Sunday, June 1, 2014

Daredevil Kate!

Both Ty and I were off work for Memorial Day so Josie and I baked some fun unofficial-start-of-summer cookies. They were really good. I made plenty, so we took a bunch around to the neighbors.

After that we headed into Lowe's to buy some fence posts, rope and anchors for our new awesomely orange sail shade for our deck. (actual deck may vary from what is pictured).

So, we loaded the girls into a shopping cart and got all the goods. In the rope aisle, Kate stood up in the child "basket" of the cart. I quickly sat her back down and noticed the strap was broken on the seat belt. I tried to try it, but it wasn't long enough. Ty loaded the fence posts on the cart and we headed for the checkout line. As I paid for the items, Ty realized he had a coupon for $10 off in his wallet and left the girls and cart to bring it to me. At that moment Kate stood up and lost her balance and her and the 4x4 12 feet long fence posts ended up on the ground. Unfortunately, Kate's left hand ended up between the wood and the concrete floor. I ran over and scooped her up before I even realized what had happened to her hand...I just thought she had fallen out of the cart. Her hand immediately started to turn black and purple and swell within just seconds. 

The others in the store tried to help by getting some ice and assisting as they could. The workers there wanted us to fill out an incident form, but with how quickly it was swelling we decided to head straight to the hospital instead. We were going to go to the quick care, but since it was 5:30pm on Memorial Day, it was closed.

So the ER got a new screaming baby with a crushed hand to take care of. They gave her some ice when we got checked in, but she would let us even touch it to her hand. Within just a few minutes we headed back to talk to the triage nurse. All the rooms were full except the Trauma rooms, but it pays to have both of us employed here, so they put us in on of their nice glass rooms. It must be a coincidence, but our friend Kaycee Teeter was our nurse again. For Kate's ER visit in April read here. :(

They came in and checked her out and decided she would need some IV Fentanyl for the pain. But based on previous experience, I knew that starting an IV would be really, really difficult. The last time the only IV they could get was her left hand, go figure! She has the chubbiest hands and feet and arms and legs and...well... everywhere is chubby on her. They tried with 4 different nurses in several different places, with a vein light, warming pack and every imaginable technique, all the while with a screaming Kate being held tight, by both Ty and I, before the doctor came in and said lets just give her some oral Motrin. Good idea! It didn't take long before that started to kick in and she was a whole different child.

Just a funny side note...when all the nurses were in the room trying to find a vein, and kept saying her hands are too chubby to see any, Ty said, "We're planning on getting her into see a dietitian..." One of the nurses was horrified and said, "No! Babies are supposed to be a little chubby!" Only Ty, myself and our friend Kaycee knew how funny that really was! We explained that I'm a dietitian, so it was just a joke. :) It was a great chance for stress relief!

Sorry for the poor quality pictures...we didn't plan ahead enough to bring our fancy camera.

They took some x-rays and sure enough 3 broken bones, "at the base of the 1st, 2nd and 3rd metacarpals", as Ty would say! Basically at the base her thumb, pointer finger and index finger. But thankfully! they were non-displaced, meaning they hadn't shifted out of place.

 You can really see how much soft tissue swelling she had...

If you look towards her thumb you can see 2 long arrows pointing at the small breaks there and the 3rd break is much more obvious...on the left side of the middle bone.

Here, let me just make it easy for you! :)

Meanwhile, Josie wasn't feeling good. I asked for a blanket that she took a nap on in the corner. Which is very unlike Josie. She never takes a nap unless she's sick or strapped in a car seat, but more to come on that as well.

After waiting and waiting the doc came back and said the ortho on call had been notified and would be in soon. I ran up the street and grabbed some dinner for everyone and meds for Josie while Ty held Kate and tried to get her to rest. She was so exhausted, but she didn't want to sleep at all!

