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Wednesday, June 25, 2014

first trip to the ER

Well- we've managed to escape it for some time…but Saturday morning made it into the books as we made our first trip to the Emergency Room.

On Friday night- the kids spent the night at my mom's house because Geoff and I were both scheduled to work early Saturday morning.   My mom called me around 8:30pm on that Friday and said that Grace had been rough housing and hurt her elbow.  She was crying and wouldn't let anyone touch it.  I should have known then that something wasn't right….but sometimes when Grace is overly tired and it's past her bedtime, as well, then she tends to have meltdowns.  She had also cried pretty good when we dropped her off which was also out of the ordinary.  So the fact that she was crying a lot about hurting her elbow made a little bit of sense to me.

Well- she ended up sleeping in bed with my mom and was up every 1-2 hours.  So around 3:45am- my mom got in touch with me again letting me know all that was going on.  I woke up Geoff and we headed to pick her up.  I called my work letting them know I wasn't going to be able to make it…and then Grace and I headed to the ER.

For the record- she asked me to take this picture of her.  She told me to take it and then send it to her daddy and let him know that she was being brave.

We did quite a bit of waiting.  A resident doctor came to examine her- a resident I recognized from my work since these doctors rotate through my unit.  I thought she was doing an ok job until……until she asked my 4 year old, "On a scale of 1 to 10, how is your pain?"  And when Grace answered, "Good," in her sweet little voice, and the doctor laughed and replied, "Oh you're so cute."  I about lost it.

It's pretty scary and nerve-racking to be in an ER with your sick {read IN PAIN} child, and to feel like you can't really trust that you're getting the care you need.

The room we were in had a TV, but wasn't turned on- so thankfully I brought an old iPhone and she watched a show on Netflix while we waited.

She had x-rays.  And then waited some more.  The attending came in and told us that her x-rays look good….there is no fracture (which I didn't really think it was fractured since she didn't really have swelling and we were setting an ice pack right on top of it, per her request, and that did not bother her).  He said he thought she had nurse-maids elbow….pretty common in toddlers and preschoolers….it's an elbow sprain…where a tendon (or ligament, I don't really know) gets a little out of place and there's this 'simple' maneuver they do that gets it back in place.  It can be pretty painful so they gave her some medicine and waited about 30 minutes.  

So 30 minutes later- the attending and another resident that I recognized (and to note, was not very fond of) came back into the room to 'set' her arm.  The doctor said she felt the 'pop' fairly quickly.  Grace was screaming and crying.  It was awful.

So the thing with nursemaids elbow is that once everything's back where it's supposed to be….most kids are good as new.  No more pain.  Well- Grace was still in pain.  READ: a lot of pain.  And she still wouldn't move it.  Not for anything.

They gave her this popsicle and thought they'd give her some time to settle down and then try to get her to move her arm again.  She sat and ate and watched Frozen (by this point the nurse turned on the TV for us).

So when they came back in, she moved it very little.  The attending (who I also wasn't very fond of, just to be honest) said that sometimes if you don't reset the elbow as soon as it happens, a little swelling can happen and cause a little pain…and so he said he was going to give her a splint to wear for a couple of days to help keep it stable.  And if by Monday, she still was in pain, then we would need to try to see our pediatrician….where they would maybe need to try to reset it.  What??????

Ok.  So here were go.  The nurse put this on and I think she was excited about it at first.  She said, "Momma- Parker's gonna say, 'I want one, too.'"  Hahaha!

So this sister had been up since 3am….and really didn't rest well before that….and even after pain medication….she would. not. fall. asleep!!  I guess her pain and adrenaline wouldn't let her.  But a few minutes in the car and she was out.  Thankfully!  I know she was so tired.

So I was hoping I'd be able to transfer her from the car to the house and her stay asleep.  But that didn't happen.  So we ate lunch, and then I got her to lay in my bed with me.  We laid there for about 45 minutes, and when her movie was over we headed back to my mom's house where Parker and Nolan were.

While at my mom's….we all just sat around replaying the events of the night and early morning.  All feeling guilty.  Like we should have known she was being serious.  How we should have trusted her and taken her in sooner.  How it even happened?!  And how bad we all felt for her that she was hurting so.

She was acting in pretty good spirits.  She even went and played Barbies one-handed with the girls for a while.  When it was time for Nolan's afternoon nap- I made Grace come on home with me to rest and then promised we'd come back for dinner.

She didn't put up much of a fight.  We went home, I put Nolan down, and made her a pallet on the floor.  She watched a movie and I ended up running around trying to clean the kitchen and do a few other 'cleaning' things around the house.  Her hair had gotten pretty matted up and so I laid some towels on the counter and washed her hair in the kitchen sink.  Being clean just always seems to make you feel  a little better I think.

So Saturday night- she goes right to sleep at 8pm.  I put her in bed with me.  She requested to sleep on my side, and I let her.  I slept on Geoff's side and he slept in her bed.  My mom offered to keep Parker another night because she was having so much fun and also to just give me one less kid to worry about.

She slept all the way until close to 4am.  She'd cry out that she was really thirsty and that her arm hurt.  I got up and got her some water and some ibuprofen.  It had been since before her bedtime that she had gotten medicine so I figured the pain was probably pretty good by now.  Only problem was…when I felt of her….she was hot.  I went and grabbed the thermometer, and she had 103.4.   I asked her what all hurt and she said her arm.  Then I asked if anything else hurt, and she said, my throat and my head.  I was thinking, "Oh my goodness…this girl can't catch a break!  How is this happening?  Bless her heart!"

