Our Family's First ER Visit

It finally happened. Frankly, I'm surprised we made it as long as we did without having to take my little wild ones to the ER. Unfortunately, Sunday night was the night.

Graham had one of his typical little accidents... lost his balance, bumped his head. I didn't actually see it. Cole and Graham and I were all in the hallway upstairs and they were doing their "super speedy" nightly race up and down the hall before winding down for bed. There was an empty pampers box in the hallway, and Graham kept climbing into it between races and then tottering over. The last thing I saw was him pushing his Pampers box into his bedroom. About thirty seconds later I heard a wail and found him on the floor with his feet in the pampers box and his head up against his changing table.

I picked him up and loved on him, but he didn't stop screaming, which is really uncharacteristic since usually he's so tough. So I tried laying him down in bed with some blankies and he STILL didn't stop. By this time Dan had made his way upstairs to see what all the raucous was. When he picked up Graham and held him, I saw the back of his head for the first time and noticed a spot in his hair that looked wet.

I did what any trained ER physician would do... I totally freaked out. "Oh my God!! Is that BLOOD!!!" Let me tell you, it is an entirely different ballgame when it's your baby who's bleeding. I was definitely not the doctor who can take care of mangled trauma patients. I was just a frightened mom, and I couldn't even approach his head to inspect the injury without feeling overwhelmingly nauseated. I was so paralyzed by my fear of how bad it could be that Dan had to step up and take the first look.

Fortunately, it was just a simple linear laceration, about 2 cm long. It was gaping open so much that there was no way that sucker was going to heal on it's own. So we threw some sneakers on him and a coat over his PJ's and I took him into my ER for some staples (yes, that is the standard of care for scalp lacs).

I called ahead to tell them I was on my way and even though the ER was SLAM busy with people waiting for hours on end, Graham and I waltzed in and were whisked to a room that they had reserved for us. Aaahhh, one of the few perks of my job. We were in and out in about an hour.

At first he thought his ER visit was great. He was making friends and running around like a little wild man. At one point we were playing peek-a-boo through the exam room curtain and he ran full-force into the curtain thinking he was going to run into me on the other side; Instead he slammed head-on and full-speed into the metal stretcher with his forehead. That made another big hematoma (goose-egg) smack dab in the middle of his forehead, and it was the beginning of the end of his good times in the ER.

Then came the lidocaine shot (right in the cut) to numb it up. I pinned him against me in a head lock, and he squirmed and screamed and struggled and squealed. He fought so much that for the actual laceration repair, he had to be pinned face down on his stomach. I never thought sweet little Graham had it in him to be so bad. I had to lay on his torso and control his arms and legs, and the paramedic had use two hands to control his head... just so my colleague could put the staples in. It was very stressful for all parties involved. I was all sweaty and tired from the exertion, and Graham was bright red in the face, furious and covered with tears. This is the "after" shot:




















4 staples total.


















The good news is the cut is healing well, and Graham has forgotten the staples are even there. He only seemed to notice the morning after when I put him on his back on the changing table. I could see him rolling his head around like he felt something weird on the back of it, but now he doesn't even seem to care. And his hair is even long enough to hide the row of staples, so all is well.

Maybe he'll have a little "tough-guy" scar. We'll see!

Book Nazi

"Agaih! Agaih!" (That would be "Again, Again!" without the "n.") That is what Graham screams at the TOP of his lungs in his vibrant little one-year-old voice as soon as you finish reading one of his books to him, close the cover, and say "the end."

The child is relentless. There are books everywhere in this house, because I wanted to encourage a love of reading, but I never anticipated this overwhelming response. No matter what I'm doing Graham is always chasing me down, book-in-hand with a little persistent scream. "Abuh! Abuh!" (translation = "A book! A book!") He'll follow me and whine until he gets to sit in my lap and I finally open the book for him.

If I'm reading Cole one book and Graham has a different selection in mind, he will come over and try to slam Cole's book closed, throw it on the floor and hand me HIS book in it's place. You can imagine that goes over REALLY well with Cole.

He has his favorites and he'll demand the same book over and over and over again. "Agaih! Agaih!"

At one point his demands continued so persistently despite Dan's attempts to engage him in a nice game of catch with his brother, that Dan finally laughed and said, "Son, put down the book and pick up a football already!"

Someone is definitely his Mama's child. I couldn't be prouder!

Tough Love

The art of medicine is really about getting people to do what you want them to do, which (if you are a decent doc) is what will make them better and maybe even save their life. Ideally this is accomplished without too much of a fight, but unfortunately it's not always that easy.

