Simon's second ER visit: A dislocated elbow

posted by Jeff | Friday, June 24, 2011, 11:00 PM | comments: 0

I don't know if we've been lucky or if it's normal, but Simon hasn't had an ER visit since he was two weeks old. Today was unfortunately that day for his second, but all things considered, it was a pretty easy visit.

Shortly after I got home from work, Simon was in good spirits and he climbed up on the couch to flop around and be tickled. He went from a sitting position to a standing up against the back, and when he got up, he turned around, with his face in the crying position, so much in pain that he couldn't get the first scream out. Finally it came, and we wondered what happened.

He continued to cry for the next fifteen minutes. During that time, we noticed he was holding his right hand, so I figured that maybe he hurt his arm. Diana gave him some yogurt melts, and he wouldn't raise his hand to his mouth. Trying to crawl seemed like instant pain. I gently moved his arm around at his shoulder, and it didn't seem to hurt him. I wiggled his fingers and that didn't seem to trigger any pain either.

Given his general cranky issues, his binky-less sleeping and inconsistent napping, plus his varied appetite, we figured he was probably hungry. That's when it became more clear that we had to get him checked out. While he did eat, it was entirely with his left hand, which isn't typical for him. He wouldn't pick up his sippy cup with both hands. When he'd drop something on his bib, he'd reach for it with his right arm, which would trigger the screaming. Otherwise, he just kept his right arm down along his side, straight next him.

By the time I got him to the car, he calmed down, and I gently got him strapped in. He propped up his arm, outstretched, on the right side of his car seat, and didn't move it at all for the 15 minute drive to the ER in Issaquah. Being on file in that hospital's system, and the fast service we had last time, I definitely wanted to return there.

We explained to the nurse what we were observing, and she described a fairly common thing called Nursemaid's elbow, which is a dislocation of the radius at the elbow. Simon was calm, but definitely had a bit of fear in his eyes. He wasn't crying, but he had a little pout on his face that was "heartbreaking" to the nurse.

The doctor came in and explained the dislocation, but just kind of observed Simon on my lap. I was kind of annoyed, because I wanted him to ask fewer questions and poke or prod my kid to figure out what was wrong. But as Diana pointed out, he was probably observing and establishing some amount of trust with Simon. Finally, he came over to feel his arm, and then did a quick maneuver to pop his elbow back into place.

The resulting scream was jarring and awful for both of us, but especially for Diana. Simon became momentarily hysterical, but our comforting seemed to chill him out pretty quickly. The doctor went back to lean on the counter and talked a little more about the injury and said he wanted to watch him a bit. Once the child forgets about the pain, they tend to just resume normal use.

Simon got back to a pout, but seemed more and more interested in looking around the room at everyone. He looked up at me, and I asked if he wanted to go home and take a bath, knowing that he would sign "bath" if he wanted one. He kind of half-assed it with his right arm, but it was the least still he had been since the injury 90 minutes before. I asked again, and he waved goodbye at the doctor... with his right arm!

The nurses cheered with us, and he gave a smile and a giggle. Our happy little boy was fixed! It seemed almost like a miracle. He just sprung back to normal after that, and decided he wanted to check out stuff around the little ER room. The stool step in particular, with the four-foot high handle, seemed particularly interesting, and he pulled himself up, again with his right arm, and sat down on it.

The nurse came back with the discharge paperwork and said to look out for recurring injury for a few weeks, and the housekeeper brought Simon a little Beanie Baby. We went home, took a bath, had a bottle, and he peacefully went to bed. Diana just checked on him, and he's looking like a peaceful little boy. With his Beanie (a rainbow colored bear that we call "Trippy").

Thinking back, I have to say that he was actually very brave throughout the ordeal. He seemed to really want to roll with the pain, but it clearly frustrated him because he couldn't really play, or even eat right. You could sense his fear at the ER, but he seemed to control it. Maybe I'm just projecting, but I'm really proud of how well he handled it all.

We'll have to be careful when helping him up by his arms, as kids who had the dislocation are more likely to have it again. Yet another adventure on the road of parenting!


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