Saturday, December 15, 2007

How Not To Break Your Arm

...Continued from Wednesday...

With the washer back in the active roster, I closed out the ticket on what I thought was to go on record as a successful, productive day. That was before I welcomed my 12-year-old home. She came in with her right arm at a strange angle and saying something about having her elbow hurt in choir. It seems that she was in class and the teacher had the girls all lay on the floor to demonstrate how much better that position makes the voice project. As my daughter was lying down, her arm was put in an awkward position. Her elbow popped so loud, she said it echoed in the choir room. Everyone turned around, shocked, and asked if she was all right. She lied and said she was fine. As the rest of the day progressed past choir, the last class, her arm got stiffer and stiffer. By the time she got home, she was in quite a bit of pain and her right hand was going numb and cold. Not a good sign.

I had some frozen lasagna in the oven, and it was nearly done, so I called the pediatrician’s office and asked what they thought. The nurse asked if her fingers were pink and I said “no”. That was when she uttered the dreaded words, “You’d better take her to the emergency room”.

There was lasagna heating, the sixteen-year-old was not quite home from swim practice, and my wife was not quite home from work. I called her and told her what was going on and she was understandably in shock at the news.

The lasagna was just about ready, I called the swimmer and she was nearly home, so we waited a couple of minutes to go. Then, off to the Alvin Urgent Care Center.

When we arrived, nobody was at the front desk, there was a lady with a fever filling in the check-in form; hopefully she hadn’t added some of her germs to the stack of paper...I used my own pen. I gave the form to the girl who popped up from nowhere and we advanced to the waiting room. We only sat there for a couple of minutes when we were called back, mainly because one of the nurses didn’t like the color that my daughter’s fingers were displaying. Sort of a blue tint, and they were cold as ice. We were hustled straight into triage where another nurse hammered all of our information in on a computer terminal. Cool and efficient, she made some quick assessments and took us to our own little room.

We waited for about half an hour until the doctor on duty came in and asked her what happened to her arm. This was the fifth of about twenty run-throughs of the story that she would tell that night. He listened patiently and I asked if perhaps it was dislocated. He said that it was possible and did a cursory examination, trying to bend her arm and pushing and squeezing her elbow, all the while she tried to be strong, but I could tell that it hurt.

After the doctor left, we remained in our cell for a short time until the sprightly x-ray technician came in for our trek down the hall and into radiology. Not being a super-modern facility with the film-free digital x-ray (multi-million dollar) machines, the smell of Dektol permeated and nearly-but-not-quite defeated the smell of “stale hospital”. As the technician place the wee lass’ arm in the proper position for the x-ray, it was clear that it wasn’t the proper position for her arm. She silently bore the pain, but big tears fell from her eyes and on to her dress code khaki pants. The tech tried to explain why she had to move her arm in such a way, but the wounded joint didn’t quite understand. I know that it’s his job to place injured and sick people in optimal attitude for radiographic examination, but my little girl was in a pretty good amount of pain. All I could do was reassure her that it was going to be just a minute or so before it would be done.

The two exposures done, we were able to return to our waiting room. The doctor on duty came in shortly and said that there didn’t appear to be a dislocation or a fracture, so he was going to send us to Clear Lake Regional for another doctor’s opinion, along with the possibility that if it actually was dislocated, they could sedate her before they started in on it. Oh joy. Immediately, the patient began to look around nervously like a cat in the car.

My wife arrived from work but could only stay a little while, and she had to go home and see to our other offspring. That in addition to the fact that sometimes our little trooper troops better with Dad; Mom’s presence makes her want to try for a dose of some sympathy and some extra, “this hurts really bad...”. She did, however get to experience the new nurse, Vivian. She was a whiskey tenor with a friendly and chatty demeanor. She came in and hammered on the computer terminal for a little bit, getting more nuance out of the same information we had given an hour or more before, and administering a couple of doses of acetaminophen with codeine for the pain.

In a few minutes, a male nurse came in, asked what happened to her arm (number nine by now) and said that he was going to start an IV so that when we got to the hospital, it would be easier to give medications if necessary. He was very friendly, reassuring and gentle in starting the catheter IV line, and my gal was being a real trooper. They told us that they would be transporting her by ambulance, to which I gasped and dollar signs flashed in front of my eyes. I asked if it would be possible for me to drive her over there (as I should have done in the first place), to which they replied that it would be best, since she would bypass the teeming hordes in the waiting room. I acquiesced, and I called my wife and told her what was happening and added that it would likely cut our wait time.

So the EMTs came in and helped her onto their high-tech gurney. They strapped her on and wheeled her to the door. I headed to the exit to meet them at the ambulance. My girl looked so small tied down to the hardware like that, her right arm still stiff and her left arm wearing an IV terminal. I kissed her on the head and told her that she could ask them all the questions she wanted to. That seemed to cheer her up a little. The driver told me that I should go ahead; she guaranteed that she would catch up with me. She sure did.

