On Her Own...

Yesterday Hannah had her 6 month check-up at our family dentist. She did fine, as usual (we spent several years brainwashing her when she was little, so she really likes the dentist now). The dentist did find a cavity though. Hannah has deep fissures in her back teeth, and they are perfect places for cavities to grow. All of her molars have sealants, but her bicuspids don't. This cavity was in her right top bicuspid.

On our way home we talked about what a cavity is, how it grows and how to remove it. I told her about the shot, and the noises she'd hear from the tools the doctor would use, and how they'd feel in her mouth.

So this morning we went back for the filling (and getting sealants on her 12-year molars). We were in the waiting room for a bit, then the assistant came to get Hannah. I have always gone with her in the past, but lately I've given her the option of going alone. Today she decided to go by herself!

I sat in the waiting room eavesdropping (it's a small office). I heard her chatting about Narnia, so I knew she was comfortable (I've been reading The Magician's Nephew to her). Then all was quiet. So I went to take a peek. She was just getting her shot. I couldn't see her head, but her hands were relaxed and calm (I always have white knuckles when I get dental shots or drilling). She remained calm through the entire procedure! The staff could barely believe it (me too!). She came out happy, without any stress at all.

My favorite part was when we were driving home. She was being silly--her mouth felt funny from the numbing medicine. She said, "Hey! DumDum! Give me some Numb Numb!!!" (If you've never seen the movie Night at the Museum, this won't make sense.)

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Soon after we got home, Kate called from Jordan! Yay! She was traveling near Petra over the weekend, so she couldn't call until today. She sounded great! She is tiring of pita and hummus. And she will be switching host families. Her new family does not have hot water...hmmm. We'll see how that works out! But she only has a month left of training.

Tomorrow her group will be meeting the US Ambassador. She is excited about that. I told her that if the Ambassador isn't prompt enough she should say, "If this is a consular building, then WHERE is the Ambassador???" (a la Star Wars).

She feels like she's been away for six months, but it's been just less than a month!

She has had the opportunity to meet with other Peace Corps Volunteers who have been in Jordan for a year or more. This weekend she went to visit a volunteer who helps young adult women with disabilities with job training. They are sewing and knitting. Kate commissioned a knitted hat for Hannah, made by a woman with Down syndrome!

Last week she got to go to a field day to meet some students in another area of Jordan--she was happy to be with her peeps!

I'm sure once she gets through her training she is going to have so much fun with her students!

The Last Baby Tooth

Surgery went well. She's still a little loopy from the Versed, and doesn't understand why her mouth isn't working right (novocaine--or whatever derivative they are using these days). She was great for the doctor. It was short and sweet.

Of course, Hannah likes to wear her scrubs and lab coat when she has any kind of "procedure". She likes to blend in with the staff I guess!

I didn't take an "after" picture, but she looked about the same, except for being pale and having gauze hanging out of her mouth! And maybe no smile.

Anticipating a quiet day at home. I've got a 1/2 bushel of peaches to slice and dice for the freezer. I guess I'll do that in front of the TV while Hannah watches Chitty Chitty Bang Bang.

Thanks for your well wishes!

Orthodontist

When Hannah was little she detested the dentist. We worked very hard with "playing dentist" to get her more comfortable with strange masked people and power tools in her mouth. It was a resounding success, and now she loves the dentist--she even wanted me to make a movie of her recent dental visit.  I'll spare you that, only giving you a quick visual aid.

It kind of looks like she's got wide scared eyes, 

but really she's concentrating on listening to what they hygenist is telling her.

Last week we had a regular dental check-up and discovered several things about her mouth. The first, and most surprising to me, was that all four of her 12 year molars have erupted. She just turned 11!

The second is that she is missing 3 adult teeth, all are premolars, two bottom ones and the upper right. (James is also missing some of these permanent teeth, but his baby teeth are still doing the job.) (So I'm blaming him.) (And he's just glad to see that she's following in his footsteps. A proud moment in every parent's life.)

The third is that her left canine and premolar are impacted. She had her upper canines pulled when she was 7 or 8 to reduce crowding, and the left one has never come in. That's because it's sideways, laying flat on top of her bicuspid. And so is the premolar.

I'm a little miffed that we didn't know this earlier....it's not like the girl hasn't been to the dentist and had x-rays before. It's not this dentist's fault, this was only our 2nd visit with him (and I don't really know if it's anyone's fault, but I think someone could have noticed missing tooth development from bitewing x-rays). I had been asking about this canine tooth for a few years now (don't forget, we move frequently, so I've had plenty of opportunity to get varying opinions). I've also been asking about braces for a while. The answer always was, "After she's done loosing teeth." Of course, she wasn't loosing teeth because there aren't any to push the deciduous teeth out!

Anyhow, off we are sent for an orthodontist consultation. Yesterday was the day. I've had two kids with braces already, so I know the drill pretty well. And Hannah had two ortho consults before they pulled the upper canines years ago due to crowding.

I should have known--the warning signs were there. When I called to set the appointment I asked if Dr K. had many patients with special needs. The answer was, "Umm, no, not too many, really." So I went on to mention that Hannah has Down syndrome, but she would be a cooperative patient.

