Patient with Special Needs Gets Emergency Treatment During COVID 19
There are not too many people who write thank you notes to their dentist.
But Janelle Wolff does. The 26-year-old has a special relationship with her dentist.
Janelle has Dubowitz Syndrome, a rare genetic condition that involves intellectual and developmental disabilities, several medical issues, and a very small jaw, creating numerous oral health challenges like crowded teeth and periodontal disease.
Having had failed experiences with other dentists, she was eventually referred to Dr. Wayne Lipschitz at UR Medicine’s Eastman Institute for Oral Health.
“She just clicked with him,” recalled Sherree Wolff, Janelle’s mother. “She trusts him 100 percent, because he understands her and she knows it.”
Janelle, who functions at the level of a preschooler, has been Dr. Lipschitz’s patient for 10 years.
“His approach is so sincere. He treats Janelle like a young adult and talks to her at her level in a way that’s kind and not insulting,” Sherree explained. “As a parent, that means a lot to me.”
But, like many people with intellectual and developmental disabilities, Janelle has a very difficult time receiving treatment in the dental chair.
“Many patients simply cannot tolerate it,” explained Dr. Lipschitz, who’s been treating patients with IDD for more than 20 years and serves as director for Eastman Institute’s new Specialty Care clinic at Eastman Dental. “Patients with advanced IDD often become very anxious, especially when they’re experiencing pain. They don’t understand that we are there to help, and as a result, patients can become combative.”
In these situations, Dr. Lipschitz will treat patients under general anesthesia in the operating room, where multiple or lengthy procedures can be completed at one time.
“Dr. Lipschitz has treated Janelle in the operating room a couple of times with great success,” Sherree said, and, due to many of her teeth having poor prognoses, they had a scheduled appointment in June for several extractions.
“But when I was brushing her teeth recently, I must have pushed slightly too hard, almost knocking one tooth out,” Sherree described. Because the COVID 19 situation isn’t allowing elective surgeries, Dr. Lipschitz told her to keep an eye on it and call if it worsened.
Several days later, Janelle was clearly in a lot of pain.
“At first she was just grumpy,” Sherree said. “Soon after, she wasn’t eating, and then stopped drinking. She started other behaviors we knew indicated severe pain like pulling her hair and pinching us if we tried to look in her mouth.”
Sherree and Dr. Lipschitz knew Janelle couldn’t wait until June, but also knew her severe pain and anxiety would make treatment in the dental chair very challenging. They decided to try.
The next morning, Sherree gave Janelle a sedative and drove her to Eastman Dental’s Specialty Care clinic, designed specifically for treating patients with IDD and medically complex conditions.
As Sherree and Janelle were being screened for COVID symptoms in the lobby, Dr. Lipschitz entered the building.
“Janelle has a lot of doctor appointments, and becomes very anxious each time,” Sherree said. “But when it’s Dr. Lipschitz, she always loves to see him even though her mouth is hurting. He has a special way of putting her at ease immediately.”
Sherree’s mother, Terry, stayed with Janelle for the procedure, while she stayed in the waiting room. “I don’t handle that stuff well at all,” she admitted.
“Before I knew it, I could hear Janelle yelling, ‘Whoo hoo, Grandma! It’s done and I did good!’” Sherree said. “It brought tears to my eyes.”
After applying a little numbing cream, Dr. Lipschitz and Dr. Nadia Stephens, assistant director of Specialty Care, and a couple of dental assistants worked together to successfully extract two teeth that had become infected, causing Janelle so much pain.
“After a good nap, Janelle ate and drank well, and didn’t need any pain medication,” said Sherree, who added Janelle quickly returned to her usual cheerful and talkative self again. “Dr. Lipschitz even texted me from his personal cell phone to check on her early the next morning. That meant a lot to both Janelle and me.”
So much so, that Janelle insisted on writing her favorite doctor a thank you note.