Zane's Big Break...life with the cast begins

So I left off with us getting into a room for the night. Sadly no one got any rest because as we all know, a hospital is the very last place one can truly rest. Zane was having breakthrough pain between the 4 hour dosings of the Oxycodone, for which they were giving him morphine. Sure he was quiet and trying to sleep, but he would relax, move his leg slightly and jar himself awake and in pain. Or someone would come in to check him or the boy in the next bed. Or a machine somewhere would alarm. Or the intercom would crackle an announcement of a fire drill. Something. This went on all night, I know because I sat at his bedside, sideways in the "sleep chair" with my hands folded on the bedrail and my chin on top of them. My Mom sat in the other straight back chair with a blanket around her and her head on the extra pillow laying on the foot of the bed. Each time Zane would wake up, he would be scared and cry so I was keeping alert to try and soothe him right away, let him know Mom was there. During all of this time, he did get meds, as I mentioned. Thank God I was paying attention to this because around 6am a nurse came in for the other boy and I asked her if she could let our nurse know he was seeming to be in pain and needed something, and it was time for his Oxycodone again. Instead of that, she got the meds and came in with the syringe to administer the dose. She was literally 3 inches from his mouth (liquid meds, not injectable) when I noticed the dose. She dropped the syringe onto the bed just as I reached to grab her hand - mind you her other hand had his mouth ready for her to squirt it in. I grabbed the syringe and told her "NO! This is NOT his meds, this is way too much do NOT give this to him!" She looked at me like I was nuts but said she would double check. She came back in and said, "Oh yeah, you were right. I thought the chart said 7ml so that is what I drew but his dose is 1ml" ...Yeah, you read that right. She almost gave him 7x the prescribed dose of a controlled narcotic. Thing is, for her to draw that dose, she had to enter it into a computer, which would then alert her to the change in dose since the last time and ask her to confirm the increase. I try very hard not to think how things might have gone.

Moving on, the gentleman who brought the breakfast tray in was incredibly nice and I have to say, the food smelled amazing, but Zane would not eat any. I had a juice cup I tossed into the tote bag from home and he only asked for juice so I gave him that. He chugged down 2 full juice cups, about 6oz per cup full, in record time. I called for Daddy to come up around 8am as we had a few things to go over with the care and maintenance of the cast as well as of Zane while he is in it. We watched a video, narrated by Dr Woo (remember that name for later) which honestly was no more than we had been told already but I get that they have to have some measure of saying you were "trained". Nurse Mary came in and showed me briefly how to change his diaper and while I did pay attention, I have no idea what she did or said. Some ladies from Child Protection Services came by to interview us AGAIN. They were nicer than the other lady but still annoyed me. Daddy and Macy wandered about and finally found the play area where there were two ladies helping kids make crafts. That was a lifesaver for us as Macy was bored stiff. Lunch came, smelling better than breakfast had and again, Zane refused even the mac and cheese but he drank some juice and chocolate milk. At Daddy's insistence I ate some of the lunch and I can tell you it was very good. I did not eat much, my tummy was not ready for food yet. We were visited by a very nice lady who loaned us a special car seat designed for kids in spica casts and she helped Lon put it into the van in place of Zane's carseat. She said that since they called for her, surely we would be discharged in short order. 4 hours later, we were. It was 5:30pm when we hit the road for home, 27 hours after arriving. We had a prescription to fill for his pain meds, I did get them to give him a dose just before we left, to be sure we had time to do all the shifting and shuffling. Good thing.

We stopped at Jonesville Publix to get the Rx filled. It was just before 6 now, keep in mind. I hand off the written info to the tech and she reads it, looks worried and walks to the pharmacist to confer. They both come back over and say that they cannot fill this Rx as there is no strength indicated on the instructions and it is too late to call the Dr for this info. I advised them of the situation and that there would indeed be some sort of pain meds given for this child TONIGHT even if that meant a partial fill and I come back in the morning for the rest. The Pharmacist asked me to give her 20 minutes and she would see what she could do. What she did was use her best judgment on the strength per dose and sent me on my way. We finally got him home about 7pm and then discovered the fun of life with this cast.

