Today is one of those days when the world is quite overwhelming.  There’s business responsibilities and family responsibilities and each one needs attention.  Collectively, though, they require more energy than I have.  Some of it is manageable and finite (work) and some of it is vast and unknown.  Often, if I ponder on a challenge in advance, the actual experience goes more smoothly because I’ve considered the many scenarios that could play out.  But new experiences with Nate are difficult to imagine so they’re a bit more anxiety provoking for me.

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There are two new Nate experiences coming up.  The first? On Monday, he’s going for his six-month dental cleaning. As you may recall, the dentist experience is quite overwhelming for Nate.  Our first appointment identified a cavity, which was remedied with Nate going under sedation in an operating room.  The second appointment was cavity-free but still required the horrific turn-your-child-upside-down-on-a-board moment while he’s kicking and screaming to get a look.  Our dentist, who specializes in working with kids on the spectrum, strongly suggested that we begin visiting their office weekly to desensitize Nate to the experience and, hopefully, put an end to traumatic visits.  Best part, they offer these weekly visits for free.  (Nothing related to autism is free–as if diagnosis comes with a windfall of cash–so this was a breath of fresh air!)

We’ve been going to the dentist’s office faithfully every week for the past six months – and we’ve gotten farther than I ever imagined.  Nate will let Ms. Colleen (his awesome hygienist, who always remembers that Nate wants a red balloon) count his teeth while wearing purple gloves, look at all his teeth with a mirror, and floss his teeth.  “Mister Thirsty” (that water sucking pick) has been to Nate’s lips without being attached to the machine.  We tried getting the plaque scraping thing into Nate’s mouth but that was a no-go; he flipped out and turned his head, which caused the pick to cut part of his lip and face.  (We won’t be trying that one for a while….) What we haven’t accomplished is getting the tooth polishing brush in his mouth.  One week, Nate loved the gritty fruit punch polish paste and ate a cup.  The next week (and every week since), he won’t go near it.  So while we’ve made strides, I know that his upcoming dental appointment won’t include some of the key elements, like a cleaning or fluoride treatment.

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Of course, 2014 had a lot of surprises and we haven’t been visiting the dentist as often as we usually do.  In the past six weeks, there were two snow days, one visit that I completely forgot, and one day when behavioral issues took priority over outside adventures. So, Nate’s out of practice….and his appointment is in three days.  Awesome.  

At our last appointment, Colleen and I talked it over.  We decided to keep the upcoming visit (which, now, we’ll likely need to cancel because of snow) but adjusted our expectations.  We know there won’t be a cleaning but we hope that the examination by Dr. D. is less traumatic.  Colleen gave me fluoride to take home and administer on Nate’s teeth in his sleep. I’ve decided to wait until after the dentist appointment. If they find an issue, Nate will need to go back to the O.R. where they can surely better apply fluoride than I can in Nate’s sleep.  If they don’t find an issue, then I’ll go ahead and manage this one on my own.  Nate wakes up when I cut his fingernails and hair while he’s sleeping so I anticipate a similar reaction with sticky fluoride on his teeth….

Left is Nate's first brace at age 3; right is Nate's 2nd SMO at age 4.

Left is Nate’s 1st SMO at age 3; right is Nate’s 2nd one at age 4.

The second? Nate’s pre-fabricated SMOs no longer meet his needs.  We started working with a new physical therapist, Kelly, who agrees that Nate still needs this extra support to build strength.  Unfortunately, the most recent pair of SMOs have been problematic.  At first, they made bright red marks on the top of Nate’s feet. Our orthotics specialist modified them to prevent the issue but, as Nate’s feet have grown, the issue’s back.  In fact, they’re causing blisters and bumps on the tops of his feet.  This isn’t good. The solution? Nate needs customized SMOs, which requires a cast be taken of each of his feet.  Nate can’t stand the feeling of a wet washcloth so I’m certain this is going to be a special occasion.  It’s just me taking Nate to the appointment.  I plan to be armed with Curious George on my iPhone and treats galore but I’ve also emailed Ms. Susie and Nate’s OT, Ms. Jen, for advice on how to help desensitize Nate fore the big day.

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And then there’s Pete, who ran out of Prozac and just wants to steal Nate’s hot dogs at dinner time.  I need to find time to go to the pharmacy….

That’s the skinny around here today.  Lots of big things that need to get tackled and not enough energy to do them….here’s hoping that the weekend will turn me right around.

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