Sunday, February 26, 2012

Sunday Snapshots-Sort of.

I'm going to use this post, which I intend to be just pictures with captions...as a decompression for the last few days. You'll bear with me. My week went south, fast. Here are my beautiful boys on Thursday morning...playing in some wet sand at the playground.

Here is Three about 15 minutes before the fall that wrecked our world. He was super proud because he made it all the way to the top of the wall, and was able to see over!

Then, it was time for us to go...and Three asked to do a somersault over the bar one last time. This is something he learned last month (and I'm pretty sure there is a pic I took of him doing it up on the blog...yeah.) I taught him this trick. Yay mom. He has done it probably 2 dozen times since he learned, and at least a half dozen times on Thursday. He loved it. I said yes (oh, how I wish I had simply said no we needed to get going.) He asked for my help, and I told him "You can do it." *shakes head* He lost his balance on top of the bar, and fell from at least 4 feet up--the bar was about chest high to me--bringing all 42 lbs of his body down onto his left elbow. From the angle that his arm was sticking out from under his little body it was immediately clear it was broken.

There were several things that convince me that the universe was on my side on this day. First of all, Two was with me. We have preschool co-op on Thursday mornings and normally One and Two stay home and complete their school work while I'm gone with the boys. BOTH of them asked to go with me on Thursday! They haven't gone to co-op with me since September, and on this day they both offered to come. Two was a GREAT help with Four while I was carrying Three to the van, and into the ER. Second, I didn't let One come. She is dramatic, and would have lost it and I'd have been trying to comfort both Three and her if she had been present, so I'm glad she was not there. Third, we were at a park literally half a mile from the hospital where all the kids were born. And, Fourth, my BFF was right across the street from the hospital. This is a BIG deal because we both live about 45 minutes from where we were, but the universe lined it up just right.

I scooped him up, and I held his elbow to steady it because his arm was just hanging there and every time it moved he screamed. When I touched his elbow, I could FEEL that the lower part of his arm was completely disconnected from the upper part. I almost vomited. We got to the ER, I merely showed the receptionist Three's elbow and they immediately took us to a room. They let us skip the paperwork, and the triage room just by looking at it. Yeah. His elbow area literally looked like an S. They had us in X-ray within minutes (yay ER team!) and the x-ray tech told me "I've been doing this for 23 years. This the worst break I've ever seen." Yeah. The dr. came in and told me that while they have a Ortho there, they really felt strongly that we should transfer to the other branch of this hospital (about 20 minutes away) because they have a FULL children's ER and hospital there, and they were already sending a truck for us.


My poor boy was in so much pain and so high on morphine, that he even turned down their offer to turn the lights on for him before loading him into the truck. I took a picture of it because I knew he wasn't in the frame of mind to appreciate it at the time, and normally this is something he'd have been ALL OVER! We get to the Pediatric ER, and see an ortho. They tell us they are going to take off the sling he's in (which the first hospital put on to stabilize him for transport) and try to realign the bones a little, and will do surgery in the morning. They also tell us that they have sent the x-ray to the on call Ortho (the guys we've been seeing are residents) and that the doc that is on call is an "upper arm and hand specialist." (Another area where the universe was looking out for us!) The nurse says "You couldn't have ended up with a better on call doctor for this particular injury." You see, they have been very concerned all afternoon about his hand...there are apparently 3 very important nerves in your elbow, and they are worried about nerve damage. Fortunately, every time they've asked, he has been able to move all his digits and squeeze their fingers. So, super-ortho doc receives the x-ray and sends in the "head resident" to do a "hands on assessment of Three's arm," before he arrives. Head resident comes in, and cuts off the splint and looks at the arm from the outside, looks at me and says "We're not going to try to move it and wait. We'll leave it alone and operate today." Upon viewing the x-ray and doing a more hands on assessment, they determined this injury required emergency surgery. I didn't know that at the time.

They take us back to pre-op and I get to meet Super-Ortho-Doc (a super nice guy, and the kind of doc who strikes you as really knowing what he's doing, without being condescending...thank you universe for sending me Dr. Nwoko!) Dr. Nwoko explains that they will attempt to maneuver the bones back in place with a machine (they told me the fancy name...but well, I got nothing.) If they are unable to manipulate it to their satisfaction, they will have to make an incision. He is hopeful they won't have to do that, again, they don't want to risk damaging those nerves since he seems to be fine in that area. He leaves the room.

The anesthesia team comes in, and in their questions asks about the last time he ate--which I've told at least a dozen other people so far today. I tell them he ate around noon and had a PB&J, Cheetohs, and a juice box while we were at the park. The anesthesia people get an alarmed look on their face because it hasn't been 8 hours, and since he had morphine they know his digestion has slowed and there is a good chance his stomach is still "full." He asks the nurse about why we aren't waiting and she tells him something I hadn't heard yet "Dr. Nwoko deemed this emergency surgery." It felt like a kick in the stomach. I mean, I had viewed the x-ray. I had touched his elbow. I knew it was bad. But, deemed an emergency by a specialist. Wow. The anesthesiologist gives her a *look* and says "It's a broken arm." She gives him a *look* and says "I'm not the doctor." (I liked her spunk.) He then calls the doctor back in and they have a conversation in front of me, which I'm not sure they should have...but Dr. Nwoko informed the anesthesiologist that this is a *medical jargon* compound fracture and that No, he does not think it can wait another couple hours (as the anesthesiologist has suggested.) Not something you want to hear...that your baby's arm is broken badly enough the doctors don't think it can wait 2 more hours for his food to digest before they operate.

He was in surgery for an hour. They placed 3 pins in his elbow. They are external and therefore the elbow area of his cast is GIGANTIC. He was allowed to take his beloved Bear (whom he has slept with since he was 6 months old) back to the OR with him, and Bear emerged with a cast as well. This was such a nice touch. Rock on Ped Drs. Rock on. You can also see the remnants of a prized Batman shirt that the ER people had to cut off of him, that my BFF fashioned into a shirt and ninja headband. ;) He has popsicle lips, as they gave him a cherry popsicle in recovery. We had to stay overnight at the hospital, but were discharged early the next day. He walked himself out of the hospital, and through it all was such a CHAMP. His bravery is insane. Even the doctors and nurses commented on how calm he was through the process. His pain has been well managed, and he has slept great since being home. His cast is crazy heavy (it's plaster....for 2 weeks, then he gets a different lighter cast.) But, he's adjusting to playing with it on.


I have immense guilt. Like...if I had never taught him to do this. If I had simply said no. If I had helped him when he asked. If I had been able to catch him. If I could have...stopped him from being a boy. I've cried and cried about it. I'm crying as I type it. I know we always wish we could take away our kids pain, but I feel like this is mostly my fault and it doesn't matter that doctors, nurses, my family, my friends...have all told me that things like this happen all the time. I broke my boy. The end.


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