Houston broken bones

First of all, Corine sorry for taking so long to respond.  I live in Houston and while we still have no electricity, etc. at our house I do finally have a generator that has allowed me to get back online.  I’m so glad to hear the blog has been some help; that’s nice to hear it’s doing what I intended.

I saw an article just a moment ago on the Houston Chronicle about effects of Ike: 

CHILD INJURIES INCREASE

They survived Hurricane Ike’s powerful winds and torrents of rain, but now dozens of Houston-area children are landing in emergency rooms with broken bones, skull fractures and other preventable injuries.

Doctors are warning parents preoccupied with fixing their homes and obtaining food to pay closer attention to their children.

Since Ike, emergency room visits at Texas Children’s Hospital have increased by as much as 30 percent, said Dr. Paul Sirbaugh, an attending physician.

Sirbaugh said children are climbing trees and falling, getting hit by cars and breaking bones.

“My big fear,” he said, “is that this is something perhaps overlooked in the community. I want to remind parents that their houses and electricity are very, very important, but they need to do their best to keep an eye on their 4-year-olds and their older children.”

Sirbaugh encouraged schools to reopen as soon as possible.

“I would put a call out. We need to get these kids back in school,” he said. “Parents are so distracted at home.”

Memorial Hermann Children’s Hospital also reported an increase in child injuries similar to that seen during the summer holidays.

follow up

It’s a good thing we ended up making our 1 month follow up with another doctor.  The short story is his staff way overbooked him for our original 1 month post cast off appointment.

I left and came home to book another appointment at the main location in the medical center; the first appointment was at the annex close to our house (which is known to always overbook but I forgot since the last time we used the annex was a couple of years ago).

His rescheduled 1 month appointment was supposed to be this week, which would be more like 6 weeks later but his dad scheduled a follow-up with another doctor last week.    So his 4 week appointment ended up being at 5 weeks with another doctor.

I kept the rescheduled one with his original orthopedic doctor though, which was supposed to be this week.  I had a phone call today that they had to cancel it because he needs to be in surgery so they gave me the next available appointment – July 7th.

Which would be more like 10 or 11 weeks for what was originally supposed to be 4 weeks.

My take-away on that is 2 things.  Glad we rescheduled with another doctor so we could have the follow-up x-rays done and know that he’s on track.  And two, apparently the 1 month follow-up isn’t as crucial or they would’ve fit us in before then.

It all worked out at least.

it IS shorter!

Pony, you are one smart woman. I sure learned a thing or two today (just a reminder, our family had no broken bones when I was growing up, or since then so I know nothing about them except our recent adventure).

Turns out, his right leg is a bit shorter.

On purpose!

When the guys came home from the doctor’s appointment and he told me they had set it shorter on purpose, it was a “WHAT ON EARTH FOR???” shout heard ’round the world.

Turns out broken bones grow much faster than non-broken bones, so they set it shorter – on purpose – so they’ll end up the same after a year’s time. Aspiring basketball players, don’t try this trick on both legs; it’s not worth it.

This was a different doctor than the one we had been seeing, but he backed up with words what the first one did with action – assured my husband that this was actually standard procedure.

The boy is thrilled to be cleared to go back to gymnastics finally! He got a written note from the doctor (my insistence) so all is well with the world.

1 week later

I’m multi-tasking (and if anyone wants to help me catch up on work, just let me know). One week after the cast came off, I think a video tells the story best as to his progress.

http://www.youtube.com/v/HPZg4Bj6XrU

He can stand upright for a few moments. He occasionally will take a few steps but prefers to crab crawl; not a problem as the walking is obviously going to happen at some point.

I do have a concern with his toes pointing out to the right when he does walk, so I called his doctor to get a referral for physical therapy (TCH has an annex with physical therapy 5 minutes from our house). They generally give the patients 2 weeks to work things out so it may be another week before I can get the orders written for physical therapy but we’ll wait and see how it goes.

Here’s my lesson of the week. Be patient. Learn to manage expectations (for the adults as well as children).

comments

As far as his walking goes…it is definitely our expectation that he will walk normally again. Right now he has little muscle control but it’s coming back. He has dreamed of being a baseball player his entire 4 year life; some days I think all he talks about is the Astros and his dream to play baseball with Lance Berkman. I don’t think that’s going to happen since his growth plate has likely been affected and he was already treated at TCH for height and weight issues before this happened..

I need to convince him being a horse jockey is an admirable profession!

The first day it took him 9 hours after the cast was off before he did anything, and that was to scoot.

The second day he wanted to walk everywhere for brief periods of time as long as I held on to both hands above his head – literally toddling, just like a toddler – side to side.

