Tag Archives: lacrimal bypass with jones tubes

Good Thing I Had My Orange Juice

You’ve seen the Florida Orange Juice commercials right? The ones where the people are sitting at a table and a whole group is telling them all the things that are going to go wrong that day..and at the end they say “Well…good thing I had my orange juice” Ha, well I totally felt like I was in one today…and if you haven’t seen one, here ya go:

[Disclaimer: I am not being paid for this, it simply related to how I felt today. I actually prefer Simply Orange orange juice instead. No, I wasn’t paid for that either.]

Today, Braxton had two doctors appointments.  Normally, I schedule appointments around Joseph’s schedule so I will have help getting him to and from appointments.  I work about 5 miles from most of his appointments, so it really helps when Joseph is home for him to bring Brax and for me to just meet them there.  Well, unfortunately, this week, Joseph was called in to work early leaving me to fend for myself with today’s appointments.  Normally, I leave about 15 minutes til the appointment time and arrive just on time. When I’m on my own, I have to leave an hour earlier than I planned so that I can drive all the way south to pick Braxton up from daycare and then all the way north for appointments.  Sadly, none of the specialists we see are near our house so it’s a good 30-40 miles from home for every one of them.  Blah! Needless to say, my breakfast table had Joseph telling me he had to go to work early. Excellent. Work telling me I’d be incredibly busy for the morning. Lovely. Braxton telling me I’d have to drive all the way to his daycare to pick him up. Sweet. The dentist telling me to arrive 15 minutes early for paperwork. Fantastic. The ophthalmologist telling me I’d have to wait an hour and a half to see her for 5 minutes.  Stupendous! And the weatherman saying it was going to rain all afternoon. Oh, joy! And finally, Aileen telling me she was going to have a bad day and throw a fit when I got home.  Swell. Unfortunately, I did not have a glass of magical orange juice.

The Dentist appointment went really well! There is a special needs clinic near the other specialists that Brax sees, but the waiting list was too long, so I found another dentist who has experience with SN children.  She was super nice! The whole staff was! From making the appointment, to filling out paperwork, and even the exam everyone was very nice and patient and helpful about the whole process.  Since he is still a baby his first cleaning was a lap exam, where he sat facing me and then he was laid back so the dentist could check him.  Usually, you have to sit awkwardly on that uncomfortable exam table, well this clinic had a large comfy chair I got to sit in! Pretty nice!

Quite the cozy exam room!

Quite the cozy exam room!

The comfy chair I got to sit in while they examined Brax

The comfy chair I got to sit in while they examined Brax

The dentist checked his mouth and we knew Brax had his 2 front top and bottom teeth, but turns out he has SIX more teeth coming in!! They are all in a crazy order, but the dentist reassured me it’s perfectly normal (regardless of him being SN) His top molars are coming in on both sides and his top & bottom canines are also coming in! Holy cow! I had no idea!! Guess we’ll be investing in a toothbrush sooner than expected. I also talked to her about taking his pacifier away and she said from a professional standpoint, she didn’t see any reason for me to take it away.  She mentioned speaking to a child psychiatrist who told her that taking away the pacifier could actually be detrimental because it’s something that is familiar and is comforting for him, so if we take it away it could set him back.  He hardly uses it anyway, so I’m not too concerned about that.  Brax also has one of his front teeth coming in a little crooked and covering the frenum on the inside of the upper lip.  The frenum is that small piece of tissue that you see under your upper lip connected to your gums.  Anywho, Braxton’s tooth covers that and I thought it might have to be cut or something, but the dentist said that wasn’t necessary.  She mentioned that it didn’t appear to be losing blood supply or anything and that in the future we could put an extension device in to help straighten the front tooth out. Overall, the visit went very well and multiple times the dentist told me she sees a lot of the same things in “typical” children who have no underlying genetic issues…that kind of made me feel a little better about everything. At least not everything about him is out of the norm.

Brax's tooth covers the frenum

Brax’s tooth covers the frenum

Our second appointment of the day was with the ophthalmologist.  I have a love/hate relationship with her.  I think she is very knowledgeable and thorough, but her office is terrible! I wait over an hour EVERY. SINGLE. TIME! We went straight after the dentist, so we arrived a little early (about 2:45 for a 3:00 appt) and there was no seat, so I had to sit with Brax on one of the little kiddie super uncomfortable wooden chairs -__- until we were called back at 3:55. Doc came in right away and visited with us for maybe 5 (ok ok I’ll give her the benefit of the doubt – 10) minutes.  This was a follow-up regarding Braxton’s abnormal tear ducts.  The lower ones are very small and the upper ducts are missing.  We tried probing and irrigation in April of 2012, but even the smallest probe had trouble fitting in to Braxton’s tear ducts. We’ve been playing the “wait-it-out” game ever since. The doc said that over time his ducts would grow and eventually they could try the probing again.  Well, today she looked in office and said that she could somewhat see the tear ducts, but that they still looked a little small to try and probe again.  She recommended we again wait until just before his 2nd birthday to see if they get any bigger.  If they do, Braxton will be put under anesthesia again and she will attempt the probing & irrigation again and possibly insert silicone tubes into his tear ducts.  The tubes will help to open up the tear ducts and allow the tears to clear naturally and eventually the tubes would come out, but leave the new tissue that has grown in tact so he would have working tear ducts.  She said we’ll be coordinating this procedure with the occular plastic team, because if, for some reason that STILL doesn’t work, we will have to go ahead and do a reconstructive surgery. :( He would have to have Lacrimal Bypass Surgery with Jones Tubes, which means they will break a small connector bone at the top of the nose and essentially create NEW tear ducts, therefore bypassing his original ones completely.  After 3-4 months the tubes would come out leaving the system in tact for his body to use instead of the original ones.  Blah, poor kiddo. (Images below from here.)

Illustration of Normal Vs. Blocked tear duct

Illustration of Normal Vs. Blocked tear duct

Before the surgery

Before the surgery

After the surgery

After the surgery

All in all, it was an ok day, albeit an extremely busy one! Good thing is, that it didn’t rain! Woo, take that weatherman! Haha…small victories.  It’s also a good thing that aside from daily therapies, we don’t have any appointments until the end of February! Could that be right?! o_O

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