Back To the ER

It makes me nervous when people are nervous about things they see with Peyton.  We had a home nurse on Saturday who has only been with Peyton once before.  She was here a couple hours when she noticed that Peyton's left arm seemed swollen above where her splint ends.  I agreed.  It also seemed that when you would touch this particular spot, that she would flinch as if it was hurting her.  The nurse was fairly concerned, which, of course, heightened my concern.  Not that I wasn't concerned on my own!

I decided to call the hospital and have the pediatric orthopedist on call paged.  They told me the resident's name and said he would be calling me back within 30 minutes.  That didn't happen.  As it drew closer to noon, we started debating whether or not we should venture off to the ER.  It's not an easy task bringing Peyton anywhere, especially now.  She actually hadn't left the house since she returned home from the hospital via ambulance on February 14th.  She hasn't sat in her wheelchair for more than a couple minutes {total} in all that time either.  Let's not forget she requires oxygen all the time now, so that adds another level of complexity.  We had to be sure we needed to go. 

Our children's hospital has an after-hours walk in clinic which handles all types of issues, including fractures.  It is no further away from our place than the hospital - just in a different direction.  We've never been there but since I knew this wasn't a time where I would expect Peyton to be admitted, I wondered if we might be better {and quicker} served by going there.  I called them and explained our situation and asked them what they thought we should do.  They told us to go to the hospital ER.  So much for that.

We had to wait a little longer than normal in the waiting room, which made me nervous simply because the longer we waited, the longer Peyton had to be upright in her wheelchair.  She has two compression fractures in her back, so we're just nervous.  Eventually we were taken back to a room.  I'm not sure of the exact time we arrived, but it was probably a little before 1:00pm.  As you can see by the picture below, Peyton is a bit of a moving target.  She never likes to lie straight on the stretcher.  She usually is straight across it {the short way}.  Quite often I will find myself in this position, having to hold her head in my hands as she lays like this. You can put her head back up on the stretcher, but she's only going to wind up back in this position anyway.

They paged the orthopedic resident who, by the way, happened to be the one who didn't return my phone call.  I didn't say anything.  It sounded like they'd had a couple traumas that day, so I let it slide.  You never know what's going on on the other end, so better to just extend some grace and trust that there was a reason.  There seemed to be.

In addition to the arm issue, Peyton has thrown up a few times the past few nights - for no reason.  No illness.  No known reason.  Since she can't tell us, and she has a shunt in her head for hydrocephalus, they like to err on the side of caution and make sure that it isn't a shunt-related problem.  They did an abdominal x-ray to make sure there was nothing unusual going on there.  There wasn't.

Ortho came in and removed the splint from her left arm.  The arm was x-rayed to make sure there were no new fractures.  Long story short, there weren't.  Not sure what was causing all the swelling but when the splint was removed, it really highlighted just how swollen it was.  Below is a picture of her splint after it was removed:

The doctor decided that it would probably be a good idea to get a shunt series done.  This required a trip to radiology {the arm and abdominal x-rays were done in the room in the ER}.  They x-ray the head, chest and abdomen {multiple x-rays} to get a look at the shunt itself as well as the tubing that runs from the shunt down into the abdominal cavity.  There's several feet of tubing in there!  From there, she was to get a head CT.  But first the Orthopedic resident caught up with us in the x-ray room.  He had to come out of surgery to look at her x-ray and re-splint her arm.  He had only a very short amount of time as he had to get back into that surgery.  He did what he needed to do and left.  Then Peyton was moved to the next room over for the head CT.  She was put on the table for that, strapped in, and secured.  Only she kept getting her arm out from under the piece that was supposed to be strapping her down.  She was also extremely agitated and wouldn't hold her head still.  Of course, they're talking to her like she can hear or or comprehend that she just needs to lay still for a minute.  Needless to say, the head CT didn't happen.  We went back to the ER room.  Eventually they decided that the x-rays looked good and were comfortable with not doing the head CT.  Thank God.  It was now after 7:00pm.

It was quite the lengthy process.  We didn't get home until after 9:00 or so.  Nothing is ever easy.  I feel like we put Peyton through all of that for nothing, but at the same time, we needed to go - we didn't know what that swelling was from.  It's just a shame she had to endure all of the transferring, moving, sitting, and so on.