Thursday, May 27, 2010

How Far Kenny Has Come...and How Quickly Someone Can Blow It

We headed out this morning for the 3+ hour drive to Glenwood Springs to visit Kenny's orthodontist. He ate an apple and lost a front bracket on his braces as well as the wire. Wanting to get it taken care of before surgery, we hustled to get an appointment and were on our way.

Upon our arrival, we were ushered in to the orthodontist's office for a quick consult, where he shared with us that he had just gotten off the phone with Shriner's, and it was requested that Kenny have 4 baby teeth pulled today in order to have time for healing for surgery. We knew it was possible he might have to have 2 pulled, but had been told they would do it during surgery, but after receiving copies of his latest xrays they decided 4 had to go in order to allow more tissue to use to try and close the palate again.

Dr. Johnson knows of Kenny's fears of procedures and handled it beautifully, presenting it as if Kenny had options, explaining everything, and explaining why it would be best to do it today so the surgery could go ahead as planned, I talked with Kenny and between us we decided he would go ahead with it, and I was so proud of his courage for what I know was a very intimidating and scary decision for him. He asked two or three times if they would give him the shots to numb it, as that was what he was more concerned about and if that would hurt. Dr. Johnson said they would have to leave that up to the dentist who shares his office space with him, and then he handed us over to the dentist to do his work. I explained to the dentist about Kenny's fears, and how we had to let Kenny lead on this. He was a young guy, kind of cocky and blew me off a little but I trust Dr. Johnson and knew he would pick someone good with kids to partner with him, so didn't worry too much.

Perhaps I should have...

We get into the back office area and they give Kenny nitrous to mellow him out and use the gel to numb his gums.. Kenny asks 3 or 4 times about the shots, and the dentist reassures him he won't need any becausde they are baby teeth and he is at the age they should be ready to come out and probably have very little root anyway. I am reading a People magazine, glancing up here or there as Kenny is so mellow there was no real concern and he was floating quite high :-) The next thing I hear is Kenny saying a quick "ouch" and the dentist saying "I am just wiggling that gel in there Kenny, no problem.". He and the nurse have their backs to me and at my angle I can not really see what is going on.

Then I see a needle being hidden down below Kenny's line of vision and I realize the dentist just lied to him, and continues to do so as he is injecting his gums again to numb them. I was livid, but also realized if I said anything at that moment Kenny would jerk up in a panic and was likely to get hurt so I decided to clamp my lips together and shut up for the moment, praying Kenny didn't catch on.

I was SO MAD!!! We have always promised Kenny we would be 100% honest about any medical procedure, and that when possible we would give him choices. This is a kid who has literally had pliers used on his teeth in the orphanage, and was also often not told about medical procedures until they were about to begin. His anxiety level with medical procedures is understandably high, and we have worked 3 years to gain his trust that Mom and Dad will always tell the truth, even if the truth isn't pretty. We have made great strides in this time, and it is because Kenny knows he can always trust us to give him the straight when we tell him these days that something really won't hurt much at all, he is able to calm himself significantly based upon that trust in us, where before he would flip out over everything because he didn't believe what anyone told him.

Thankfully, Kenny did not figure it out during the procedure, and within a half an hour all 4 teeth were pulled.

I was going to have a little chat with the dentist to express my displeasure, but before I could he starts pounding on me about 2 of Kenny's bottom molars that have the beginnings of cavities in them and need to have fillings. I explained to him that we were not expecting this procedure today which was quite expensive, and were not prepared to deal with the other financially for a bit but would get to it. He continued and pushed and made me feel like a totally rotten and neglectful mother because I was not willing to do the work today or schedule an appointment to do so. I explained to him that we had 5 kids, 2 new to us that also needed significant dental work and that was going to have to come first...and the truth is that Kenny's are not full fledged cavities yet and this is more preventative than it is medically necessary. Sure I'd love to catch it right now at this stage, but we have to prioritize and Angela's crown has to come first, as does Olesya's chipped front tooth that bothers her tremendously. We are working on getting these things taken care of now. I couldn't believe I was actually sitting there justifying to this guy who had just lied to my son why I was not going to get a procedure done right then. I might add that his price was $563 for two minor fillings. We have not had to fill any cavities yet on any of our kids, but is this SERIOUSLY the going rate these days?? It felt more like I was trapped in a used car salesman's office being tortured until I gave in and purchased the extended warranty policy!!

