Or as I like to refer to it…
“Can this poor kid catch a break???”
On 19 March 2010, Jacob had surgery on his left foot (every time I say that, I have images of Daniel Day Lewis in a wheel barrow, ranting…). He had an accessory navicular, tight heel chords and tight muscles in his calf (I had originally – and mistakenly – said loose ligaments in his calf).
As usual, he spent part of the night throwing up from the anesthesia. This was aggravated by the pain in his leg/foot. He alternated between the pain ball (a catheter was inserted next to the nerve that runs down his leg and pain medicine was released to sheathe this nerve to block pain…similar to an epidural) and a morphine drip. (The pain ball would sometimes numb him so well that he couldn’t even move his toes, so they’d turn it off and within an hour he’d be wailing that he hurt, so they’d come in and give him morphine). Because he was throwing up from the anesthesia, they were giving him IV fluids (because he had NO interest in eating or drinking).
But in true Jacob-Fashion, he perservered and perked up and became my sweet boy again.
He even joked and smiled while learning to use his crutches WHILE DOPED UP ON MORPHINE.
My Peanut amazes me.
After we were released from the hospital, we go home…with the pain ball. We were to leave that in for 24 hours.
My mom and I set him up in the living room (in the recliner) and let him sleep as much as he wanted. Thankfully, the vomiting had subsided, but we had issues with the pain ball again. Not as bad, and we left it in until it had to come out. Now, I’m not all that squeamish when it comes to medical issues, but I did NOT want to be the one pulling that thing out of his leg. Crimeny, it was pretty much attached to a nerve!
Thankfully, one of my wonderful, awesome, can’t-live-without-them, neighbors is a retired surgical nurse. She came over and had that thing out lickety split! No pain, no nerve damage. I *heart* her! (Thank you, Delores!)
An hour later, he was popping Percocet. To give him credit, he really tried to NOT take it, but if it will take the pain away and intake is being monitored (by ME), I want him to take it.
We kept this up for a few days and were able to wean him down to just Tylenol for pain before mid-week and then cold-turkey by week’s end.
That boy is such a trooper!
His friends. Lemme tell ya. They surprised me and humbled me. I thought for sure, being Spring Break, they’d maybe come say hi, but then be off, riding bikes, playing ball, etc. And they were.
But boy did they come, EVERY DAY to check on Jake and coax him outside. The first time I took him outside for a walk (in a wheel chair, because at this point, he was NOT adept with those crutches), every kid that saw us immediately stopped what they were doing to come play with or around Jake. They were SO happy to see him outside and he was so happy to have the attention/companionship.
This started a trend. The kids would come to get him. I would take the wheel chair outside and set it up, two kids would get him out the door and to the chair. We’d get him in, one would push, the other would take the crutches.
He spent the entire Spring Break PLAYING WITH HIS FRIENDS.
(I note that until my next door neighbors moved in, Jacob was the last choice any of the kids made to play with. He just wasn’t athletic enough or “cool enough”. Don’t know WHY this changed, but I’m glad it did).
The day before he went back to school, we had our follow-up appointment with his orthopedist. X-rays were taken and a cast put on. Blue…SMURF blue. LOL
The day after his cast was put on, he returned to school. Boy, were they all glad to see him back. Even his teacher. Everyone was willing to accommodate him, help him and sign his cast. *I* was a nervous wreak all day, expecting to get a call that he fell down the steps (OF COURSE his classroom is on the second floor and there are no elevators), banged his foot, got sick…you name it, I worried about it.
As usual, I worried for nothing. (side note: I have a tendency to worry about the dumbest damn things…inconsequential really, but I worry. Now, surgery? Not worried. Figured I’d not worry unless there was something to worry about…why can’t I do that for the little things?!)
10 days pass by with little to note. A few stumbles, but nothing to worry about.
However, on Wednesday (14 APR), he fell twice at school. Once on the playground (we assume he tripped over his crutches) where he actually fell to the ground scraping his hand and BUMPING THE TOES OF THE “BAD” FOOT. (note: this foot is to be NON-WEIGHT-BEARING for 6 weeks). A teacher and a few students helped him right himself and go about his day.
Fast forward an hour or two and he falls trying to go up the stairs to class. Falls off the step and bangs his hip.
Neither time did he (or anyone else) think to inform the nurse.
Being Wednesday, he got out of school early and I wasn’t going to be home until a little later (because I made up a little time that I’d lost during his recovery time and also decided to treat myself to some pretty new nails).
I come home (not more than an hour later than usual) and he’s in the living room with Natalie and Delores (remember her? The retired surgical nurse?). First thing through my head is “ah shit, what happened?”
First thing out of Jacob’s mouth is “Don’t worry, I’m fine!”
He apparently passed out, fell and hit his head while playing at a friend’s house.
He was sitting down, throwing baseballs into a bag. One got away from him and he got up, hopped over to where it was (no crutches), turned to throw it and “fell asleep”. He said it felt like he got really tired and just fell asleep. He DOES remember hitting his head (and hip…the OTHER hip), but he was confused and dizzy when my neighbor came over to get him.
The kids say he just passed out and was unconscious for like 5 minutes.
We think he was out for a minute or two.
Delores said to just keep an eye on him and he should be fine.
