Cast Day

We went to see Dr. Quatro today to let her remove Amanda's splint, remove her stitches and put her in a cast.


This is the first time we've seen Amanda's incision. Dr. Quatro left the tape on under the new cast. She did one little snip on the stitches, and just as Amanda was beginning to cry she pulled one string and they all came out (under the tape).


Next, Dr. Quatro put a giant "sock" on Amanda's arm in preparation for the cast. What is not shown next is where Dr. Quatro and the nurse had to help Amanda increase the angle in the bend of her elbow before putting on the cast. Amanda's elbow has stiffened up from not being used, so there was a bit of yelling and crying, but she was a big girl and got through it.


Amanda chose a lime green cast. Dr. Quatro said today's x-rays showed Amanda's elbow has set well and everything looks good. The cast will be on for two weeks, then we go back, take the cast off and begin using the elbow again.

The Surgery - Live Blog

A new trend I have been picking up on is "Live Blogging". I did not have a live Internet connection this morning as Amanda went into surgery, but I 'blogged' on my Pocket PC so I could post it this evening.

6:00am
Good morning. The dogs are the only ones happy to be awake at this time of day. Our goal is to leave for North Richland Hills by 6:30am to allow for traffic and arrive there by 7:30am.

6:20am
Picture of Mommy and Amanda before we headed out.


6:25am
Mrs. Debi in driveway. Going to follow us to the hospital and stay with us to pray and offer moral support.

6:55am
Arrived early. Traffic not as bad as expected.

7:05am
Paperwork filled out. Watching Disney Channel. Took a picture with Mrs. Debi and with Daddy.




7:30am
Back to pre-op. Amanda got the official hospital gown and we had to wait. Amanda was very brave. A few tears and a few fears here and there, but she was a brave little girl. Amanda played games on the Pocket PC to pass the time and to keep her mind off what lay ahead.


8:15am
Dr. Quatro paid us a visit to let us know she was finished with her previous surgery and would soon be ready for Amanda. She explained that we should prepare for Amanda to be in surgery somewhere between and hour and an hour-and-a-half. Look at the brave girl smile!


8:30am
Nurse brought the 'giggle juice' to help Amanda relax. Another nurse, one who would be helping with the procedure also stopped by to say hello, check some notes, meet Amanda and assure here that they were going to take real good care of her. Everybody there was EXCELLENT with children. Just a little crying

8:42am
They took Amanda back for surgery. She teared up a little bit but was being brave. Mommy was trying to be brave, but she teared up more than just a little bit as Amanda disappeared around the corner.

8:45am
In the waiting room with Mrs. Debi and Mrs. Pat from church. We prayed, waited, called our parents and waited some more.

9:50am
A nurse came out and called for us. We are in a separate waiting room now. Nurse said Dr. Quatro would be in to discuss how the surgery went and then we could see Amanda in recovery soon.

10:00am
Dr. Quatro came in and said all went well and explained what all she did. After Amanda was asleep, she moved her arm all around trying to reduce the elbow (get it back in socket). It would not go. She then made an incision and checked the socket for debris that was keeping the elbow from going back in socket. Nothing was there, but the tissue around the joint had obviously moved into the vacancy previously (and rightly) occupied by her elbow! Once this tissue was gently moved back, the elbow went back into place easily. Dr. Quatro said she then worked the elbow 'quite hard' to see if it was going to pop out of place again and was pleased that it stayed as it should Amanda's arm was moved all around. Amanda was closed up, stitched up and put in a sling.