Yesterday he stood in front of me just learning to balance for seconds at a time while not holding on to anything. And a few times we took short walks with me holding on to just his right hand. Karen made a good point that until he’s really steady on his feet, we need someone near him whenever he’s on his feet.

Cassie, did I ever tell the story here about my mom? She said it was amazing she had all those kids and none of us ever had a broken bone. I told her I thought it was amazing she had all those kids and none of us ever had a tattoo! LOL!

off comes the cast

The first thing we all did was briefly walk through what was going to happen and he saw a demonstration of the saw in action so he would realize it wasn’t going to cut him.

He had a little circular hand saw to use, and cut a series of straight lines that would eventually connect together. He started at the bottom of the foot by the ankle bone and cut a straight line up the inside of the cast to his knee. Then he did the same thing with the outside of the cast on that same leg.

If it isn’t obvious, the little boy hasn’t been able to touch his toes for two months but suddenly, those hands were everywhere. The man cutting his cast off (that’s the same one who makes all the cast adjustments) kept reminding me to keep his hands away. I almost got the impression other children before us have lost a finger in the process of getting their cast cut off.

That’s a photo of the technician (I don’t know his title) keeping the boy’s hands and fingers away because I’m not doing my job.

Everything was going fine until he started making the cut inside his leg from the knee up to the pelvic area. This is what sheer terror looks like on my son’s face.

It eventually all cut cut off though, albeit with much screaming of “I don’t want my cast off! Noooo…don’t cut my cast off!” Sadly, I have no video of that.

Step 2 surprised me because I didn’t know there was a step 2. I just thought they sawed the thing off and off the whole cast came. No.

Step 2 was to take the instrument you see on the left side of this photo and run it through all the cuts to make sure he hadn’t missed any parts to saw. In effect, its job is to separate the 2 sides of the cast from each other.

When he was done with that, he cut through all the medical tape and moleskin that was still keeping the edges attached. The reason he did all of that was when he was done, he could lift the top of the cast off in one big piece so that no sharp edges would be near his skin.

I thought this was a great shot below; you can see how the cast is starting to come off.

We were almost done!

bath time

We put him back in his car seat – the first time since 8am, February 15th, and headed home. Mr. Boone drove; I sent text messages to just about everyone while he drove.

I carried him literally from the car to the bathtub and he was still very upset. It was as if we were in a time warp back to when the cast first went on. He was crying, he was afraid to have anyone touch him, he said his leg hurt, he was sure I was going to drop him.

We started off with a nice warm bath with just water in it. His left leg (the one with the shorter cast) is pretty raw.

It took all of 2 minutes before he announced he had peed in the bath water.

Sigh.

We drained the water and started the whole process again. This time however I added bubbles to the mix and just let him sit in there. He sat in that tub for over an hour.

I think that did him a world of good. By the time he came out, he was my happy little boy. He even let me get him dressed which is more than he came home in. We were lucky to get a pull-up on him. I had decided to use a pull-up instead of underwear just in case he had an accident since he hasn’t used a toilet during this process.

Turns out, using a pull-up was the best thing I could’ve done. After his cast came off, he kept his right leg out at that angle the entire time until he got in the bath. When he got in the wagon to go to the car, it was at that angle. When he got in the car seat, he sat in it sideways to keep it at an angle.

I never would’ve been able to get regular underwear on him at TCH without him screaming and being really terrified and in a lot of pain. Since pull-ups have those sides to them that you can velcro together, it worked out great.

In other words, the shorts, socks, shoes…we didn’t end up putting any of that on him.

It’s 2pm and I’m wrapping this up finally. He’s back to his cheerful self and that’s because we kept today as low key as we could possibly get it. After the bath, he sat on the couch and he’s been there ever since.

He won’t graduate from high school sitting on that couch so I’m going to follow his lead on what our schedule is.

Our next appointment is in 4 weeks and best news of all is I can go to the annex that TCH has near our house instead of going to the med center.

Oh! I keep forgetting – this is the question I’ve answered so many times today. He hasn’t stood up yet. He hasn’t crawled anywhere yet. I’ve only carried him to where he wanted to go, and that was only to the bathtub and then to the couch.

I don’t know when he’ll crawl, or when he’ll walk but we’re just going to wait for when he’s ready and not push it.

shell

That picture creeps me out a bit! That’s the top half of his cast on the floor after it had been cut off of him.

Step 3 was a surprise because I didn’t expect step 2 so obviously I didn’t expect step 3. The next step was to remove all the cotton that enveloped his body. This picture looks a lot like ones of him with an adult diaper on, but that’s really the cotton that was the layer just beneath the cast.