I could barely pick him up, the cast is wide and heavy and I am short with short arms. I can't reach around him and lifting him is hard for me. Daddy will do the lifting for now. We took inside all the folded blankets and pillows that they packed into the red wagon for us to take him out of the hospital in - yes, I took the damn pillows and blankets but left the wagon. We have one. We did not have the extra pillows and blankets tho. It took a few tries to get a place set up for him on the couch, but we did it. It took both of us to change him for the first few days, but we did that too. After a trip to CVS to buy adult diapers and some pantiliners and sanitary pads as was suggested to use inside his regular sized diapers, which have to be tucked under the edges of the cast, I came home and we decided to try it their way. Yeah that way sucked. I got online and read everything I could read about the care of children in these casts and with that knowledge, tackled it a new way. Mind you we did it their way long enough to know it was just not going to work for us, about 2-3 days. Once we tried the stuff I came up with, life got MUCH easier with this contraption and continues to be less of a pain in the neck now. With my way, he can actually be dressed and look somewhat normal and not have a disgusting looking adult diaper wrapped around the outside of the cast. I shared this info with the Ortho clinic staff.

The meds issue was good and bad. I still have no idea if the Rx was filled as intended because he was seeming to be in pain even a few days later. I called in and was advised to give Ibuprofen between Rx doses to control it. The other thing is, the Rx causes constipation so now he has a whole new issue of pain to deal with. One thing I can assure you is you do NOT want an explosive diaper while in this cast. After speaking with the nurse again, we tried some OTC meds that eventually did the job, so we're all good there. He was not helping by refusing to eat and drinking sparingly. You ever try to rationalize with a 2 year old? He will win. I did score by giving him V8 Fusion juice - you know the one that advertises a day's worth of fruits and veggies per serving - so at least he was getting nutrients. He was fine with, and continues to chug down, chocolate milk. I no longer care that he is being spoiled, I just wanted something going into his belly. We added the Pedia Sure drink with Fiber to help things out, but he caught on and refused the chocolate milk with that stuff mixed in. Oh well.

A full day at home and we found an issue with the cast. Thankfully the Ortho clinic was able to get us in right then so we sped off to see them and had about 1/5 inches trimmed off of the top of the right leg side. It was kind of high and pressing into, shall we say a "delicate area" for him. The cast tech there, Lindsey, he may go on our Christmas card list. He was SO helpful with showing us tricks and tips and alleviated some fears we had with handling Zane as well. He is amazing at what he does. Cannot find enough good stuff to say about Lindsey. Found out that transporting with the wagon is a huge pain in the butt, there has to be a better way!!! Leave it to me and the internet, I will find something!!

We have his first Orthopedic appointment on the 2 week mark of being in the cast. We will see Dr Woo (yes, he did the video) and we're hoping for the best. Until then all we can do is the best we can do and hope it isn't too terribly wrong. Oh yeah, we did have a stroller that actually works for him so I got the person who borrowed that a while back to return it and that has been GREAT! He likes to sit in that and it is much easier than the big wagon. He will be able to go out much more often using that and I know that will be far better than being house bound all the time he is also confined in the cast.

Life WILL get better, things will improve and maybe we will have good news from Dr Woo on the 23rd. Please?

