Monday, December 28, 2009

Fun and Exciting

LH has a broken wrist.
It isn't all that bad. It was diagnosed as a right radial buckle fracture which means the bones smooshed a little when she fell on them. The bones are not displaced from each other so there is no need to set it and it should probably heal pretty well on its own. We will be heading to the ortho on Thursday morning (way too early) to get more x-rays and see if the fracture will require a cast, a brace, or nothing at all. She doesn't hurt very much and she is doing fine getting around with the temporary expansion cast.

The incident happened on the 23rd, while family was visiting and LH was enjoying the nice weather. She decided to ride her bike and was trying to learn how to ride while standing up. Thankfully, she had on her helmet and she actually was holding on to the handlebars when she hit something and proceeded to fly superman-style over the handlebars.

At first it looked like she just had a case of road rash on her left elbow and a her right palm was a little bit scratched up. I was more worried about the elbow than than the wrist. After I cleaned her up and gave her some bandages, she was right back out playing (although the bike was quickly moved to the back yard where it has stayed). She had no visible bruising or swelling in her right wrist and there was no indication that anything was wrong at all, except for her inability to lift more than  pound or so.

I feel pretty awful right now, because I really didn't think it was anything to really worry about. I thought she might be over-reacting. I thought she might have a slight sprain. I have fallen so many times and strained my wrist in the process. I know that there is very little to do about it other than ice it, wrap it, and take some Tylenol. I gave her a wrist brace to wear for a day or two, and I figured that wold take care of it. After two days, she told me it still hurt, so I grudgingly took her in for x-rays on Sunday afternoon.

I also have to mention that there was another injury that she was dealing with that had me much more concerned. She developed a small staph infection around her left thumbnail. I also know very well how to take care of things like this (having been a terrible nail-biter growing up) so I did what I could here at A few days before, I made an appointment for her to see the pediatrician about it, but I ended up canceling and trying to take care of it here. After 10 days, though, it didn't seem better, and it actually started to seem worse. When I took her into Children's hospital for the wrist, I was planning to ask the staff to look at the thumb as well.

It turned out that both of the injuries were, indeed, something to worry about. Now I really felt horrible for waiting so long to take her in. The nurses brought in an expansion cast first. After a few minutes she was splinted and had the arm propped in a sling. No problem there. But, when the nurses saw the thumb, they started to call in other doctors for observation and I knew there was going to be a little more to deal with. They wanted to attack the infection aggressively because if it were to spread, it could very quickly become a blood borne infection that could travel to her heart and infect the stints that she had placed just last year. They decided to give her an hour's worth of IV antibiotics and to lance and clean out the wound so it could heal more easily.

The major issue here is that LH is phobic of needles. I don't mean "oh, please don't stick me!" kind of scared. I mean running around, screaming, turning white, kicking, punching, pushing and needing multiple nurses hold her down for one booster shot kind of scared.

When the nurse came in and explained what was going to happen, she turned white. Then they brought in their best tech to handle things and she started to panic as soon as she saw the IV kit. The technician was named Zachary and he was just awesome, though. He was patient, kind, and straightforward and really helped to keep the process moving without letting LH stall too long. It was about 30 minutes of prep for her and 2 seconds of "pricking" to get it over with. She was pretty brave about it, all things considered and only yelled some, and cried a little, and didn't fight at all.

There was a teensy problem, though. Zachary promised her only one stick. It was only 15 minutes later they came in to tell us what they were going to do for her thumb. This entailed FOUR shots of numbing stuff and then the poking of the thumb where it hurt the most. I can tell you that LH was completely pissed about that. She had been getting through everything so far with the idea that she wouldn't have to deal with anymore needles and now they were coming right back in with more stuff to stick her with.

She told me the biggest reason she hates all of this is that the doctors and nurses always tell her that the shots won't hurt, but they always do. In her mind there is no such thing as an acceptable level of pain. You either hurt or you don't. To say that a shot doesn't hurt is a complete lie to her and she feels very betrayed by that. I can't really say I blame her. She is so used to having to just sit and deal with pain, and pokes, and medicines that taste like crap that by now she just doesn't want any more.

As a mother, it is heartbreaking to see your child upset, or sick, or in pain. It is a thousand times worse, I think, to see them in a panic. There is almost nothing you can do about it, except be there for them until they can get their senses back and calm down. I have learned the best way to keep calm and try not to add to her panic, and I know where to stand so I'm not in the way of the technicians but LH can still see me. I have still shed tears almost as often as she has during shots, IV's, and blood drawing. She becomes a completely different child all of the sudden and it is heartbreaking. She swings back and forth between "Wait, just give me another minute to calm down!" and "I'm so sorry I am acting like such a baby!"

By the time the nurses came in to handle the thumb, I guess they just didn't want to drag it out any more so there was very little waiting and talking. They just kind of pushed through and did it. I think she did her best but she was so panicked and angry that there was not a whole lot of coping left in her. There was a LOT of screaming. I have told her that if she has to yell in order to keep still, she can yell all she wants. She takes that as far as she absolutely can, I think. It still took one nurse to hold her hand and another to actually give her the shots and lance the thumb, but we didn't need anyone to actually hold the rest of her down, and that is an improvement over the past few "episodes." She thrashed and kicked a bit, but when she realized that the nurses were going to stick her no matter what, sh relaxed and just started screaming as loud as she could. Better that than a choke hold and restraining straps. You think I'm kidding about that, don't you?

I really don't think the Novocaine, or whatever they use, really works all that well on her. They used a topical solution on her IV site, and she still felt everything. They used a topical cream on her thumb for 30 minutes before they came in with the shots and she still felt everything they did there, too. Her father has the same problem. He has to have roughly twice the amount of Novocaine as anyone else does when he goes to the dentist. Perhaps it runs in the family.

I think the worst part of  all of this is that needles, shots, and IV's are a way of life for her. The cardiologist has never had to use them, thank goodness, but the pediatrician has to every year for a flu shot, at the minimum. She also has to go in every few years for a heart cath to check the internal pressures of her heart and the valves so she gets to get poked, knocked out, and wakes up with bandages around her legs whenever that happens.

I have wished so many times that I could take her place whenever we have to do this. If I could get poked and stuck and pushed around so she doesn't have to, I would do it in a heartbeat. This is part of what she has to go through, though, to get the best care possible. There aren't many kids her age still alive that were born with HLHS. She has come so far and done so well. The doctors are extremely aggressive when it comes to treating small injuries and illnesses. She doesn't quite heal the same way as other kids do, and it makes all her doctors nervous whenever she so much as sneezes.

It is times like this that I am thankful that I have done all I can to help her live a normal life in spite of whatever is going on inside of her. It means that she has all the fun and joy she possibly can so maybe these little episodes of pain and sickness won't be what she remembers most about her childhood.

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