The other night a 70ish year old woman who had spent her career working for our local cardiologist's office came in with a really good story for chest pain of cardiac orgigin. She knew all of the cardiologists that cover our ER, and I assumed (stupidly) that she knew the ins and outs of a chest pain work-up. The history (what a patient tells you) is key in deciding how to proceed with a chest pain complaint, and this woman told me all the classic symptoms of cardiac chest pain, probably unstable angina. So I told her I was going to proceed with a high level of urgency, talk to the cardiologist on call, and probably plan on admitting her. She seemed sophisticated enough to comprehend all of this.

So I left her and ordered all the necessary medications, lab work and x-rays, and then, because it was already 12:30am, I decided to call the cardiologist and have her admitted to the hospital based on history and risk-factors alone, since I knew the cardiologist wouldn't want to hear from me at 1:30 or 2am when all of the test results come back. It was a slam-dunk admission, especially when I mentioned that the patient is the woman who worked in their office for years and years. So I filled out the admission paperwork and went back to give the patient a prompt update, assuming she'd be pleased at how expeditiously everything was handled.

"Mrs. H, I talked to Dr. B and he is going to admit you to the hospital because of how concerning your chest pain is tonight."

Well, damned if Mrs. H didn't go postal on me. She couldn't stay.... She had to go home and take care of her husband.... She didn't understand what about her chest pain was so concerning... Why couldn't it be done as an out-patient?.... blah-blah-blah. It was the same initial response most people have when they think they're just coming to the ER to get told there's nothing wrong with them and get discharged, but then their doctor tells them they have to stay.

Problem was, Mrs. H apparently thought her career as a cardiologist's secretary made her more qualified than me to decide what she needed. "I'm not staying." Then she proceeded to drill me about why her chest pain was so urgent. I tried to play along and re-hash all the eliments in her history that were concerning, and she fought me tooth-and-nail on every miniscule point... even denying some of her initial history. "I never said I was nauseated!" she snapped at me. Why the hell do people come to the ER when they're not going to listen to what the ER doc has to say?

Finally, she wore out my patience. When someone is threatening to leave AMA (against medical advice) and they have an emergent and potentially lethal medical condition, you do what you have to do and say what you have to say to try to get them to stay. I could have said "Whatever you want," and given up and walked out of the room. But, no, I fought for her well-being and I fought to get her to stay. And, yes, I was stern and, yes, I was threatening, i.e., you could DIE if you leave here tonight! I can count on one hand the times I've played the Yale card with patients, but she was so incredulous of my decision-making that I finally said, "Look, based on my education and experience, you need to stay. I know I look young, but I have a degree from Yale Medical School and I'm residency-trained in emergency medicine. I know what I'm talking about."

And damned if the stubborn old bag STILL would not consent to stay. So I just told her I wasn't going to argue with her and left the room, leaving her family members in there with her to hopefully convince her not to leave AMA.

It was a busy night and I had plenty of other patients to keep me busy. I optimistically kept the orders for Mrs. H's care active and went about my work. About an hour or so later I looked up and saw Mrs. H's daughter at the desk and I dashed over to get the scoop. "Is she going to stay?"

Well, according to the daughter, Mrs. H was, in fact, going to stay, but she thought I was very rude. Rude? RUDE? Excuse me for trying to save her life! I told the daughter, "Whether or not she thinks I'm rude, the important thing is that she's going to stay, and as long as she IS staying, I was effective."

But it really bothered me that this woman who, as my luck would have it, knows every cardiologist in town, thought I was rude, because normally patients love me. I'm not used to getting that kind of feedback.

I went about my work again but it kept eating at me and eating at me.

Finally I went back to Mrs. H's room and said "I've come to make nice. I'm sorry if you thought I was rude, but I was concerned about you and I didn't want you to leave here and die."

The stupid old bitch STILL wouldn't come around. She gave me this pouty nasty face and said in a condescending way "I accept your apology," in a way that was all too clear that she was going to hold a grudge to her grave.

Great, she hates me. This is what I get for trying to get her to do what was in her best interest. Sometimes you really can't win. Tough love is hard.

Son of Spaz

I have many talents. Athleticism, unfortunately, is not one of them. However, as the mom of two potential jocks-to-be, I try my best to be sports friendly, and I just hope that my boys will overcome my severe sports deficiencies.

The other day I thought I was doing a great job of working with Cole on the football pass. We were throwing the ball back-and-forth and I kept coaching him to "keep your eye on the ball." Well, be careful what you tell a two-year-old...

Next thing I know Cole catches the ball and proudly exclaims, "Mama, I'm keeping my football on my eye!" Then he puts the football LITERALLY right on his eye like an eye-patch or a telescope, and he flashes me his proudest smile before he tosses it back to me, like that's how the game is supposed to be played.

Yup, that's definitely MY son.

Tough Little Dudes

Today was flu shot day for Mama, Cole and Graham. The boys had no idea what was in store for them. I told them we were going to the doctor's office to see the turtles and get a flu shot, and since they don't know that shots are painful, they were just excited about seeing the turtle tank in the pediatricians office.

