Tuesday, August 11, 2009

Broken

Sunday evening I watched as my little toddler was getting down from this very chair while holding this very pencil and paper. She has maneuvered in and out of these chairs hundreds of times carefully and without incident. This time holding on to her writing materials was a little too much for her. It looked as though she had fell flat on her back. I scooped her up and she didn't stop crying as she normally does after falling down. She cried unconsolably for 15 minutes. I did an assessment on her and found a little bit of bruising and the slightest bit of tightness in the skin of her left forearm. The swelling wasn't even visible at that time. I put her princess cold pack on her arm gave her some Motrin and started brainstorming. Meanwhile the swelling became noticeable. Bill and I were hoping for a sprain or deep bruise. The swelling made me concerned that we might be dealing with a fracture. We called the Ped after hours clinic, they don't do XRays. Meanwhile Laura Ann has stopped crying but is holding her arm and saying OOWWW, BOO-BOO. She is left handed and would not use that arm.
I called the Pediatrician on call ( I thought). They now filter their calls through the Children's Healthcare of Atlanta Phone nurse. Frustrated, I answered her questions and listened as she told me not to give any more Motrin but to use Tylenol. I told her that I indeed wanted to speak with the Pediatrician on call. I received a call from one of the docs that I used to work with at both the clinic and on the Peds unit. She helped me brainstorm and reminded me that an ER would only splint a fracture and wait on the orthopedic surgeon to see her on Monday. I remember working nights and evaluating children with their splints waiting for the cast the next day. This wait also helps with swelling issues. Casts that are put on when there is increasing swelling end up having to be cut off and reapplied.
After talking to the doc, I applied Mama's homemade splint ( An ice peri pad left over from Laura Ann's delivery) and wrapped with an Ace type bandage. We kept ice on it as long as possible (of course no longer than 20 minutes at the time) and elevated it as much as we could. I gave her some Tylenol and a dose of Benadryl and put her to bed. I did the same thing for her that I did for my patients in the hospital. I did round the clock checks on those fingers and made sure that the arm above the sling wasn't swelling too much. I did skip waking her to ask her about sensation (Do you feel that?) She is a little young for that. It is not like I could sleep any way! Praise God she slept through the night.
I took her in the next morning to see our wonderful Pediatrician Dr. Jackson. I could get an earlier appt with him than the Pediatric Orthopedist. I made an appt with ortho for 2pm just in case I would need it. Laura Ann was such a sweet compliant patient. She sat for her Xrays without wiggling. Dr. Jackson looked at the images and found that her radius and ulna ( the two bones of the forearm) were both fractured. The growth plate was not involved and it would not need to be manipulated or "set". Dr. Jackson said to keep my splint on and to see the Ped Ortho that I already had an appt with. Meanwhile a sweet friend Erica had Mr. Will. He was picked up before we ever ventured out for our day of Dr. Appts. He had a blast.
Laura Ann fell asleep in the car after seeing Dr. Jackson. He gave us an RX for some Pain meds. We had a little time before the other appt. We met a couple of sweet friends for lunch and then met Daddy at the next doctor appt. The doc sent us for a cast and told us to come back in 4 to 4 1/2 weeks to get it removed. He also said that Motrin would be the best thing for pain relief. I told him about my advice from the nurse.... He said use Motrin.
Laura Ann was a sweetheart during the cast application as well. It was hard for me not to help.
We have had a challenging time trying to keep the cast clean (especially during meals) and dry (imagine bath time). It takes two of us to bathe her now. She is more fussy than usual and I am having to do her coloring for her so far. She sits and shows me what color she wants... I am working on getting her to use her well-non dominant hand. She wants me a lot closer right now and needs more help. Well it seems that my attempt to put her to bed early was ineffective. I am being summoned.
Please pray that God knits the fracture up and that it will be completely healed. Please pray for pain control for Laura Ann and patience for Bill, Will (who starts school tomorrow) and I.

5 comments:

J said...

oh misty...i got a lump in my throat and tears in my eyes. i'll be praying for all of you. she's so precious...and with that pink cast! give her a hug and kiss from me! and how wonderful that you have all that experience nursing! i would've been terrified.

love you, friend!

oh, and i really like your new header.

Kim said...

Bless all of you! That is so tough watching your child hurt and go through all that. Sounds like God was gracious tho. I hope all is well and we will pray for a speedy recovery in the next month. I'm glad you explained all that bc now I know what Gracyn's arm wasn't put in a cast until 2 days after her fall. We got the edited Thai version. :)

Cindy Saunders said...

Oh bless her heart!!! Donovan broke his arm going into the summer on the last week of school a few years ago, but he wasn't nearly as young as Laura Ann. God will take care of her....I am sorry she broke it....I love the pink cast! so girly!!

andi said...

So sorry! David broke his collar bone a couple of weeks ago! I love the new picture. To see her little smile while broken, breaks my heart!!! I know you handled it great! :)

Bill, Misty, Will, and Laura Ann said...

Andi: Did you blog about David's collar bone? I missed that.
I am so sorry. I know that he was hurting and that you were hurting worse.
Thanks to everyone for caring about little Laura Ann.