff were happy, James was transferred to a wheelchair and wheeled down to our car and we set off back to our house. He was a little unsteady on his feet at first so we got him sat at the table where he wanted to do puzzles and there he stayed. I managed to clean him up a bit as he was rather bloody around his mouth and he had a drink. He also managed to eat some rice pudding. He’d had so much pain relief at the hospital he wasn’t due any more for several hours. 

James stayed with us for the rest of the afternoon and then we took him home. I was a bit anxious about leaving him but he appeared well and quite happy. He was also with staff who know him very well and as he has waking night staff they would be able to monitor him very closely. Personally, I was shattered too having been up with James late the night before and again very early that morning. I knew his staff would call me if there were any concerns and I did check the care control app several times that night!

As advised by the hospital James was given regular pain relief for the first 48 hours as the likelihood was that everything was going to be feeling a bit tender and sensitive. In all honesty he showed no signs of discomfort so we were able to reduce his pain relief very quickly after that. His staff were particularly careful regarding his diet, making sure everything was nice and soft. Also brushing his teeth was left until the next evening and then only commenced with great care.

Two days later James’ GP rang me with his blood results. Essentially everything was normal, nothing concerning at all. His kidney function is at 85%. I was disappointed but not surprised to hear it is that low but the GP reassured me that I wasn’t to be overly concerned about this as they also checked his creatine levels and they are stable based upon those taken in 2016. 

James was an absolute star; he was so good on the day of surgery and the following day he had a chilled-out day at home. By Monday he was back at day service like nothing had happened. I cannot fault the hospital staff who were so accommodating of James and his particular needs. Overall, thankfully a very positive outcome I am relieved to say.