Zane's Big Break

My little boy fell at home, just off of a step stool designed to help kids get onto the potty which is maybe 6" tall and has grippy feet. I was in our bathroom when he apparently decided to go potty by himself, and tho I am not certain how he did it, he fell. I got to him after hearing the scream and Macy coming to get me to say he was hurt. He was laying on the floor, crying inconsolably but there was nothing apparent that hurt. I lifted him up, tried to get him to stand and that elicited more screams, so I picked him up and took him to his room. I laid him on his bed, finished undressing him, which meant removing his shirt as he had taken off everything else in the bathroom. I got a clean diaper and put on him, feeling an odd 'click' in his right leg when I did so. Given the intensity of the crying that followed, I figured he had possibly dislocated his hip, so I only put the diaper on, handed him his "Fluppy Dog" and covered him with a blanket. I flexed his ankles, and that was fine, as were shoulders (remember there is NO mark on him to indicate what the issue was) and he was ok as long as I did not touch his right leg above the knee. I called Daddy, who had JUST left about 5 minutes before Zane fell, and said "You need to get back home. Zane is hurt and I think its bad, we need to take him to the ER." Daddy was northbound on I-75 so no real way to make a U-turn, but assured me he would be back as soon as he could get here. Since the crying had calmed down some, I thought it best to leave him there, safe and warm and seemingly happier while I investigated what happened. I walked into the bathroom to see the stool was wet, likely he tried to pee in the big potty and missed, and all around the toilet was wet and his clothes were in a pile where he removed each item. I cleaned up the wet stuff, picked up his clothes and went back to his room. As soon as I walked in, he tried to get up but ended up crying again with sheer agony written all over him. I called Daddy again, he assured me he was less than 10 minutes from home. I had Macy pack herself some quiet toys in her tote bag, explaining we had to take Zane to the hospital and only quiet toys were allowed there. I packed Zane's tote, no toys but with slip-on shoes and some clean, dry clothes. I was pretty sure he had dislocated his hip given the pain when it was moved, the clicking feel and how he was lying when I got to him. Daddy pulled in and we were actually able to get Zane into his carseat, just could not buckle the crotch latch. A risk I was willing to take. Loaded everyone into the momvan and by God we WENT to Shands like a bat out of hell. Thank you God for keeping us safe on that drive. We get there, I did not know the ER had moved so I am banging U-turns, then searching for parking in a seemingly tiny lot. Thankfully we found a spot, got out and I carried Zane into the building. With each step I made on my left foot, the side I was holding him on, he would whimper. Inside we were triaged fairly fast and sent to the Peds waiting area. It felt like a 30 minute wait, but may have been 5. Get into an exam room, go over everything that has happened. They prep him with an IV and did preliminary exams, noting his pain level each time his right leg was touched. I explained my theory of a displaced hip and they agreed it was possible, but they needed X-rays to confirm. Sure, go take X-rays, then lets get the joint put back into place, a quick shot of pain meds and orders to take it easy so we can go home. The Dr walked back in and the look on her face told me it was not a dislocated hip. My little boy had broken his leg. Badly. A spiral fracture. I felt like someone hit me in the gut with a shovel. How in the world did his leg BREAK from a 6" fall?? How was it not something minor?? How did I not know this and suddenly the memory of the 'click' in his leg when I diapered him hit me full force. Oh my God...had I made it worse? The Dr positioned herself in front of me, looking at me and said "this is not a simple injury. It is bad, it will be hard on him and on you. Brace yourself for all I am about to tell you." and I don't think I heard her entirely after that because all I could see in my mind was his little face when I touched his leg or moved him and the level of pain finally registered with me. I paid attention again when she said they were required by State law to report the injury to DCF. DCF?? Why?? He fell off of a stool, no one did this to him. It was an accident. She went on to tell me they were going to be at the hospital shortly and I needed to compose myself to talk with them. She also said they needed more X-rays so I sent Daddy with Zane to keep him settled. The look on Daddy's face when he returned, along with the clear signs he had been crying about as hard as Zane had, told me it was good I did not go with him. I would have punched someone. They took a total of about 25 X-rays, head to toe, and moving him this and that way - with NO pain meds for him. He was in agony. The Dr came back in, explained to us that he would have to be put under, using Ketamine, and have the bone reduced and set in something called a SPICA cast. She went over the risks involved in total sedation, but explained there was no alternative given what they had to do to get his leg set correctly. I nodded and signed, hoping for the best. They had us wait for the Peds trauma room to be free, and wheeled us over to wait for the teams to do this. Oh and during all of this, I called my Aunt, had her come pick Macy up and take her to her house first, then