Thursday, September 08, 2011

Cast Story

 I'm so behind.  Gotta tell the story of Kelly's arm.

So, at last check, Kelly had managed to significantly break her right arm on the last weekend of summer vacation.


She broke it on a Friday night, and her discharge instructions at the ER (given to us after midnight.  zzzzzz) was to 'follow up at pediatric orthopedics ON Monday"

Alas, Pediatric Orthopedics isn't open on the weekend, so I was on the phone bright and early Monday morning, to see when they'd be able to see us THAT DAY.  Well, I was the first one on the phone, right at 0830, so I knew I wouldn't be waiting long... or would I?

"Ah, well, we can fit you in some time on Tuesday afternoon, or maybe Thursday"

WHAT?  My paperwork distinctly says "ON MONDAY", and the doctors were adamant that she need to get out of the *temporary* splint, and into a permanent cast before any incorrect healing happened.  Her break is the kind that can SLIP, and that would require re-breaking to fix.  *shudder*

After going back and forth for what seemed an endless time, I was told that someone would call me back (within an hour) to see about getting  an appointment "some time today".

So I did some work around the house,  And then I went up to Nate's school to see about getting the Library ready for opening.  The library was a disaster.  Egads, that's a whole entry in and of itself.  But I'll derail this story if I go off on that tangent, so here goes:  I was in the library, when I realized that I had not heard back from the clinic, and it was now TWO hours after they said they'd call.  Kelly is still mincing around in a splint and a sling, and needs a real cast.  So I call back.

"Oh, I'm sorry, Mrs. Parker.  Unless we know who you talked to originally, we can't clear this up.  Do you recall who it was that made the original appointment here?'    (first off?  I didn't have an *original* appointment.  And secondly, my brain isn't fast enough to register when someone says "good morning, I'm (insert name here), how can I help you today?" and then goes on to ask me a dozen questions about things that seem far more important than the name of my scheduling operator.)

I get put on hold more.  Grr.  And then they come back to say "Well, things have gotten busy here in the last little while.  We can fit your daughter in on Friday afternoon, if that time will work with you, otherwise, we're booking into NEXT WEEK"

I nearly had an aneurysm.  But I patted myself on the back for not sounding shrill or hysterical on the phone.  "My daughter's paperwork from the Stanford Emergency Room states that she MUST be seen by Pediatric Orthopedics ON Monday.  Seven days... or more... is much different than the 72 hours than her discharge papers state."

More muzak, as I'm put on hold again.

"Mrs. Parker?  Thanks for waiting.  Do you have a preference of which orthopedist your daughter sees?"
Yikes!  At this point, I'll see ANYONE.  Put the janitor in a white coat, and I'll be happy.  And besides, I have no clue who works in that clinic (which I suppose is a good thing), so I say "I will see ANY doctor,  I just think it is important that my daughter be seen as soon as possible, as dictated in her discharge papers."
"Well, we can fit you in tomorrow morning, if that will work for you."

And how is it that I now feel grateful and relieved to be getting a Tuesday appointment, even though it's outside the bounds of the discharge requirements?  It's like thinking you're getting something on sale when a store marks up the prices before discounting them.

So we head to Stanford on Tuesday morning, spending the last day of summer vacation (School starts on Wednesday) at the hospital instead of at the beach.  The orthopedic clinic is pretty busy, but we're ushered to a room only shortly after our appointment time.

The clinic manager noticed that we were wearing matching tank tops.  Heh.  I didn't even notice until she pointed it out.  Here you can see that Kelly is still in the sling from the ER.

The doctor was great.  He didn't look to be much older that Skip, but he sure knew his stuff, and was enthusiastic and really engaged Kelly.  He looked over her hand, and arm, and said that this kind of break was usually repaired with screws and a metal plate.  But then again, this type of break was also usually seen in adults.  Kelly's break ran through her growth plate, so he didn't want to mess with it if he could help it.  He fiddled around with her hand a bit, and then said that the original re-setting of the bones had been quite well done, but wasn't complete.  When he put on her new cast, he said, he would have to do just some small adjustments, and they might hurt a bit, but she was to scream if it hurt too much, and he'd stop.
Kelly is such a trooper.  He took off her splint, and cleaned up her arm, and then felt around the break. She winced a bit, and he said that he'd try to do some manipulations when he was putting on the cast, so that he might be able to avoid surgery.  He offered her a rainbow of color options for the cast, and Kelly chose the one that most closely matched her tank top and the new turquoise skinny jeans that she wanted to wear to school the next day.