I'm supposed to get my flu shot for free at work, but I decided it was worth it to pay $30 to get mine with them so they could watch me before they had to do it. "First Mama's gonna get her shot. Then Cole will get his, and then Gi-gi."

Cole ate it right up, since he loves to do everything that Mama and Dada do. So I stood there and got my needle and the damn thing HURT. (In fact, my arm is still burning and aching as I type this.) I smiled and said, "Oh, a little pinch," so they wouldn't be completely caught off guard that shots involve pain. Then I got my festive kiddie band-aid.

"Now it's my turn?" said Cole excitedly after watching the whole procedure.

"Yup."

Cole eagerly climbed up on the table and got all ready. I held his hands as she plunged the needle into his thigh and told him it might hurt and he could cry if he wanted, and damned if it didn't even seem to phase him. He just sat there and watched the needle go in, watched the band-aid go on, and then jumped off the table. Not one whimper or peep!

"Yay Cole!" He was soooo proud of himself.

Then little Graham, who wants to do everything Cole does, climbed right up on the table just as eagerly. And damned if he didn't even whimper once. I could tell it hurt, because he got a pissed off look on his face, but that was about it.

I looked at the nurse in disbelief, "Did they get the same shot I did?" She assured me they did. And, really, I don't understand how they weren't screaming in protest, because that shit was PAINFUL. Even the nurse remarked that it was really rare for kids not to cry. She was going to brag to her colleagues that she had just given two shot without tears!

And now it's my turn to brag: My sons are TOUGH. It really was amazing.

I was so impressed that I took them to the toystore immediately after and let them pick out two new toys. They earned it!

For Dada, kid-at-heart.

Cole, do you know what it's time to start thinking about?

Yeah!

Oh, you know already! What?

I dunno....

Dada's Birthday.

No... MY birthday!

Yes, that's coming soon too... after Christmas, but Dada's birthday is before Christmas. So, Cole, what kind of birthday present would you like to get Dada?

Blue!

Blue what?

A blue present!

Oh.... a present wrapped in blue paper?

Yeah!

What do you think should be underneath the paper?

A box.

Yup. Good idea..... And how about inside the box?

Ummm... How about a T O Y ? !

I'm here!

And by here I mean

HERE.

That is our awesome new house (which I finally got around to taking a picture of a few weeks ago), or "white house" as Cole calls it. I think "nuthouse" is more appropriate. The past few months have been ridiculous. Dan has continued to be out of town 3 nights a week (apparently that has come to an end, though he IS out of town as I'm typing this, so we'll see...). And we took the boys out of the crap ghetto daycare and hired them a full-time nanny, Margo, so they've been home 24-7 which has been an adjustment. And I'm still working full-time nights, and the nightshifts seem to be getting busier and busier and busier. And... what else? I cannot even begin to sit and try to pinpoint where all the time has gone. All I know is that it has flown by. My life is incredibly rich but probably too fast-paced, and amidst all the running, running, running my babies are growing up and now Cole is already getting ready to turn 3!!

Since my last post,

We've had an impromptu weekend at Virginia beach

to celebrate summer's end(s).

We had a family trip to Ann Arbor, Michigan for a football game at "The Big House."

And of course we had all the usual October festivities like Halloween

with cute costumes

and candy.

Our little Pooh (Graham) just made himself at home at each house he visited. He walked right in to each and every foyer and tried to keep going like he lived there. At one house he shut the door behind him, leaving me on the front porch with my two kids inside!

The boys are doing great. Graham is talking now: He'll say "Again!" when he wants a book repeated, "Bubble Bath," "Dora" & "Boots," and he surprised me with "Paci" the other day. Of course he says "Mama" and something resembling "Dada" (but sounding more like "Nana") and lots of others, including some colors. His favorite word by far, though, is "DOGGY"! He is a HUGE animal lover and squeals with glee when he gets to play with our two corgis, Savin and Winston. He has learned to give the sweetest little kisses on command, too. He's our sweet baby!

Cole is a pistol. He is getting more and more independent and he wants to do everything "all by myself." He loves to do anything he sees Dan or I doing... even housework! About a month ago he got put in time-out for misbehaving and he was PISSED about it. When Dan went to check on him, Cole was standing in time-out with a pouty little stance and looked up at him defiantly and snapped "DOUCHE BAG!" at Dan. Like father, like son. Since then Dan has curtailed his language around our little imitator.

I'm going to try to do a better job blogging their day-to-day memorable moments because the things they do and say are priceless.

So, those are the whirlwind highlights of the past 3 months... presented at the only pace appropriate for this family -- really, really FAST. I will say one thing, though...

It's NEVER boring!