Toothache

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Elijah came to us with tooth issues. It’s hard to miss his missing two front teeth and his slurred toothless speech. It makes him very distinct. Elijah entered care with very poor teeth, so bad that he had to have a mouthful of cavities filled and those mentioned two front teeth extracted.

Even though the boys moved in with us back in May of 2014, not all of their healthcare did. It took several months for the dental to transfer to a local vendor and then several months for an open appointment with Jayme’s dentist who takes the Oregon Health care plan. This became a bigger issue when he started to complain of tooth pain.

Now for Elijah to talk about pain is kinda a big deal, we have noticed that he as a pretty high pain thresh hold and tends to hide pain. The upsetting part of our story is Elijah will have reached this high level several times before this blog is over.

DENTIST OFFICE #1

A few weeks before the appointment Elijah started talking about a tooth hurting. It would be several months before the pain would be 100% gone.

Daddy Anthony was in charge of the first Dentist visit. Gabe, Anthony and Elijah all crammed into the exam room for a long cleaning. Elijah did great with the x-rays and did great with the cleaning. What he did fail at (and so did Gabe and Anthony) was the 45min after the cleaning waiting for the Doctor. Once the cleaning was done we sat and sat and sat. The Doctor was busy with another treatment and could not come in to see Elijah. With 10 mins left before we had to leave to get Jayme from school she appeared.

Strike 2 for the Dental office was quickly identified. The hygienist had failed to get a x-ray of the bad tooth so the Doctor had no way to see how bad it was. But she did open Elijah’s mouth and quickly find 6 cavities all in need of treatment. As we rushed out the door to pick up Jayme we found out the next closest treatment appointment was 6 weeks out. Elijah would have to wait to get his tooth fixed.

6 weeks later, Joshua takes Elijah in to the Dentist for his appointment. Everything was find until it came time for the shots. They tried numbing topical meds, they tried gas but nothing could get Elijah to relax and allow that needle into his mouth. After about 15mins the Doctor gave up and told Joshua that he would have to take Elijah to a pediatric Dentist. Now this was a shock because we thought we were at one. But it seems the pediatric Dentist that Jayme was seeing at this location quit. So they only had regular dentists now.

 

DENTIST OFFICE #2

It took a week for us to get a call from the pediatric Dentist office. First date available was another 6 weeks out. With some pleading about Elijah’s case and how he was a foster kid and how poor his teeth were they said they could do a examination only appointment and the Dentist would judge if the tooth needed rushed attention. The only time open was 7am the next day. So Joshua took Elijah in on his way to work, with the plan Anthony would pick up and take him to school later after Elijah got to spendsome time at Joshua’s work.

Joshua and Elijah arrived at the new Dentists office. Joshua presented Elijah’s medical insurance card and then the receptionist asked to see Joshua’s ID. Now this was a new thing for us, we have never been asked that before. Not at our Medical Doctors office with Jayme or the other boys. Not at the Pharmacy when picking up controlled prescriptions. So Joshua asked, “Why do you need to see my ID?”. The reply was to prove that he was who he says he is. Joshua said sure, but I am not the patient my foster son is.

It should be added that having now worked with the reception and booking staff of this office, clearly Joshua asking why was a challenge to the receptionist supreme godly authority. She quickly got back up and then told Joshua that since Elijah was a Foster child they could not see him today. Now to Joshua’s credit, no one was killed. But he did leave a bit mad. Not sure why, waiting for 12 weeks with a child in pain might have something to do with it, but who knows.

Joshua and Elijah returned home and told their tale. Anthony took the boys to school and then called the Dentist office to see how we fix this.

The phone was answered by a nice man. Anthony explained what happened. The man on the phone sounded confused and asked for the insurance information. He was then quickly able to pull it up and said, “I am not sure what the problem is, all of his insurance is correct, both of you are listed. Can you hold and I will talk to the receptionist?”

Several minutes later a woman comes on the phone, this turned out to be the receptionist. She started telling Anthony that since they had no idea Elijah was a Foster kid they had no way to confirm that Joshua was the foster father. Now this is a lie, as all of our names and information are listed on Elijah’s insurance HIPAA information. Anthony mentioned that he had told the scheduling person on the phone Elijah’s whole story just 2 days prior. The receptionist then without asking transferred Anthony to the scheduling receptionist.

She picks up the phone with “You never told me he was a foster child, because if you had I would told you we needed a form from DHS.” It should be noted that Anthony has not yelled. Anthony calming say “Well that is not true and I don’t like being called a liar. But, it’s not important right now. I just need to know what I need to get you so Elijah can be seen.”

The scheduling receptionist stated again, “I will need a DHS form.”

Anthony asked  “What form do you need, what form number is it?”

“I just need a DHS form.”

“Ok, but what form do you need? A DH1-45 form or some other weird numbered form or something like a consent form..”

“I need something that proves your the Foster father”

“Well that is in the HIPAA insurance information that you can pull up on your screen. Do you need letter from DHS?”

“Yes”

“What needs to be in the letter?”

“It needs to say your the foster parents”

“Ok, does it need to be on letterhead? Does it need to be a live signature or can we fax it?”

“You can fax it.”

“Ok what is your fax number”…

This strange banter continued for a few more minutes until we got to the next logical question.

Anthony asked “So how soon can we get Elijah back into be seen?”

