Why did the insulin die in my pancreas?

Tomorrow at 10.3oam, Lance is undergoing “awake” surgery at the dentist. From years of mouth ulcers, infections and antibiotics, there is severe damage to four of his precious little pearly whites.  He has been having pain for a long time, and it wasn’t until one night last year when he was brushing his teeth that he commented how he was tired of having toothaches. I had him at the dentist the very next day, and she gave us the verdict.

So tomorrow, after extensive discussions with an assortment of specialists, the dental surgeon and I have decided that she should extract the teeth whilst he is awake. The anaethetists and paediatrician ran a mile once they knew that Lance had Type 1 Diabetes, fearing a hypo whilst under general anaesthetic. So after a heap of excuses and brush-offs, tomorrow is the big day.

Firstly, I have to give him a hearty breakfast when he wakes, along with his insulin dose. I am going to play it safe and give him a unit or two less of both his insulins, just to decrease the risk of blood sugar issues. For morning tea, the plan is to give him a fruit smoothie, complete with yogurt, low fat icecream, mango, banana blended into a creamy batter with a splash of milk. Then, he brushes his teeth, flosses, and we go to the surgery. ( This is one ritzy dentist..I half expect Julian McMahon from Nip/Tuck to come sashaying out of the surgery to welcome us!) Every person I have ever seen leave has the Extreme Makeover smile, and boy are they happy to show it! (Lance is particularly impressed with the Kids Room. There is a Playstation3 set up,and he is warmly encouraged to indulge in a game whilst he waits for his consultation. Having current technology there is a very smart psychological tactic; Lance is itching to get that control set in his hands, so at the moment, he LOVES the dentist I chose for him. I do have to admit that it is slightly different to our GP’s play area, I’m quite sure the toys were donated by the doctor’s wife from her own personal stash of their children’s once loved treasures. (They have that distinct 70’s design and seem almost familiar from my own childhood, growing up in the 80’s.) I always wonder how many times each block has been sucked or handled by germy little hands over the years.. 

Today Lance commenced an antibiotic which is to be administered 4 times daily until finished. Tomorrow, he will receive 14 needles in his gums and cheeks to completely numb his mouth. If he starts to panic, or wants to do a runner, I have given my consent for him to have the maximum amount of nitrous oxide permitted for his weight and degree of pain. I’m hoping that it will plant him in the chair, and he has some nice head buzzing feelings, so that he is distracted by the unfriendly, clunking utensils that will be piercing his gums.

I am doing mental backflips at the moment, as my greatest fear is a panic induced hypo.I know stress on the body usually causes adrenalin to soar, thus elevating blood sugar levels, but not always in Lance’s case. He is reknowned for being carried out of events and restaurants. white as a snowflake, his head tilted back with his eyes rolled backwards so all that is visible is the eyeball, his azure blue eyes hiding somewhere in his skull.

I have decided to do BSL tests every 15 minutes, because I am not taking any chances. In the event that his blood sugar does fall to hypo level, I am giving a small dose of glucagon to bring it back up. It’s the only way, as once they have started “work” he cannot consume any food or drink.

I’m as nervous as hell. I don’t know what to expect. Dentists and their assistants speak a language exclusive to the oral health community.They communicate in a monotonal drone,making it impossible to get an idea if it’s a routine procedure with no complications, or if there is a potential concern.( Unlike endo talk, which I can decipher like I have spoken it all my life.)

I’m worried that Lance will panic and want to get out of the chair.

I’m worried that he will be overwhelmed by having needles in his mouth, and panic, screaming and begging me to set him loose.

I’m worried that he will have to be restrained, and lash out at the dentist and her assistants. (He still has issues regarding being held down, left over from when he was first diagnosed with Type 1 Diabetes.  A team of burly doctors held his small, tense body firmly to a stainless steel examination table whilst frantically attempting to find a miniscule vein. Despite his dangerously vulnerable condition, he managed to conjure up some brute-like strength and fought like a 15 year old half back.)

I’m worried that he will have bleeding, or a deep cavity that will require stitches.

I’m scared silly of finding a number under 5mmol/L during the procedure.

Mostly, I am secretly devastated that this is Lance’s first official Diabetes related complication. It’s not that big of a deal, however, if I had decided to leave the teeth in, one day, with no particular warning, they could have developed absesses, became infected and at worst, fatal blood poisoning was “a real possiblity.”

I guess I’m just feeling like it all seems very real.

Diabetes, I mean.
I know it’s there, every minute of everyday, however, my seven year old son has to undergo a procedure tomorrow that even adults are admitted to hospital for, and have the privilege of general anaesthetic, leaving them none the wiser. As one specialist put it, Lance just “slips through the cracks of the medical system.”

The best news is that Lance was disappointed that the appointment wasn’t today, AND he loves the fairy-pink, cherry flavoured antibiotic. I’m really going to have to take a leaf out of his book-he has the most extraordinary inner strength and the ability to not sweat the small stuff.

I need to find some peace without creating this world of chaos for myself. The only problem with that, is that my fears often ring true.