I left the office fuming after refusing to sign a document outlining the costs for the fillings, which looked to me like it was essentially binding me financially to get it done.

Now, I know the reason he didn't want Kenny to know about the needle, and I understand he didn't want to deal with a child's fear if he didn't need to, but he should have consulted me before lying to Kenny. Kenny left with a false illusion that there is a way to do extractions without needles, and that needles hurt way worse than they actually do, as he experienced today. We were halfway home when he was talking to his siblings about it and explaining how they didn't even use a needle when I told him the truth, and why I had not intervened. I apologized profusely, told him that I promised him I would never lie about anything and I honestly hadn't known what was going on until it was too late, and then for his safety I made the decision to let the procedure continue since I knew it would not mean more pain for him. I asked his forgiveness for allowing this to happen, and told him I hoped he understood why I acted the way I did. I wanted him to understand that he HAD experienced the needles so that he could recognize that it really didn't hurt bad. Because he has years of ongoing difficult procedures, I wanted him to be confident knowing that he didn't need to panic in the future if a needle was required because he now knew it was all OK and wasn't that bad at all.

I then asked Kenny what he thought I should have done, what he might have done in my position. He thought about it a lot, and a few minutes later replied "Mommy, I think you did the right thing. I know you wouldn't want me to get hurt, and that had to be a very hard decision for you to make right then, especially when you were so mad. I don't think you lied to me, you were just protecting me from being more hurt. But that dentist is not a good man, he shouldn't have lied to you or me. I will never trust him now ever again." and I told him that neither would I and we would not see him again, that we only wanted to work with medical people whom we could trust.

You know, you work and work to gain a child's trust, to move past their very rational fears from their past, and after years of hard work someone can potentially blow it all up for you with one reckless action. I know many parents probably would have preferred the lie, they might even be happy that the work was done and their child was none the wiser. I also know many might shake their heads at my decision to reveal to Kenny what really happened, but honesty is honesty and I want him understanding how all of these procedures are nothing to be afraid of...and that Mom will always tell you the truth. The next procedure with the next dentist might require a needle and Kenny would still have a fear of it, and also a different expectation of what it all will feel like.

But I feel lousy tonight, I know I failed him and am kicking myself. I am also mad at myself for not standing up to the "medical guilt bullying" that was attempted to get me to agree to more costly procedures. I was embarrassed at the fact that we flat out couldn't afford to drop almost $1000 total at the dentist in one afternoon (Like who CAN without warning??? I know we sure aren't the only ones!) and wanted to "shop around" the fillings to see if we could find a lower fee, Why I was feeling embarrassed, I don't really understand, as part of our health care system problem is that many of us DON'T shop for services. I was upset and angry over the way the extractions were handled, and I slunk out of there feeling about 2 feet tall. Of course I called Dominick on the cell immediately to vent, but it didn't help much.
As usual though, Kenny was wonderfully understanding and insightful when at the and of our conversation he said "It can be really hard being a mom and knowing what decisions to make. I am glad you are the Mom, you always seem to make the right ones." Feels like quite undeserved trust tonight.


Kelly said...

My child just had a minor cavity filled on a back molar (an actual cavity and not the beginnings of one) and it cost $110. $563 for two fillings seems unusually high to me. I think you have to seriously question that dentist's character - lying to your child? high pressure sales on filling the beginning of a cavity? Sounds very self serving to me.....Even if the price was reasonable - it is an awful lot for a kid to go through in one day - 4 teeth pulled AND fillings. Don't let someone like that make you feel bad - don't give him that much power! I also think you absolutely did the right thing in being honest with Kenny. You have just helped set him up for success for the next dental procedure.

