Wednesday, December 02, 2009

A Night at the Urgent Care

The Monkey dislocated his elbow last night while attempting to do cartwheels.  Mr. Stang heard a distinctive "pop" at the time though neither of us were closely watching so didn't see exactly what happened.  They call it "Nursemaid's Elbow" and it's common in pre-school age kids because their ligaments are not fully developed yet.  It's generally seen when an adult caregiver unintentionally pulls or twists on an extended arm (like doing arm swings).  But apparently cartwheels can do it, too.  Our family doc. tried to pop it back in (or do a "reduction manuever") twice.  Didn't go. So off to urgent care we went.  They tried a third time - didn't go. Got X-rays.  Urgent Care Doc didn't see any fractures or anything serious but he's still hurting and he has limited mobility.

We are still waiting for the radiologist report to confirm the diagnosis. They tell us they never have to do surgery for "Nursemaid's Elbow" but it's unusual to not pop back in after so many attempts.  Google tells me it will probably self-correct in a couple of weeks regardless of failed reduction attempts.

The Monkey was so very, very brave.  For good or bad, I've settled on a "no sugar coating" the truth approach to bad news with him.  He seems to take more comfort in knowing exactly what's going to happen and suffers more upon discovery of being lied to than he does in the anticipation of traumatic reality.  With adults I can bullshit with the best of them but I just can't do it with kids.  Not when it's important.  Not even to smooth over the rough spots.  It feels like a betrayal of trust.

Sample of the tearful conversation follows.  In reality there were a lot more tears, a lot more "NO, I don't WANNA GO's!" and pathetic "do we have to? and "couldn't we instead????" 's.

Me: "we're going to put ice on it for 20 minutes - if you still can't move it we're going to Dr. L."
Monkey (through sobs): "What is she going to do?"
Me: "She'll need to touch it, move it a little to see what's wrong.  She might try to fix it.  If she can't fix it we may need to go to a different place, like a hospital where they can take a picture inside to see what's going on."
Monkey: "Will it hurt?"
Me: "Yes, a little.  But it's the only way to help it start to feel better.  If we don't get it fixed, it's going to hurt for a lot longer, and you may not be able to use the arm again".
Monkey: "I don't WANNA GO to that place!!!"
Me: "I know, honey, but it's got to be done."

He agreed to go see Doc. L, He was calm in the car and during the examination, though shaking a little.  Then came the first adjustment attempt.  I'll spare you the play by play of the screaming - it was bad enough watching him go through it once.  Let alone twice... then a third time at the urgent care. 
As we were heading back to the exam room at the Urgent Care the lip starts quivering again and he askes "is it going to hurt?"

Daddy, in a transparent attempt to forestall resistance says "No, honey they're not going to hurt you again".

Disbelieving, Monkey says "Mommy???"

Mommy sighs, hesitates then leaves Daddy twisting in the wind.  "I won't lie to you. They're going to need to move it to help figure out what's wrong, and again to get good pictures.  That will probably hurt a little.  If they try to fix it again like Doc. L that will hurt a lot. But then if it works, it will quit hurting."

Sorry Daddy.

Chin quivering, eyes glistening the Monkey stoically walked back to face his doom.  I don't know if gaining the kid cred is worth it.

After all was said and done and the Snoopy splint & sling applied he calmly said "can we go home now?". 
And in the car:  "That wasn't so bad.  I'm thirsty."   And requested root beer.

He slept well all night and this morning greatly enjoyed having us at his beck and call.  Though with Daddy suffering from a sinus/chest infection following a cold (acquired via the Monkey, via daycare of course when we finally relented and let him go back for one day after they got their H1N1 vaccines) he won't get to milk it very far.


sandraj said...

How is the little Guy doing? I hope better.

Mustang Sally said...

Much better, thanks. He's using it almost fully now. Just a little lingering tenderness. Isn't quite ready to try cartwheels again but back flips are no problem.