10:10am
We were allowed to go to recovery and see Amanda. Mrs. Debi and Mrs. Pat came with us. Wow, this was not fun. Amanda was crying and in distress. The nurse explained that Amanda had kicked and removed the IV from her foot before all of the 'coming out' medicine had been administered. She then explained that the very 'giggle juice' that made her so happy before surgery would make Amanda very emotional, and probably angry, coming out of the anesthesia. Since there was no IV, it was either let it work it's way out of her system or stick her again (which nobody wanted to do). For quite a while Amanda did not respond to our presence in the room. The first couple times she looked at us it was almost scary. Due to the drugs, she did not really recognize us and she looked...well, she just looked mean. I cannot describe the way her eyes looked other than to say it was definitely drug induced, and if I ever see a grown up holding a weapon in their hands with that same look in their eyes...I expect that to be the last thing I ever see! Mommy cried and loved on Amanda as only Mommies can. Eventually she could recognize and speak to us (telling us how badly her arm hurt).

11:00am
Going home. They sat Amanda up, got her in a wheel chair and we headed to the car. Mrs. Debi drive the car around while Mrs. Pat and Mrs. Barbara helped carry all of our stuff (clothes, pillow, backpack, new stuffed animals and a barf bowl) to the car. Thankfully the barf bowl was not needed on the way home and Amanda drifted off to sleep.

12:00 noon
We got Amanda home and situated on the couch in my office. Her arm hurt, so we just prayed and let her rest. All of the sudden she started whimpering and we wondered what caused her to hurt so badly all of the sudden. Then we found out...we found out why she whimpered suddenly and why they sent the barf bowl home! After a bit of clean up, we opened up the hide-away bed and got Amanda set up on that.

2:00pm
Both Amanda and Mommy were sleeping so Daddy went to work.

6:00pm
Mommy and Daddy ate dinner prepared by Mrs. Debi and Amanda had a Popsicle and some ice cream. Daddy and Boo came into the office to support and encourage Amanda (see picture).


8:00pm
Amanda went to bed. Thank you Jesus the day has gotten better! Amanda made it through the afternoon with no pain medicine, although we did give her some at bed time to help her sleep. It seems we are getting a little more accurate reading on the 'Amanda pain scale' now, too. Daddy felt really bad about telling Amanda to 'suck it up' (not in those exact terms) last week when we thought she had a sprain but her elbow was really dislocated, but Amanda also learned the lesson about being a hypochrondiac and saying every pain was excruciating. She is sleeping now and we are all feeing much better.

That Explains A Lot

We went to see the pediatric orthopedist today...Dr. Quatro (pictured right), about Amanda's elbow. She examined Amanda and took a ton of x-rays. She concurred that Amanda's elbow was indeed out of socket. Due to the fact that it came out of socket a second time, she said she thought there might be some cartilage or a bone fragment in the socket that kept it from going back into place properly. This would account for its tendency to pop out of socket so easily the second time. She wanted to line up surgery for Wednesday with the game plan being: put Amanda out with anesthesia at the outpatient clinic, try to reduce the elbow (put it back in place), try to pop it back out of place (to see if it was too easy), cut into the elbow if necessary, clean out the joint and reduce the elbow. Treatment would include a split or a hard cast.

Dr. Quatro mentioned she would really like to see the x-rays of the previous dislocation and the x-rays the hospital looked at the second time, but she could not read the CD the x-rays were on. The x-ray CDs came from the hospital. When we saw the first orthopedist, he just popped the CD into his computer and the CD loaded a program to view the x-rays. Since they gave us the x-ray CDs to take to Dr. Quatro, I popped them into my laptop last night and looked at them. Pretty cool! That is also where I got the x-ray for yesterday's post.

I told Dr. Quatro I had gotten the CD to open on my laptop, so she invited me to try it on hers. The CD did not auto-open, but I was able to open it by going to My Computer, right-click on the CD, select Explore and then double-click the program that is on the CD. It opened and she could view the CD.

Dr. Quatro said she could not tell anything from the initial x-ray (elbow x-rays are read more easily when the elbow is bent at a 90 degree angle, but when it is dislocated, that cannot happen). Almost as soon as she saw the x-ray of Amanda's elbow after it had been reduced and put in a splint the first time, she said, "Oh yeah, there's the problem. That never reset correctly. There is something in there."