Janet said...


a dentist (who was recommended to me.....) tried to convince me to put 2 metal crowns on my dd's baby molars....I refused.....he was then rude to me....
Turns out (2nd opinion another dentist) that she only needed 2 quick small white fillings.
Kids are easy targets to get fast $$$$$$$$. I think whenever we feel 'pressured' or 'guilty' to make decisions on the spot, we need to see that as a warning sign. You did the right thing.

Anonymous said...

We are so conditioned to give blind trust to our health care providers that it is difficult to disagree without feeling the incredible pull of our old unquestioning trust. Kenny is correct. You made the right decision, and this is an incredibly wise kid partially because he is being raised by two thoughtful caring parents and is surrounded by caring siblings that reinforce his wisdom and compassion.


Anonymous said...

I'm sorry for your bad experience at the dentist. You've made the right decision not to deal with that "professional" again. Yikes!

I know the guilt from having an incident quickly get out of hand before you even have a chance to think. Years ago our oldest daughter had a bad experience with a pushy photographer. The next time we went for a family photo (another daughter had been added), we had another pushy photographer. Before I knew it, the situation was out of my control. He was making me feel guilty too, for having a uncooperative child. In reality, as can be seen on the resulting photo, she was just too terrified to move where he was asking her to move. Not sure why I ever bought the photo, as it brings back bad mother guilt for allowing a stranger to bully my family. I learned, though my daughter suffered that day. It was the last professional family photo we've had. I set my self-timer and jump in the photo once a year at Christmas now! I was so mad at myself. But in reality, those things can happen very quickly, and it's not until later that we see what we could have done differently. We learn and become more assertive for the sake of our kids.

Kenny knows the truth about you and your love for him and open relationship with him. That's the good that came from the bad situation.

We have a great dentist/orthodontist in our small town. He does great work and I think is fairly reasonable on cost. Though we owe him an arm and a leg from having six of our eight go through braces, he works with us on payments. He's replaced retainers at no cost (or his cost) and generally given us a deal. I was trying to teach one child responsibility, after she lost her second retainer by making her pay for it out of her savings. Drat it all, the guy didn't charge her! (kidding, as that was a blessing) He probably figures those costs into his charges to begin with. Still, I figure we could just about declare him as a dependent, but he's a great guy and the kids like him. Hope you find someone like that nearby.

Nancy in the Midwest

Anonymous said...

Oh, and our dentist has this sign posted in his office, "We cater to cowards". He knows I need the gas and the shots, plus a lot of calm talk to get me through procedures. Oh, and he also gives me one valium to take an hour ahead, if I'm having work done. I asked him once if he ever used placebos. Not with me, he wouldn't!

Just about the time we think we're getting caught up on our bill, it comes time for annual checkups for eight of us, or hubby and I need a root canal.

But like Kenny, I've also learned that it's never as bad as I imagine it's going to be. But... just in case...we take all precautions. I went through an episode of panic attacks many years ago. The first one came on in the dentist's chair, so hence my apprehensions.

Nancy in the Midwest

Ali said...

You might want to check out a dental school if you have one in the area. The dental school near me is known for doing a great job at a good price. The students do the work along with a dentist, and all work needs to be checked by pofessionals (so it is high quality work). In fact, you may even be able to get a tour for he kids, and make it an great educational opportuinty!

Hilary Marquis said...

Creep! You did the right thing on all accounts, Cindy. I know that when shopping for a new dentist in MN I'm going to have to explain all about Tyler before taking him to someone...every child is different and for some kids they need to see and know every little thing that is going to happen. Some are "on a need to know basis". I have a couple of each. I want to know that the medical profession that we've chosen will go the extra mile to listen to me as the parent, to ensure that each one of my kids is comfortable while sitting in his or her chair. Kenny is a different case, an individual, and he should be given the courtesy of total honesty if that is what is best for him! I wouldn't have allowed that dentist to continue and do the fillings...nor would I have taken any other kids back to him. HE blew it. He had no business bullying you or any other parent. If he paid the least little bit of attention to you or your child he would've known that you and Dominick TAKE WONDERFUL CARE of your kids and the extra procedures would indeed be taken care of. Sorry you had a rotten day, but you did not fail Kenny. You told him the truth and you kept him from further harm by not alarming him. You are such an eloquent writer...drop Dr. Doom a letter ;)

Anonymous said...