home to wait for us so Macy would be in her own room and so forth. Mind you, my Aunt lives about 2 blocks from me so this was not a huge imposition. With Macy safely taken care of, our focus turned to Zane. Then the call came down that the trauma room would not be ours just yet, so back to the exam room we went. DCF showed up, in all her glory. She was not unpleasant but her tone and leading manner were very annoying. The huge ACSO deputy with her kept me from telling her that I did in fact question her heritage by suggesting her parents either never married or were closely related. She interviewed me for almost 30 minutes. Then she asked me to go get Lon and send him to the little room, where he was asked less than 5 questions. We're waiting more now. Ortho Drs have stopped by, finally gave Zane some morphine and got his leg into a splint so he would stop trying to use it and create more pain. This was about 7:30. We got there at 2:30. Five hours of prodding and moving with nothing for pain and I am being interviewed for possible abuse? We got called back to Peds Trauma, where I knelt and prayed for a good 10 minutes solid. I just wanted him to be out of pain and only they could do that. Half of the team showed up, we were all set save for Ortho and we got the call. There had been an accident. A bad one. A guy had a badly mangled leg, with his motorcycle embedded into much of it. All Ortho hands on deck for this one. We got bumped, again. This time we went to something called Minor Care. It's now after 9 and he has had one dose of 1ml of morphine in all this time. Zane was exhausted. Every time he would fall asleep, he would relax and his leg would move, hurt, startle him and he would tense all limbs, creating more pain....it was a vicious cycle. Lon decided to go home to be with Macy. My Mom, who has worked at Shands for 20+ years was with Zane and I and he figured she could do me more good than he could. He went home but asked me to call and update him with what happened. It was about 11:45 when we were called back to Peds trauma, with the promise that it would happen this time. I did my best to comfort Zane as they prepped the room and equipment around him. When everyone finally showed, anesthesia walked in and told me what to expect, said "Lets do this" and in under 2 minutes my son was out. He looked like he had died. Eyes open but fixed, just one minute moving some and whimpering and BAM - out. That freaked me the hell out. Mom took me out of the room and I asked to go outside. I was losing it and I wanted no one around to see that happen. I called Lon once I regained my composure, told him they were finally getting him set and in the cast. He asked me what time it was - almost 2am. Twelve hours ago, we were flying to the ER and they were only just now getting him set. Mom and I went back inside as it was quite chilly that night. I asked her to direct me to a soda machine, I needed caffeine badly. We got drinks and went back to a waiting room, the same one I had sat in with DCF and the Deputy but this time was just us. She saw an intern she knew and asked him to look in on the procedure to see how it was going. He came back with, "It should not be long, but definitely stay here" with a nod to me and a slight shake of his head. A few more people came by that Mom knew, each of them expressing their thoughts and prayers for Zane. I could not tell you their names, aside from Marcus who was the one to check on things. Finally we were called into the room we had been in and out of several times waiting our turn. I knew what they explained to me, but it did not prepare me for seeing him. He is not a big boy, only weighed 28lbs (roughly, he would not let go of his Fluppy Dog to be weighed and to this very day some 10 days later he still has not) but he looked SO tiny and helpless. Then I realized he was still out, and asked why we were called in if he was not awake. I know the nurse did not intend to scare me, but she did. She said "We can't get him to come around and wanted to see if he will wake up for you". I of course heard nothing after "We can't get him to come around" and my heart about fell on the floor. I went to him, stroked his hair, his face, chest all while calling his name. Nothing. I resorted to the old knuckle in the breastbone and just barely a flicker. After about 10 minutes, his eyes opened. Thank you God, his eyes opened. All we were waiting on now was a bed assignment. As luck would have it, part of my Mom's job is bed control so she marched out of the room, got on an internal phone for about 5 minutes then came back to the trauma room. She told the nurse, "We will have a bed in less than 15 minutes" and in about 10, her cell rang and she was told he would be in 4539A. When the transport people came to move him, they didn't even know but were waiting on a page with the room number. Mom told them she knew and lets get him out of here so we went. Turns out we went under Archer Road, thru "the tunnel" and took him into the original building - we had been in the new tower where the ER moved to - but I didn't even realize all this. We got him into his room, the page came as we were in the hallway and sure enough, 4539A it was. Imagine that. The nurses got him settled into the bed, did his vitals and left. The charge nurse came and told us where we could get food and drink, brought extra blankets and left us for the night. Of course it was about 3:45am so it was almost over, but it was nice of them to try and let us adjust. There is more, but that will follow. This has wiped me out to re-live.