Monday, January 27, 2014

Anxiety, Medication and the Dentist

Today is attempt three at getting a dental exam for my 9 year old, attempt THREE. Last year he was able to open his mouth enough so that the dentist could see two cavities, this was enough to qualify for sedation dentistry where one cavity was filled, one baby tooth was extracted, he received a full cleaning and a full set of X-rays. Pre-Op proved more traumatic than Post-Op and we considered this a success (with the qualification that there were no other options and given that, it turned out okay).

Fast forward six months and its time for another check-up. Full meltdown. He sat in the chair very briefly and put his head back and we left it at that. Second attempt went a little better, he opened his mouth and let the doctor look but it took 45 minutes, lots of screaming and calming and screaming again. The roller coaster left us both exhausted.

There's no question his anxiety is getting worse over time. We are working on it with a behavioral psychologist. From what I can tell, known issues are worse than un-known ones. He is curious enough to want to try something once, even if it is cautiously. It's the follow-up and repeat instance where he knows enough to make it bigger, more stressful, scarier in his mind. Its fighting against a known fear which, even exaggerated, is extremely difficult.

Tell me to stop being afraid of spiders. Tell me to stop worrying about things I cannot control.
Stop being afraid of spiders (or earthquakes or the vastness of outer space). 
Nope, can't do it. It would be easier to stop breathing.

So this is what I have, the tools at my disposal, going in to the dentist office:

  • me
  • my voice
  • unconditional love
  • noise canceling headphones
  • a sleep mask that looks like robot eyes
  • a dentist I like and trust
  • medical and dental insurance
  • unconditional love (its worth repeating)
And a new tool that has been added is a prescription in his name for 2mg extended release of Xanax. 

Believe me when I tell you that there is no part of my brain, heart and body that wants to give him this pill but as much as I do not want to, more powerful is the desire to help him in his fight against his fear and his anxiety. 

If you are a parent of a child with anxiety, irrational fears and Autism, I have no doubt that you have had to do a safe restraint on your child to complete an important blood draw or so that the doctor could complete an exam to identify an ear infection or strep throat. I know that you closed your eyes and willed the doctor or phlebotomist to hurry, to finish before you lost strength yourself. Because you know that you can only hold your thrashing and screaming child for so long, you can only hear them yell "PLEASE!!! STOP!!!" for just a second more before your own heart will shatter and you will let go. But you know, you hold tight because it will be over faster if you do, your child will be safer if you are the one doing it, you will stay just outside yourself long enough to get it done and then you will kneel before your baby and hold him, kiss away his tears, tell him you had no choice, apologize again and again, tell him that you love him and you are proud of him. You will snarl at anyone to tries to separate you before you are both calm enough to go back into the world. 

Then you will call your doctor and beg them for something to help your child cope with situations like this and you will receive a prescription for Xanax and you will be terrified to give it to him but you will be more terrified to not. As Mom there is no pain, worry or hurt I wouldn't put upon myself to help my child. Today I am adding a new tool to my toolbox, I'm going to try and take his anxiety and fear burden and add it to my own fear and anxiety of the appointment and my fear and anxiety of giving him Xanax. It is my most fervent wish that it helps him, that the appointment goes quickly so that we can put it behind us and grow from the experience. Maybe over time and with enough positive experiences, the Xanax will no longer be necessary. That will be a very good day indeed.   

Always know that these decisions should not be taken lightly and with much consideration by both you and your doctor. It is illegal to give your child medication that is not prescribed to him/her by a licensed practitioner, doing so can put your child's life at risk. 

1 comment:

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