Around 8pm the ortho showed up and was concerned about all the swelling. He thought we may be dealing with compartment syndrome, where there is too much pressure inside any given "compartment", like the muscle myofascia, which would cause the tissue to get poor blood supply and could damage large portions of it. He thought we might have to do a fasciotomy, which we are quite familiar with as well, as seen here. But he didn't really want to do that, so he said he would come back in about an hour and see if it's gone down at all.

So we waited for about an hour and a half and walked with Kate up and down the halls of the ER and chatted with the staff members we knew. Ty gave Kate a father's blessing and prayed that her hand would continue to function well without permanent damage and the swelling would go down quickly and that she wouldn't be in pain.

He finally came back and said that yes, they would like to take her to surgery for the compartment syndrome. This would include a facia release and an open wound (not sutured up)  on a 18 month old for 2 weeks and then they would close it back up and let it heal for a few more weeks. I had the worst feeling about having the surgery done and asked if there were any more options and if it was absolutely necessary. The doctor conceded to calling a hand specialist to get a second opinion, since we were considering driving to St Luke's Children's hospital instead.

We talked it over between Ty and I and it was not what I wanted to do. Ty even called a friend of ours that also does ortho surgery and he agreed that he would him do the surgery if his daughter was in the same boat. We finally agreed that if that's what needed to be done to help her hand heal as good as possible, we would do it. I was really upset by it all and crying. Ty gave me a blessing that I would be at peace with this and that everything would work out as it needed to.

We called the Kaycee in and told him we had decided to go ahead with the surgery. At this point we still hadn't heard back from the 2nd opinion yet. A few minutes later the ER doc, Kaycee and the Ortho doc came back in with the cast cart. Ty knew right away what it was and that they had decided against surgery.
The doctor explained that after he talked to the specialist, they had decided that the surgery wasn't necessary. Often in this situation the patient may lose feeling in their hand for a few months while the nerves heal due to the excessive sweeling, but that goes away and the hand has no loss of function down the road.

I can't express to you how relieved I was!!! Thank you Heavenly Father!!

They splinted it and finally sent us on our way with a Rx for Tylenol and Codeine for the pain.
Kate was so starving by the time we got home (they wouldn't let her eat anything in case she did have to have surgery) and ate half the fridge, I swear!

We set up the pack and play in our bedroom and around midnight finally got to bed.
Kate slept all night and didn't even wake once in pain. In fact she didn't need ANY pain medicine whatsoever after that for her hand. I know that blessings are really and the power of the Priesthood that Ty holds helped Heavenly Father heal our baby!

 This is the next night, all happy go lucky! (Ty got the shade up without further incident!)

There were multiple follow ups appts and new casts and more splints and xrays...

  ...which Kate was not happy about...

(Her poor little fingers were so swollen, even when they took the cast off!)

 ...but Kate got her cast off on the 24th of June! Only 1 month and she is doing great!
There is a lot of blood that had hardened within the tissue of her hand, but now that that cast is gone and she has started to use it again, the swelling is almost entirely gone and the dried blood is slowly working it's way out.

Note on Josie: Remember Josie had been sick that first day? Well she had an appt with the MD, the Friday after Memorial Day for her 4 year well child check and we found out the whole time she had had Hand, Foot and Mouth Disease. (Funny, because she had said her mouth hurt and I had Ty look it up to see if that's what it could be 2-3 days before we had the appt). Friday was probably the worst of it with all kinds of sores in the front of her mouth and she been refusing to eat anything for about 24 hours. I stocked up on Pediasure and made her drink those with a straw, so it didn't bother her gums and the front of her tongue. She had 4 cans down before the next day and after I talked to a friend about her experience with it, we filled the Rx for Tylenol and Codeine (shhh!) and our favorite little Josie was back to normal soon enough.

What a hectic few weeks it's been, but I'm so grateful for those in the ER that helped us and the knowledgeable doctors and nurses and family and especially for Ty and his support through all of it! I know the Lord loves us and the blessings He gave to our family are real!

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