So we arrived, and I signed her in while she was looking at the elaborate patient-funded salt water aquarium and computer gaming set-up in the waiting room (Playstation, X-Box, and something else....I don't know because we have never touched those). Can you believe there was not a single book or child-appropriate magazine in the whole place?   The receptionist got up from her post and came around to personally meet Hannah. With a hug. Ewww. That always creeps me out. Then, said receptionist turned to me and syrupily said, "She's just precious." (Don't forget we live in the South, and depending on inflection "precious" does not necessarily mean "precious". This particular "precious" had ambiguous inflection. I chose to interpret the entire thing as a woman thinking this was the right thing to do with a "retarded child". She must have seen footage of the Special Olympics in the late 1970s or something.)  I gave her a blank stare and asked if there was paperwork to fill out.

**An aside--as if you're not used to me going off on a tangent**
We have always stopped Hannah from inappropriately hugging people--those who are not close friends or family. It was difficult when she was an adorable toddler who would latch on to anyone's pants' leg if they so much as stood near her. It was awkward for all involved when I'd stop her in mid-hug and say, "Hannah, loook up at this person. Do you know this person? No. He is a stranger. You cannot hug strangers." Of course the person would say, "Oh no, she's just fine--she's adorable." Then I'd have to nicely say, "Thank you, I'm sorry, but she needs to learn proper social boundaries."

Also, our kids with Ds spend a lot of time in physical and occupational therapy. This means that adults are touching their bodies, in many places, on a regular basis, generally without asking permission. It is hard to learn what is an appropriate touch and what is not when there are mixed messages about who can touch and who can't.

**End of tangent**

So, I figured that if we were going to use this orthodonist I'd need to do some educating of the staff. Especially when the assistant also hugged Hannah on the way back to get pictures of her mouth.

At least the doctor did not hug her, but maybe that was because Hannah was reclining in the chair by then. It was all high tech, and gave me the feeling that they were trying to entertain us, rather than getting to know us.

Omitting boring details of the exam, Dr. K's opinion was that we could leave in the baby teeth and she'd probably need oral surgery to extract a tooth or two so they could access the impacted teeth. Braces now, as well, and we can take the molds right now too! All for the affordable sum of $4900! What a deal! I could have my child's personal space invaded as a bonus! And a free t-shirt! Throw in some condescension, and it seems to be a bargain I can resist.

I was not feelin' the love nor liking the sales technique. We're not going back. It's time for a second, third or fourth opinion. I don't disagree with the plan of care, but we need an office that understands that Hannah just needs a little more time and patience--not a circus of revolving faces and equipment.

I've asked for recommendations from our local Down syndrome goup, and hopefully we'll find a good match--someone who will take the time to explain things to Hannah.   I want someone who will respect Hannah.  And respect my input.

***ADDENDUM***

I called our dentist and said that I didn't think Dr K was a good fit for us.  He gave me two more names, one he highly recommended.  He didn't give me this name at first because the office is about 20-25 minutes away (near Courthouse and Midlo, for the local among you), and he didn't want to make us drive extra distance.   I am hopeful about this one--he's had oral surgery training as well, plus he did extra training for special needs individuals.

 

Ophthalmology today

We had a 4+ hour visit with Hannah's new ophthalmologist today. I like Dr. Carothers, and so did Hannah. He was very thorough, as was his assistant. The good news is that her cataracts are stable and have not grown! There were some concerns as to whether Hannah was showing some latent amblyopia, but he was able to rule it out, so that was good as well. She just has plain old low muscle tone in her eyes.

(click on the picture get get a better view of the questionable eye)

Hannah has latent nystagmus (shifty eyes! I bet you can't trust a kid with shifty eyes-they probably sneak Halloween candy into their rooms!), which is not a big problem. She does have some significant hyperopia; she's quite farsighted. Her new prescription will have bifocals. I am quite pleased because I have been thinking about bifocals for her for quite a while, and Dr. Carothers brought it up without my input. (See, sometimes I do keep my mouth shut in a doctor's office. Who'd believe that??)

We'll probably make the journey down to Newport News where I know they carry the new Specs4Us frames. It is very important for Hannah's frames to fit correctly, without any sliding down the nose, so she can have optimal use of the bifocals. Wendy just had Carley fitted with Specs4Us and loved the fit. Kids with Down syndrome tend to have flatter profiles than typical children, and the bridge of the nose is usually close to non-existent. Add in low-set, small ears, and it's difficult to make mainstream frames fit. It takes someone who really understands the nuances of the Ds bone structure to adjust frames to fit well.

I am hoping that the bifocals will help her be more comfortable with smaller fonts in chapter books. Right now she limits her pleasure reading to picture books (Level 3 or 4) because the fonts are larger. She does read easy chapter books (Flat Stanley, Magic Tree House, etc), but it is considerably more work for both her eyes and her reading skills, so we do that during school time when I can encourage her.

We had to scurry after the appointment because the dentist was awaiting at 2:00 today as well! This was a new-to-Hannah dentist. Our first try with the "recommended" dentist for Hannah left a sour taste in my mouth. So now, for the first time, she is going to our regular family dentist. She LOVES going to the dentist. I think they are going to offer her a paid position when she's old enough--she was such an ambassador in the waiting room! You'd think that her complimentary toothbrush was gold-plated--she treasures it so! "Oh! Thank you so much! I like this new toothbrush. Mom? Can I use it tonight? It's so nice!" (Or, maybe she thought a "complimentary" toothbrush meant she was supposed to use compliments???)

Her teeth are terrific. She has just four deciduous teeth left to lose, then she can get braces. "Just like my friend Amelia."

Tomorrow we are off on a field trip to hear the Richmond Symphony with the Girls' Group+brothers. Maybe I can pay Amelia to convince Hannah braces are fun?