As he wrapped the new cast material around her arm, and it started to set, he started to pull her fingers and wrist, pushing on the broken edge of the bone, to try to push it gently back into place.  Kelly winced, and then started whispering 'ow ow ow ow ouch'.  I held her other hand, and soon the two of us were both crying, while Kelly kept saying "ouch", but not screaming.  It's so hard to see your kid hurting.  But she was so freakin' brave, I was amazed at her fortitude.

Soon, her cast was done, and the doctor pointed out that he'd actually bent the cast backwards a little bit, to exaggerate the line of the bone that needed to reset.  This was actually now PUSHING on the break, to ensure that it didn't slip downwards again during the first few weeks when the healing would set the bone in the line it needed to be in.  He sent us for another set of X-rays, through the cast, so that he could check on whether his 'gentle' reset had done any good, or whether we should be bracing for surgery.

while we were waiting for the X-rays, Kelly got to meet a girl (and her mom) ahead of us in line.  The girl was deaf, and had cerebral palsy, and was waiting for X-rays to check for scoliosis.  We had a great conversation, so upbeat.  The mom taught Kelly some basic signs (and Kelly already knew a few, which surprised them),  It really puts your own minor hardships in perspective, when you can be encouraged by someone who is definitely struggling more than you are.

The X-rays came back fine.  And we were good to go.  "I want to see you in one week", Dr. Young said, as we left.  "And don't bump it, if you can help it.  I don't want to have to operate on that arm!"

We stopped in the lobby of the orthopedic clinic.  This is a very cool kinetic sculpture that we had to watch for an inordinately long period of time.  Kelly's also showing off her new turquoise cast.

Last week, we made another pilgrimage to Stanford, so young Dr. Young could look at Kelly's arm again, and decide if she needed surgery.

Gah.  Just typing that made me a little bit sick inside.

Anyways, it got her a half-day off school, and that seemed to perk her up a little bit.  I got Nate and Skip off on their ways, and then Kelly and I started our day.

First, Jewel had to have one last look at the old cast.

Yup.  It's perfect, and hard and scratchy.  Just right for filing down his toenails a bit.

We stopped at Starbucks on the way, and made a little lazy morning of things, not having to be at the clinic until 10.

Once again, we were ushered right in when we got there.  I will say that after the initial glitches with scheduling, and administration, this clinic really is the bees knees.  And I love Kelly's doctor, too.

Young Doctor Young. (Is it just me, or was that some Carol Burnett sketch, or maybe Hee Haw?  "Young Dr. Young, and old Dr. Young"?  There's a joke in there somewhere, maybe from the early 70s.)
Anyways, young Dr. Young, is really young.  Or at least he's very well preserved.  And he really put Kelly at ease, too.

Her new set of X-rays looked good, but her cast had become too loose to do any good, so she'd need a replacement.

Here we see the vacuum-saw cutting off the old cast.

And when the doctor learned that Kelly was doing her first science paper on her broken arm (Find the Science in Something You Did This Summer), he nearly talked her ear off about bones, and how they mend, and casts, and how the exothermic reaction happens in the colored webbing that the new casts are made out of.  I think he was nearly as excited about her paper as she is.

Ta da!  What a broken arm looks like without a cast.

(also, what a hand looks like after it's not been washed for a week.  He offered Kelly a baby-wipe to clean off her hand before the new cast went on)

He was very encouraging of me taking photos.  Alas, I only had my phone, but it's still a pretty darned good recording device.  And he gave a running commentary of what was happening.  First, there's a sock-like sleeve to protect your arm from the cotton padding and the hard cast.  Then there's layers of cotton padding, but not too much.  Just enough so you don't get sores from the hard cast rubbing on your skin for a month.

Then the cast material gets wet, which triggers an exothermic reaction that changes the webbing slowly from a fabric to something hard as cement. (this time, she chose purple)

And once the new cast was applied, he even cleaned out the gunk from the old cast, so she could use it for her paper, if she wanted to.

So now Kelly is sporting a new dark purple cast, covered with silver-sharpie signatures.  We'll go back to Dr. Young on the 27th, to have it removed, and then, if all goes well, we'll be hosting a Cast Away Party on October 1st.  There's a place that does glass blowing, and they do group lessons that are relatively reasonable, so I've told Kelly that she can pick a few friends, and they'll all go out together and learn how to work with molten glass as a celebration of her cast being gone.

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