She pretty much went right back to sleep, and then cried out about 15 minutes later that she was sweating.  I didn't recheck her temperature then, but figured that it must have been breaking then.  She went back to sleep shortly after.

I laid in bed then just going over and over everything that had happened.  Wondering if the fever could be from the elbow sprain?  But how?  That didn't really make sense?  But then the coincidence is crazy?  And it also got me thinking about how I didn't know what to do…how I didn't want to go back to the ER because I didn't feel like they knew what they were doing either (and I realize that there are good nurses and doctors that DO know what they are doing…..and I realize that we just did not have a good experience when we came to the ER for our first time…..but in the moment of thinking that you might need to go back….and reflecting on your experience…it makes you feel even more helpless)

So…she sleeps until 9:15ish.  Wakes up.  She's still warm….102.7 now.  I ask her what all hurts.  She says her arm and her tummy.  I ask about the throat and head, and she says no- just arm and tummy.

Not 10 minutes later and she's getting sick.  Bless her heart.  When she was done she told me she was sorry she threw up.  I told her it was ok and that I was sorry she didn't feel well.

Good news is….I got her all cleaned up and back on the couch fairly easily (minus the fact that baby brother was trying to grab the throw up bag and the throw up paper towels out of the trash can…and then tried repeatedly to climb in the shower with Grace).  She immediately requested some chicken noodle soup, and ended up eating the entire can of soup and a drank a thermos of water.  And she kept it all down.

I'm still suspicious.  What's this fever from?  Now it's a stomach bug?  But then she just ate the whole bowl of soup and a thermos of water and kept it ALL down and said that her stomach no longer hurt….only her arm.

So I give her ibuprofen every chance I could to try and keep the fever down (I would have tried to alternate the acetaminophen again, but now she hates the taste of it and it was already a fight to give her the ibuprofen…and as long as I kept it below 103, I felt ok about that because I know that fever has a purpose.  The lowest I got the fever was 100.5 one time.  The rest of the time it was greater than 101.  This is a very high for her.  I kept a cool rag on her forehead almost the entire time, as well.  She liked this because it felt good and would even request me to make it cold again when it got too warm (which was pretty quickly!).

Nolan eventually went down for his afternoon nap. And I sat up on the couch with Grace and watched Mary Poppins with her (before that she had watched all 3 Little Mermaid movies) and she was perfectly content doing just that.  I thought EVENTUALLY she HAS to fall asleep!  She's tired and the fever. She held out until Mary Poppins was almost over and then finally went to sleep for about 30 minutes.

When she woke up around 4:30…it had been about 6 and a half hours since her last dose of ibuprofen. She needed to go to the restroom and after I got her up and in there- I took her temperature and it was 104.1.  I don't play with temperatures like that!!!  I got her in the shower and was able to get her temperature down to 102.1.  I got her to take some more ibuprofen, also.

***So at this point, I'm pretty worried.  I'm unsure of the origin of this fever.  I'm not thinking it's a stomach bug.  And she has no other complaints.  And she's still not moving her arm.  And she is having higher fevers than she has ever had.***

I sent my sister an email tell her about the fever.  She calls me not long after and tells me she has read that sometimes they can get an infection after they hurt themselves.  I've thought this in the back of my mind…thinking maybe she threw up because of the pain and/or the fever.  But I was hesitant to call because I was afraid that no one knew what they were doing (I realize this sounds silly, but until you're in the situation I can see how it would).  She encourages me to call our pediatricians on-call nurse and to just be persistent and not let them brush me off when I think that there is something serious going on here.

So I get Nolan's dinner on the table first because I knew I wouldn't be able to call and talk if he was crying and needing me.  So as I fed him dinner- I called.

The nurses name was Jill, and we talked for probably a good 15 minutes (maybe it was 10, but it was quite a while).  I told her everything….and she felt like I was doing everything right and that I could probably just keep her home, and then just follow-up with my regular pediatrician the following morning.  She thought that the fever and throwing up was a coincidence and had nothing to do with her arm.  We just kept talking throwing things around…and I felt like the more we talked…the more she started doubting that staying home was the right thing.  She looked at another protocol and it also suggested we stay home.  Then finally- she decided to put me on hold and ask her colleague what she thought.  After a minute or so- Jill got back on the line and said that we had to look at worst case scenario…and worst case would be if she had an infected joint…and so we needed to go ahead and bring her in so they could further evaluate.  As much as I didn't want to go back to the hospital…there was a part of me that did because I wasn't convinced that her fever was from anything else and I was very concerned.  She said that she would call my pediatrician's office and the doctor that was on-call there to let them know and see what she thought and that Jill would call me back.  A few minutes later, she called me back and said that the pediatrician thought it would be a good idea to return to the ER and that they would put in the referral and would be expecting me.

Grace was so upset to come back because they had manipulated her arm so much and made it hurt even more (which I know they did this in an attempt to help, but that's hard for her to understand).  And she just didn't feel good and was in SO much pain.  Uhhh…just thinking about it make me sick.

Story to be continued…
(It is taking me very long to write all of this out, but I am for her memory's sake, for family to be able to see and read the whole story, and really- as therapy and debriefing for myself.  I've already started on the rest of the story- it is just taking me so long because I haven't left out many details, per usual.  :)  But I am doing my best to hopefully finish part, if not all, by tomorrow.)


Courtney said...

Poor sweet Gracey girl. I completed dislocated and fractured my elbow in high school and it hurt SO much. And when they popped in back into place?? YOWZA. I know how she feels. Sweet thing.

Viv said...

Had heard alot of this story from their Pappaw but still brought tears to my eyes! Love you Grace!(and the rest of the family too)


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