“Well that depends on how fast DHS is able to get us the form.”

“Oh, you will have the form by noon today. I will be calling Elijah’s case manager and attorney right after this call.”

One long pause later.

“Well if we get the form today, we could see him in 2 days at 7am.”

“He will be there, thank you for your help. I will call back today at noon to make sure you have the form you need.”

After a call to DHS and short talk with Elijah’s caseworker, we had the “form” which was just a letter in by 11:00am and the caseworker was on the phone to the Dentist office moments after getting off the call. Two days later Anthony took Elijah into the office. Anthony had his personal ID and insurance card ready and handed both to the receptionist before even saying who he was. Both were scanned and we were told to wait.

Now, this is the end of the Dentist drama. The nurses and Elijah’s Dentist are wonderful, kind and gentle. It is like night and day in that office. Front of the house is power mad and the back of the house is amazing. After some x-rays and a quick look the Dentist told us that the tooth that had been bothering him was now a fully abscessed. The Dentist informed us that the tooth was not savable and have to be pulled.  She gave him a prescription for antibiotics and an appointment for extraction 9 days later.

Since she recommended sedation for the procedure, the dentist office tried for 7 days to get DHS to sign off on the sedation. With no luck the Dentist called us directly and told us. We called our caseworker and they had the sedation consent back same day. The Dentist has now mentioned twice how impressed she was that we could get DHS to move so fast. The truth is we just have a great caseworker.

Extraction day could not come fast enough. The antibiotic helped with the pain and swelling a bit, but eating was still very hard for Elijah. When we arrived, again Anthony handed over his ID and Elijah’s insurance card again before speaking (both were scanned again) and we were told to wait.

Once back in the back of office, in the good zone, Anthony and Elijah entered a dim quiet exam room. Elijah got a arm hugger on his arm and little clip on his big toe. Then he got a nice blanket to keep him warm. The sedation meds are oral, so after he drank them down we had to rest for 20mins for them to kick in. Anthony read Harry Potter to Elijah as he got woozy.

The Doctor came back in and gave him some pain shots, which he handled with no issues. Then 10 mins later she came back and wiggled two infected teeth out. They told him to bite down and then they raised him up. He quickly pulled the gauze out of his mouth and said “Blood! What happened?”

We set a date to come back and look over the other cavities for 2 months later and then we headed home.

Recovery at home was very fast. Once in front of the TV he was pain free and doing great. By the afternoon you could not even tell there was anything wrong that morning.

 

RETURN OF PAIN 

About 2 week prior to our appointment Elijah started complaining about mouth pain. This time on the other side of his mouth. Eating quickly became something very hard and painful again and we found ourselves right back in the place we were just a few weeks prior.

Dentist day came on the last day of school. So we had a very very full day. Anthony and Elijah arrived at the office. Anthony handed over his ID and Elijah’s insurance card again before speaking (both were scanned again for the third time) and we were told to wait. And wait we did. It took about 30 mins before we were called into the good back. The Dentist came out and explained that a procedure had gone long and apologized for the wait. Anthony told her about the new problem and how the Dad’s really did not want any more extractions as we have become concerned that he will not be able to eat.

Once in the good back of the house Elijah had a full set of x-rays done and a tooth cleaning. The great news was the Dentist felt that she might be able to just cap the two teeth. The bad news was the next appointment open was 3 months out. Anthony and the Dentist talked about how we might get in sooner. She mentioned that she had a lot of cancelations this week and she was sure she would get another one very soon, when she did the spot was ours. We also talked about calling in each morning to see if anyone had canceled.

So the next morning Anthony called and asked if anyone had cancelled. He spoke with the same nice man as last time, the one who found our names in Elijah’s HIPAA insurance with no problems. He told Anthony that they had no cancelations, but the 8:30am had not RSVPed for their appointment and I was welcome to call back at 8:30am to see.

8:30am Anthony called back. This time he got the Serene Highness receptionist. She scolded Anthony for calling, that she makes those calls and 8:30 would not be an option for Elijah. Anthony thanked her (for his tongue lashing) and said he would check back tomorrow.

Later that night we got a call from Her Serene Highness, the 7:00am for the next day had canceled and if we wanted it she would allow it. Anthony thanked her and quickly got off the phone before he said anything to upset her.

 

TAKE TWO

Anthony and Elijah arrived at the office on time only to find the doors closed and the lights out. So we headed over to the adult side of the office rather then the pediatric side. Anthony was ready to hand over his ID and Elijah’s insurance card again. But this time on the adult side, they did not need them. A new nicer receptionist only asked if Elijah had eaten any food. Within mins we were called back to the good side for round two.

This time Elijah was much calmer, until the medicine came. He really didn’t want to drink it this time. He also was much for restless in the chair during the procedure. Anthony had to hold his hands.

The Dentist was able to cap one of the teeth, but the other was dead and the nerve neurotic, it had to be pulled. The whole procedure was quite fast and the bad tooth came out very easy, which made the Dentist comment that we were lucky and just cut off another infection in the nick of time.

Once home Elijah bounced back again and within an hour was playing Star Wars Lego and pain free.

Next appointment for the remaining cavities it in 3 months, but the Dentist said none are near any point of causing pain.

 

POSTSCRIPT

Remember the nice man who found our insurance information easily and suggested calling back. They fired him for telling us to call back at 8:30. Not kidding, they really did.