I totally agree that you did exactly the right thing by not saying anything when the injection was imminent and also by telling Kenny what happened. I guess it is a learning experience for Kenny that sometimes adults do stupid, thoughtless things. I am proud of him for his take on it. I would definitely write a letter to your orthodontist about the episode so that he might say something to Dr. Thoughtless/pushy. I've been bullied by pediatric dentists before and sought second opinions that totally discounted what the first one said. You are wise and caring and your kids are so lucky to have you. I am sorry it was such a horrible experience. You are quickly becoming my hero!!!

Anonymous said...

The fact that he wanted you to sign something related to the fillings after doing the high-pressure sell... that just sounds so sleazy.

I think it's the right decision to go elsewhere. Even if he were the most skilled dentist in a 1000 mile area, excellent chairside manner in an almost-as-good dentist would be a better choice in the long run.

Ohiomom2121 said...

Dear Cindy,
I agree that given Kenny's age and your prep, it was wrong for the dentist not to 'fess up about the needle, although our own child had several at age 3 and was not clued in during the procedures, which we totally appreciated. Frankly, the needles were so pain-free our son never knew he had a shot! So, now that Kenny knows they are not too bad, actually the process should help him, and you could reinforce that at least now he knows he can get through having a shot.
As for the pressure, I agree the bill seemed high and the tactics overblown. However, what I wish you would take from your blog friends is that you are still way too hard on yourself! I don't recall you being so vulnerable to feeling the "bad mom" fears before this past trip, and I think you should view some of your angst as just part of getting your sea legs back after some serious trauma. This guy's spiel shouldn't cause you to second guess yourself so much, and I agree that your decisions were entirely reasonable. I know it doesn't feel good to delay any child's treatment due to money, but we waited nearly 2 yrs to get braces for our youngest b/c we had to finish paying for the next oldest one's set. It didn't feel good and I'll never know if the bottom tooth that's losing bone due to hitting the top teeth will suffer any permanent less good outcome b/c of our delay, but the reality was that we simply couldn't afford 2 in braces at the same time. And, we did pay some adoption expenses before the balancing included our future children. I had a stressful, month-long trial, and a pastor in the case mentioned that we were all experiencing PTSD symptoms from it. He was right, and I remember getting totally stressed out about even being a juror b/c it brought back such bad memories (we won, but it was a nightmare; the opposing party's mother had a stroke during my argument and the highest supervisors were watching, plus the media plus I was away from my family for it, ugh!). Now I am in lots of mini-trials and there is no stress. Time healed the wounds, just as it will heal you, if you will just give yourself some slack. And maybe the dentist. He thought he was doing the right thing w/the needle, it turned out he was right, and in the end Kenny wasn't hurt. In other words, take a deep breath, find some peace, and remind yourself frequently that you are a spectacular mom!

Kikilia said...

My Pipsqueak had a cavity filled, xrays, cleaning, and the cost was $260.00--- I'm still paying on it of course as I'm a teacher that can't find a f/t job.

Still that's way too much money for two fillings IMO-- and the way he lied to you and Kenny- I wouldn't trust that he'd do the job right or that it really needed to be done.

Will you be calling the regular orthodontist that Kenny sees to tell him what happened?

. said...

Just wanted to say that I feel for you and I think you are doing a great job. We recently had a few infuriorating (sp?) dentist appointments as well and I am SO there with you on the frustration front. The latest was when a hygenist yelled at my kid for him doing NOTHING WRONG! Oh if I could have punched her! I made sure to tell my son how upset with her I had been and how proud of HIM I was. Anyways, congratulations on making it through this latest trial. Parenting sure is crazy hard sometimes, huh?!
Shan in CO