After he got that part cut away, it was extremely gross. That cotton holds all the stuff that got caked on him and we finally figured out why his cast started smelling in the final 24 hours. I’ll spare you the details.

If that was me doing this particular step, it would’ve involved gloves because no way would my hands be touching that nasty, stinky cotton.

After he got all the cotton off the pelvic area, he did the same thing with the right leg and worked his way up.

The picture below is what 8 weeks of dead skin cells accumulating looks like. The best way I know how to describe what his skin looked like was dirty, stinky, smelly. But the texture was a lot like if you’ve ever had a sunburn and your skin starts peeling. He spent the rest of the time at the hospital and on the ride home peeling skin off his leg.

His leg was pretty raw around the knee area on the inside of his leg as you can see also in that picture above.

When we were about wrapped up, the doctor introduced me to his nurse who asked if I would give her the URL to my blog. I think I mentioned it somewhere along the way when he saw us taking pictures of everything.

We made a quick trip to the gift shop on the 3rd floor to get some gum for the little guy – that was his only request once the cast came off and then it was back to the parking garage to get our car. I thought by now his mood would have cheered up a bit so I asked him to smile for the camera.

“My smiles all went away, Mom. I don’t have any left“. His right arm is still busy scratching all that mess off his legs.

it’s off

First order of business for having his cast cut off was to sit on one of 4 beds in the casting room. Previously we had only been in this room (it’s within the ortho unit at TCH so everything is very close) to get his moleskin repaired. I had in my mind the way this would work is that one of the residents would be in there with the doctor to cut it off and we would be in a regular room.

I was wrong as usual. We were in the casting room which was great because there was a lot of stuff to look at and keep us busy until it was our turn. Like a skeleton with an arm that’s no longer attached.

Across from us was an older boy who had broken his arm and I was amazed to see they put the cast on his arm right there. No anesthesia for him! It was fun – for me – to watch it put on his arm. Mr. Boone has broken his arm twice so this was all old school to him, but it was a first for me.

And the other little girl with the new spica cast was also in there but I think she was just getting her moleskin worked on and maybe the cast adjusted a bit.

Above the bed he was laying on was a mobile like babies have above their beds which was another reminder of how fortunate we really were to only have a cast on for 8 1/2 weeks. I’m sure that mobile was up there to entertain a baby who has hip displacia and will spend months and months in a cast.

The doctor came in and looked at the x-rays and gave the official word that the day of the great castoff was an official “Go“. Woo hoo!

Compared to the wishbone picture from a month ago, this looks fabulous. And I’m so glad the doctor told me ahead of time it wouldn’t look 100% healed today so that I knew what to expect or I might not have let them take the cast off today!

He left the x-rays up there after we looked at them so of course we took pictures of that too. On his way out the door, the doctor saw his heel. “Is that a hole in his cast?” Um…yes….well, we sorta let him scoot all over the driveway and…..

Finally, it was our turn!

cast off

I’m sure this is going to take me more than one post to write up the morning’s events. This is part one of the great castoff!

The alarm was set for 6am, but Mr. “I Talk In My Sleep And I’m Still Sleeping In My Parents’ Bedroom” woke me up at 5:15. But at least he was dreaming something about me that sounded pleasant so it was okay – this time.

We got the daughter off to school and headed off for the big trek to Texas Children’s. That only took an hour and 20 minutes, which for morning traffic probably isn’t too bad but a good reminder why I try to stay out of Houston traffic.

Our first course of business was of course to see the floating plastic fish in the larger waiting area.

When we got to the ortho waiting room, I noticed there was another little girl in there who had a purple cast on, and hers was very clean and not written on so I’m guessing this was their appointment at one week post op.

She had come in the reclined wheelchair like I’ve seen pictures of for other kids in spica casts and that’s when I realized…I think all things considered I like the wagon. First of all, he’s lower to the ground so less chance of injury if he did slip out of it.

And it’s big enough to put other things in there with him such as my purse. A breakfast try can slide around the edges of it and as much as it reminds me of our need for one in the first place, at least we will make good use of the wagon at the zoo in the future.

The boy didn’t notice any of this because he was busy trying to figure out how to make international calls at the expense of TCH again. Try again, honey…Dublin is 9-011-353-1-615…

It wasn’t long before we were called in for what I am guessing is our second-to-last x-ray. He wanted his dad to go in with him which was a first, so I took a picture of a totally rad sign next to a psychedelic colored wall.

Okay, that really stands for radiology. I just thought it was “like totally rad, man” when I saw the sign and it made me laugh. Unfortunately, one of the radiologists caught me snapping a photo and now thinks I’m nuts.