Monday, April 18, 2016

Week 139: Go for broke

In retrospect, it was quite foolish of me to even mention the word "normal" in last weeks post.  I should have known that mentioning this word does nothing except to inflame the tempers of the arbiters of normalcy, inspiring them to rain down non-normal events to remind you of the error of your ways. 

The week got off to a fine start. I consulted with the nurse practitioner in surgery about the granulation tissue around Lemon's G tube.  We got a prescription for a steroid ointment, and the problem totally cleared up within 48 hours or so.  We also found a good work-around to avoid continuously irritating Lemon's skin with the various tapes and other adhesive products that we were using to secure the tube to his skin.  At the recommendation of a loyal blog reader who is also a pediatrician, I did some research into G tube accessories, for which there seems to be quite a market.  I discovered a company that makes a stretchy cotton belt with holes and a pocket to hold the tube.  It  secures with Velcro--no tape or adhesives required.  Lemon liked it from the moment he saw it, and his skin definitely appreciates a break from the wear and tear, so it rapidly integrated itself into our bedtime routine.  Thanks, loyal reader!

The weather finally turned warm and spring-like here in Madison at the end of the week.  Saturday was our first farmer's market of the year.  Saturday mid-day I headed off to our local nursery to buy two little fruit trees that I've been wanting for our yard, a sour cherry and a quince.  I got them all set up in a big pail of water to rehydrate the roots, and picked out sites to plant them.  Then later in the afternoon, we all went out to play on the swing set.  And Lemon fell off the ladder.  Only from 3 or 4 feet off the ground, over grass, but fall he did.

It was clear immediately afterwards that whatever he'd done hurt.  He cried a lot, and he's a pretty stoic kid in general.  But, after a short rest, he seemed better.  He was still very protective of his arm, but he was behaving pretty normally otherwise, and ate a good dinner.  So, we were thinking maybe we were lucky and got away with a bruise or a sprain.  But, when bath time rolled around and I took off his long-sleeve shirt, I could see how swollen his elbow was, and although he could move his hand, wrist, and shoulder just fine, he wouldn't move the elbow.  Unsure of how to proceed, we called the answering service at his pediatrician's, and the nurse there recommended that we head to the ER.

It was right around bed time, both kids were in PJ's.  But, for better or worse, Lemon is pretty familiar with the hospital and knows that it keeps strange hours.  So, when we pulled him out of bed, put on his shoes, and told him that we were going to the hospital, his only question was whether he would get to watch videos on Daddy's phone, like he did last time we went to the ER.  We got there only to be greeted by name by the same nurse who helped us last time, and shown to the same room.  The doctor who examined Lemon when we arrived guessed that he'd fractured his humerus (a very common injury in toddlers, we've learned), and called for some x-rays.  It as a hopping night in the ER from an orthopedics perspective, and it took a while for the machine to get to us.  Lemon watched videos on Daddy's phone to pass the time.

Finally, the x-ray people got to us, and took some images of Lemon's arm.  These were good enough to confirm the ER doctor's diagnosis, and she paged the orthopedist.  As I mentioned, there was a lot going on in the land of bones that night so it took him a while to show up.  He looked at the existing x-rays and agreed that the humerus was broken, but didn't like the angle of the picture because he couldn't tell if the break went through the growth plate or not.  So he called for some more images.  While waiting for the x-ray team to come back, both kids fell asleep and more or less stayed asleep through all the remaining proceedings.  Eventually the x-ray people came back, and took more pictures at a different angle.  After some delay, the nurse managed to track down the orthopedist, who could now see that, luckily, the growth plate wasn't involved, so Lemon could just get a cast as opposed to surgery and pins.  Unfortunately, the x-ray team had failed to take pictures above and below the break to be sure that nothing else was wrong, so we had to wait for them to come back a third time to take more pictures, and wait further for the doctor to review the third set.  Eventually, sufficient documentation was in place to apply the cast, and we were cleared to go home at around 1:30 a.m.  Lime, upon hearing the letters "a.m." came to the conclusion that it was morning and woke up.  Joy.

The upshot of all this is that Lemon will have to have a cast for something like 8 weeks.  At the moment it's a good old fashioned plaster cast, but I'm taking him on a follow-up appointment to orthopedics on Friday to hopefully get it replaced with a fiberglass cast if the swelling's gone down.  So far he's putting up with the cast pretty well, and I've learned that the bag from a loaf of bread is pretty much exactly the right size to cover a toddler's arm in a cast at bath time.  I sincerely hope none of you need this particular piece of knowledge any time soon, but I'm just putting it out there in case any of you have a "normal" week lurking in your future.


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