On arrival at the hospital, I found the Emergency Room Patients Parking Only lot, and then to the only open space. By the time I parked, Speed Racer, EMT had already pulled the gurney out of the ambulance bearing my little dependant. As I trotted up, she indicated that the ride was fun and that she had talked the whole time. They wheeled her into the ER and as they did, I heard them comment on the volume of people in the waiting room. Good call by the Alvin doctor, I guess, because we went straight to our stall and waited. Thus began our three-hour stay in limbo. We were introduced to our nurse for the evening, a nice blonde woman who didn’t seem to be paying complete attention to our words at any time. She asked what happened to my offspring (number twelve) without actually hearing the explanation. It seemed the words she spoke to us were from a carefully crafted and memorized script. The reason I suspect it was memorized is that I couldn’t see any teleprompters in the cube.

There was a small dry erase board with the words carefully and neatly written; “welcome to Clear Lake Regional Medical Center –Your Nurse is: Charge Nurse is: . So who are they? I don’t know. I never found out. Our charge nurse could have been Clara Barton and we missed her because they didn’t bother to write it down.

As we sat and killed three hours, occasionally we heard the disembodied voice come over the loudspeaker and call out for “Dr. Anthill”...did we hear that right? Could they have said, “Dr. ANTHILL”? We half-expected to see an aardvark amble through wearing a lab coat and a stethoscope. We snickered about this every time over the next three hours. I also drew a "girraffifly" on the dry erase board and we watched “Little People in a Big World”. A couple of times, the nameless nurse came in for some reason or another, and we always anticipated her reaction when she gazed up at the dry erase board with the whimsical creature. She never even looked. We were both disappointed, but I guess it wasn’t in the stage directions for her to “glance at dry erase board”. I also happened to overhear a couple of EMTs comment on the size of the crowd in the waiting room.

Finally “Dr. Anthill” came in, and after the poor girl recounted the story yet again, he explained that he saw nothing on the x-ray. After a quick review of the case, during which at no time did he even touch or examine the arm, he proceeded to splint the ailing wing. He wrapped it and told us that the nurse would be coming in shortly to administer some pain medication through the IV that had been started hours ago in Alvin. So we waited. About fifteen minutes later, Nurse No-Name hurried by and read from her script, “I’ll be back in two seconds to give you your pain meds...”

We got to watch the rest of “Little People in a Big World”, I had no idea that this was even a real show. Finally the nurse came in and administered two milligrams of morphine. Apparently the time warp we were in was coming back to reality. We got processed in the ER, then were led out the door to be reprocessed at the Discharge window. This is where they extracted the $100 for the privilege of being ignored and told what we already knew. The one benefit was that Dr. ANTHILL (actually, no “h”) gave us advice on how to get in to the best orthopedic doctors’ offices the next day.

The entire time we were checking out, the patient, though still in some pain, was talking and singing and humming. I suggested to her on several occasions to settle down and let the morphine bring on the rest she needed. The complete trip home was filled with statements and questions that required answers from me. Not the standard yes or no answers. These required thought and speculation, getting to the heart of some ancient or hypothetical situation. I didn’t have the strength. I finally told her to contemplate how tired she really was; hadn’t she gotten up early this morning and how exhausting it had been to be on the hospital bed for so long?

When we arrived home at nearly midnight, she was hungry; we hadn’t eaten the lasagna before we had left, and all I had eaten since breakfast were four Satsuma tangerines. Before I faded out completely, she indicated that she really wanted to go to school the next day. I managed to croak out the explanation that we had to go to the orthopedic guy quick so as not to drag out the suspense any longer than necessary. She finally settled down and went to bed at about 12:30 a.m., maintaining her wish to attend school on the morrow.

She didn’t wake up till 10 the next day.

We went to Dr. Boone on Tuesday, and he indicated that he didn’t see a fracture, but would treat it as one since, “It’s better to treat a sprain like a fracture than to treat a fracture like a sprain...”. We go back next Tuesday for a follow-up and a fresh x-ray to see if she needs a full cast.


the photoSmith said...

after spending a good amount of time in hospitals the past few weeks, I can completely relate to your experience. if our nurse didn't write down her name on our board i didn't know what to do, and would occasionally call them by whatever name was left by the last nurse. since we got to stay in the hospital over several shift changes, we (we'll my wife) got to explain over and over why we were there and getting induced. i mean what are they writing/typing when they're asking you all these questions? are they chatting online or do they all hit delete when they're done so the next person to come along would have to repeat the process??
well i hope your young lady heals quickly and doesn't need a cast. but if she does, i think it would only be appropriate for it to be adorned with a girraffifly or a pronghorn tarantalope...

Falcon said...

I remember when I had to take my oldest daughter (when she was about 10 or 11) to the emergency room after she fell at the skating rink and broke her wrist. I was interogated separately by the admitting nurse, the ward nurse, and the ER doctor, my daughter was questioned in private by the ER Doctor and they even questioned my wife, to ensure we were all telling the same story.

I hope your young-un is fairing well and getting a lot of signatures on her cast.

invigilator_tex said...

Geese Louise, Geez!

That sounds like a painful and costly demonstration in vocal projection. What will this poor child say to her kids when she's a geezer herself?

Careful darlin, grandma's high school CHOIR injury is acting up again?

I knew a girl who was a Christian Scientist. She broke her arm falling off a horse in her youth. Of course there were no trips to the emergency ward, just some heavy prayer. The arm healed, but not the way it should have, but man she could scratch just about any spot on her back with ease.