Keep in mind, neither of us were aware of the two earlier falls at this point.
When Jake finally tells me about those, I decided to call the After Hours Nurse at his pediatrician’s office.
Because he was “out” we had to go to the ER (CHOP ER, not the local hospital because it’s not good enough) and have him evaluated.
We get there and wait about 30 mins to be called back (NOT long for a CHOP ER visit). The ask us to explain why we’re there and Jake gives like 3 different versions of events. He does remember the fall. He doesn’t remember the fall. He remembers some of it.
They run through there screening, including the whole, smile, raise your arms above your head, say a simple sentence, stick out your tongue, turn your head, but don’t let me turn it back, etc. (for those that don’t know, that’s a simple screen for a STROKE!)
Again, I’m all calm through this…
They think (and so do I), that he got up too fast (the last time) and got light headed and passed out (vasovagal syncope). So, they take 5 different blood pressure readings. One while lying down, one while seated and then three while standing (as best he can on the crutches).
They also check his blood sugar levels (fine, of course, he had eaten in the waiting room, so not sure how accurate that would be).
They took an x-ray of his back because he complained of pain along his spine on one side (when they were palpating). Initial view found nothing of note.
Then, an EKG.
We waited FOREVER after that test.
Turns out, his QT intervals were “mildly prolonged” and they were waiting for the resident cardiologist to come take a look.
Now, prolonged QT intervals CAN cause someone to pass out, but we’re all still convinced that isn’t what had him pass out Wednesday.
Regardless, they sent us home with instructions to follow up with his pediatrician and have another EKG performed.
WE go home (AFTER midnight) and flop into bed.
And because we’re both stupid, masochists, I go to work and he goes to school.
I call and get him an appointment for later that day (Thursday). He can’t see his primary pediatrician (because she’s out until Monday), so we see another doctor in the practice, Dr. Banner (I think his first name is David, but I always want to call him Bruce, tee hee).
While driving to the appointment, I get a phone call (@1441, which I missed) from a CHOP ER Nurse Practitioner named Jennifer. She told me to call her back at 3481.
I call her back in the waiting room, but she’s not available so I leave a message with Antoinne (1501).
IN the meantime, we’re called back to wait for the doctor.
Jacob again explains all that happened and why we went to the ER. I go over what was done and said at the ER and give him the discharge instructions.
He’s a little peeved because he can’t perform a follow-up EKG without an original to compare to. And for some reason we’re not sure of, they wouldn’t give me a copy of the one from the ER and the there was no copy in his file.
Again, vasovagal syncope is the diagnosis, but since there is still the concern of the prolonged QT intervals, we have to follow up with a cardiologist.
Until we SEE this cardiologist, he’s not to have ANY MEDICATIONS OF ANY KIND without checking with the doctor and/or pharmacist first. Some medications can exacerbate the QT issue.
I can’t even give him his freakin’ inhaler or Tylenol/Motrin without asking first.
While at the doctor’s office, we are told that his primary doctor is RETIRING. L We LOVE Dr. Huff. LOVE, LOVE, LOVE her. She’s been his pedi since he was just a 5.3 lb. preemie!
So, now we have to consider finding a new pedi. Thankfully, we can still use the same practice, but have to choose a different doc. I’m thinkin’ we’re gonna pick Dr. Banner. For a few reasons: 1.) He engaged and spoke TO Jacob. 2.) He listened to what was being said. 3.) He’s male and since Jacob is a pre-teen, I think he’d feel more comfortable discussing “boy issues” with a male doctor. 4.) He gave me is cell phone number to call him directly with any questions/concerns/follow-ups from the ER nurse practitioner. Who the eff does that anymore?!
As we were getting ready to leave, Jake hopped down (carefully) from the table and went to take a step with his crutches and hissed. His [good] knee was bothering him.
Dr. Banner came back in (at our request) to check it out. He thinks it’s just mildly injured due to all the falls and to keep an eye on it and give him some Motrin for the pain. Me, being the smartass that I am, immediately says, “CAN I give him the Motrin???”
What do you know, pediatrician with a sense of humor, laughs and says “Yes, it should be fine.” :-p
On the way home from the doc, I get a call back (at 1658) from Colleen at CHOP ER.
Jacob’s x-rays were examined again and it turns out he has Spondylolysis. At L5. Basically a small SPINE FRACTURE.
I’m in full-on whine mode now (doesn’t help that I’m sleep-deprived too).
So now, I have to call and get a follow-up with a cardiologist AND his orthopedist.
He’s already out of commission with the foot for all of Spring and part of the Summer (he gets ANOTHER cast in May and then a boot in June and THEN PT), now he may have MORE delays with a broken spine!? And heart problems?!
Granted, he can’t do much of anything anyway, and Spondylolysis doesn’t always require surgical fixes) and the QT issue may just turn out to be nothing, but damn it, why can’t he get a break.
Yes, he was a preemie.
Yes, he got more than his fair share of sicknesses, allergies and asthma (as a little guy).
Yes, he’s broken two bones (same wrist, same spot).
Yes, he’s had his tonsils and adenoids removed.
Yes, he’s had a bone removed, a bone grafted and muscles split and plans to repeat on the other foot.
Can we PLEASE get a break?!
And not a literal one.