That statement made me feel better. First of all, the doctor's "educated guess" that she had shared with us earlier based on her experience and having never seen the x-ray was proven correct (she was a good doctor). Secondly, I felt better knowing that the doctor had an idea what to expect and game plan to fix the problem. The x-ray also explained a lot as to why Amanda's elbow popped out of joint so easily (it was not my fault for taking her for a bike ride!) and it gave us a little more assurance that is should not be a problem in the future.

The Drama Continues

If you didn't know, this is what the x-ray of a dislocated elbow looks like. This is the x-ray from Amanda's first trip to the hospital. Obviously the doctors could tell it was dislocated, so they told us it was, and they fixed it. That was August 23rd.

Then there was the bike wreck on October 1st. Another trip to the ER, and apparently the x-ray was not as clear this time. The doctor said it was just a sprain, wrapped Amanda's elbow and sent us home.

And there was quite a bit of pain. Unfortunately for Amanda, she is a bit of a hypochondriac, so we did not realize how bad her elbow may have been hurting. Until today that is. We went to see the orthopedist, and he was surprised Amanda could not move her elbow yet. He looked at the x-ray from the hospital and said he could not tell anything from that. He took some more x-rays and determined that Amanda's elbow had indeed popped out of joint again...and it has been out of joint for a week now!

So the drama continues. Tomorrow we go see a pediatric orthopedist and probably schedule Amanda for an operating room on Wednesday. They will knock her out and see if her arm will relax enough to be put back into joint. If not, they will go immediately into surgery to fix it. Of course Amanda is afraid of surgery and Daddy is panicking over skyrocketing medical bills on top of seeing his little girl cry.

Daddy's New Medicine

Wednesday morning at 5:00am I was very tired. Brooke and I had both been up with Amanda much of the night Tuesday night, Brooke had been up with her for a couple hours earlier Wednesday night, and then Amanda came to wake me up at 5:00am crying with elbow pain. I brought her back down to the couch in my office, prayed for her and explained that I could not give her any medicine yet. She had already asked for it 3 times.

We had been giving her Ibuprofen rather than the Hydrocodone that she got a prescription for at the hospital because it seemed to be helping more, but we were getting concerned that she was taking it every four hours for almost 2 days. Besides that, as she asked for her medicine a fourth time, I realized the medicine had become a "miracle cure" for her. Five minutes after taking the medicine, Amanda would say she was feeling better. Ibuprofen does not work that quickly.

I'm not sure if it was sleep deprivation or divine revelation, but I told Amanda, "I cannot give you any more of your regular medicine, but let me see if I can find something else. I left her on the couch and went to the kitchen. I found her little medicine cup, grabbed some of Brooke's Fuze vitamin fruit drink, poured it into the cup then tried to figure out some way to make it taste like medicine. The refrigerator door was open and the Pepto Bismol was right there, so I grabbed it and put just a drop or two in the mix. I stirred it up and presented it to Amanda as pain relieving medicine. I say this in all honesty...her pain subsided within 2 minutes and within 10 minutes she was asleep again!

After the second use, Amanda became a bit suspicious (the lack of a medicine bottle and the distinct Pepto taste), but it worked twice and that was enough to get us through the rough spots. We are down to medicine once in the morning and once at night, so 'Daddy's new medicine' did the trick.

It's Like Groundhog Day or Something

Deja vu? You are wondering "What happened?" and I'm wondering "How did that happen?"

You may recall that on Thursday, August 23rd Amanda fell off a skateboard and dislocated her elbow. You can read about it now if you did not already know, but we went to the ER, had it set and then went home. After it was set, there was not much pain. Three weeks later, we saw a specialist who took the splint off, said another six weeks of no limited activity (no monkey bars, skateboards, biking, etc) and we were good to go.

So on Monday, with a week to go on the forbidden activities, I asked Amanda if she would like to go for a bike ride. After all, I reasoned, we've never had a big bike crash.

By this time, anybody reading this post knows what happened. We had been riding a little over 5 miles and were on our way home when Amanda decided to race. I saw the sharp turn coming up in the sidewalk and was about to caution "slow down"...but it was too late. She wiped out and skidded along the sidewalk. I knew she was gonna be scratched up, but my first thought was "at least her elbow will be OK."

As soon as the bike stopped, Amanda jumped up and yelled something that hit me right in the gut, hard..."Daddy, my elbow." I ran over to her and told her it would be OK. I then asked her to move the elbow and she said she couldn't. She cried and held it like she did before. And the flood began..."how are we going to get home?" "why did I suggest bike riding?" "how are we going to pay for another visit to the ER?" (and then again) "why did I suggest bike riding?". Guilt, panic and fear. So I (very UNcalmly) called Brooke and said, "Get in the car and come pick us up by the new library. Amanda crashed on her bike and popped her elbow out of joint again."

When Brooke arrived, I was so worked up I could not get the bikes broken down enough to fit into the car. Amanda was crying, Brooke was upset and I was just freaking out. I don't usually freak out, but I was not handing it all very well.

We came home, dropped off the bikes, let Amanda change clothes (all dirty from wreck) and headed to the ER. We noticed that the elbow did not seem quite as bad as last time, but she was crying and in lots of pain. The wait at the ER was longer this time, and that was VERY hard. They took an x-ray (again, we noticed the pain in moving the arm for this did not seem as bad as last time) and then waited some more. I bet I paced 5 miles waiting for them to come give her something for the pain.

The ER doctor came to see us (same one from last time) and told us the good news that her elbow was sprained and not broken or dislocated. They put her in another splint and sling and sent us home with a prescription for Hydrocodone and orders to make another appointment with the specialist.

Guess what...after getting put into a splint, sprains are MUCH more painful than dislocations. After Amanda's dislocated elbow was set, she needed some Ibuprofen that night and once or twice the next day, but she was good to go. Not so this time. We were up all hours of the night Monday, Tuesday and Wednesday night. Amanda did not go to school Tuesday or Wednesday.

Last night, Thursday, Amanda was able to sleep through the night on the couch in my office. She is sleeping there now as I write this, and we are hoping to have another full night of sleep again tonight. Each day gets better. Thankfully.

Why, oh why, did I suggest bike riding?

Thursday, August 23rd.

If a picture is worth a thousand words, I guess I only need a few more to tell you about this picture.

Thursday, August 23rd.

1:55 PM - Amanda standing on a skate board (STANDING, not skating). Somehow skateboard shoots out from under her. Amanda falls. Arm hurts and Amanda cannot move it.

2:00 PM - Rob, Brooke and Amanda en route to emergency room. Beginning of pain and crying.

2:20PM - They take us back. Very nice paramedic talks with Amanda to find out what happened (he could have worked at a children's hospital...he was really good). X-rays needs...LOTS of screaming. Diagnosis - dislocated elbow. IV started to administer morphine and medicine to make her "semi-conscious" so elbow can be popped back into place. LOTS more screaming and not enough sitting still...had to poke a second time. Amanda figured out that moving around meant more pokes, so she sat still second time. Also discovered that the needle stick was not near as bad as she had imagined it in her mind. Morphine helped her calm down. Then it was time for the REALLY COOL medicine. They gave it to Amanda via her IV, she closed her eyes as if asleep, they had us leave the room and three minutes later we were back. Amanda's arm was being wrapped in a splint, she was not in pain, it was popped back in place, she asked "Am I dreaming?" and had no recollection of anything that had taken place during those three minutes.

4:00 PM - A few muscle tremors and it was all over.

5:00PM - That nice paramedic brought Amanda a Popsicle and unhooked her from everything.

5:30 PM - FINALLY discharge papers arrived, we were harassed about paying our $100 deductible right then (which we did not do) and we left for home.

Thursday, August 23rd.