Friday, April 4, 2014

A boy gets a cast on his leg

 

Colin went to visit the orthopaedist today, and he came home with leg cast that will be his close and personal friend for the next three weeks. I don't feel 100% comfortable with the diagnosis since the doctor spent half a nanosecond looking at his x-ray, but then again the doctor is the expert, right?

Since the Urgent Care clinic is connected to our hospital, they could pull up his x-ray in the computer system immediately, and display it on a large wall monitor. I think that is just the coolest...I'm of the opinion that every doctor should be connected to a network, and that every teeny tiny scrap of your medical history should be accessible in a database, so that the information a doctor has is as up-to-date as it gets... Anyway.. Off track here... So he glanced at the x-ray and said it was an easy fix - just put him in an above-the-knee cast for three weeks and he should be just fine. He was not concerned about the growth plate at all. I guess I should feel relieved, but I feel a little apprehensive..

So Colin got a cast put on his leg. First the nurse removed the rest of his splint (pictured above, courtesy of photographer Colin), then put on a long 'sock', wrapped his leg in some kind of squishy material - similar to that thin packing material you use to wrap fragile stuff in, and then used a wrap that hardens within minutes. Colin was not exactly the best patient...he was pretty squirmy. The nurse gave Colin a Batman action figure that had an exact replica of the type of leg cast he was getting.


Batman helped Colin control his wiggles somewhat, but then Colin was still wiggling as he played with Batman. There were other characters, so out came Spider-Man in his leg cast, Darth Vader in his arm cast, along with Captain America. Luckily these two 'broke' their left arms, so they could still fight each other right-handed. :). We all tried in our best Darth Vader voices to amuse Colin...

"Colin...(Vader breath)...I am your father..."


Colin had about 15 color and design choices for his cast, and so he immediately chose 'safety orange'. A very appropriate choice for this boy! Dean tried to steer him towards OU red, of course. The casting from start to finish took under 15 minutes (!), and we were done. It is a waterproof cast, so he can shower, bathe, SWIM...and it is supposed to dry out in about an hour. I don't think we will attempt the swimming thing (he would sink like a rock) but it is good to know I don't have to give him a sponge bath for the next three weeks.

All afternoon Colin got increasingly mobile, hobbling all around. You can hear his cast scrape along the floor, so I can tell when he is moving around, which is nice. I can't believe he is already putting weight on it, but apparently it doesn't seem to bother him because he didn't complain of pain even once all day. Tough kid!

 

A boy breaks his leg...


If there ever was one of our kids to end up in the ER, it would be Colin.  He's the rough-and-tumble one.  I can't remember a time when he didn't have a bruise somewhere...  I just always assumed that regular trips to the ER would be the norm for this kid.  I am completely amazed that it took him four years to finally make that happen.

Just a couple of days ago, on Wednesday afternoon, Colin broke his leg jumping on the trampoline.  I was upstairs, pulling laundry from the dryer.  Dean was downstairs, working on the computer.  Dean happened to be home that day, as he was feeling like crap that morning and decided to call in sick.  As the day went on he felt better, so he was getting some work done from home.  I had just come from downstairs, and I had noticed in passing that the neighbor and his kids were jumping on their trampoline.  I heard the bustle of Jordan and Colin going outside to do the same thing.  Within a minute there was yelling and screaming coming from our side of the fence.  I hollered down to Dean to go tell Jordan and Colin to be quiet so that they wouldn't annoy the neighbor who was outside enjoying some time with his kids.  Then I heard Dean come in with a sobbing Colin and he brought him upstairs.  I came out of our closet where I had been putting the laundry away, and there was Colin, laying down on the floor and Dean looking him over.

Now, I am the kind of mom that is the wait-and-see type when it comes to injury.  99% of the time it is not as bad as our four little drama queens make it out to be.  I am hard-pressed to even dispense a band aid.  There has be BLOOD...LOTS of it.  This time around I was skeptical.  There was nothing outwardly wrong to suggest that there was an injury to Colin's leg, except the fact that Colin refused to put any weight on his leg and seemed to be in a lot of pain.  I manipulated all of his joints in both legs, there was no swelling, and he couldn't point out the exact location..he just indicated the entire left side of his body, which isn't exactly specific.  As time went on the area under his left knee grew warm, so we figured that was where the fracture likely was.  (Well, we didn't know it was a fracture, but all signs were pointing that way..)

Given the fact that he refused to bear weight, Dean thought it best that we go to Urgent Care.  Now, in the meantime, Jordan completely lost it.  It was basically his fault.  He had jumped hard on the trampoline, in order to bounce Colin really high.  It was intentional, but totally meant in the spirit of fun.  The kids like it when he does that.  We were kids once too, and we both remember that it was fun to bounce kinda crazy like that.  The problem is, Jordan can't quite regulate his quest for fun with keeping things safe.  We've warned him a thousand times that Colin and Owen are too small to bounce really hard like that, and to keep it in check.  He forgets...  So, as it became apparent that it was serious, Jordan just lost it and started bawling because he felt so bad.  Even at 13 going on 14, Jordan is a sensitive kid, and he wears his heart on his sleeve.  So, we asked him to pull it together and hold down the fort while Dean and I took Colin to get checked out.

The exam was pretty quick and routine.  Colin was not happy to be there, and refused to talk to any of the doctors or nurses.  He wouldn't even accept a popsicle from the doc - I had to be the go-between.  He had a couple of x-rays done, and sure enough, there was a small fracture line at the top of his tibia.  The doctor placed his leg in a splint and wrapped it up and sent us home.  Nothing could be done, casting-wise, until the swelling went down.  Of which there really was none, but whatever...

Since the splint goes up the back of his leg and up past his knee just a bit, Colin can not bend his leg.  So getting him home, strapped in the car seat was an issue at first.  Luckily we had a spare fleece blanket, and so we devised a long sling to suspend his leg.  We used the handle that is just above his seat to tie the blanket to and adjusted the height so that his leg was at just the right angle - it actually worked pretty well!

So for the past day and a half, Colin has been either on the couch or in bed.  We have to carry him everywhere, so bathroom trips are the most difficult thing right now.  His leg has to stick straight out, so I have to prop it up on my knee while he sits down and does his business.  His siblings have been kind enough to bring various toys to him and take turns playing with him on the couch, but I can tell this will get old, very quickly.  I think reality set in for him a bit yesterday, when he asked if he could go outside and play in the sandbox with his trucks.  'No'.  Jump on the trampoline?  'Are you serious?  No.'  Ride his bike?  'Uh...no'  This kid is a constant mover.  So the upside is that we will now know where Colin is at all times.  The downside is that Colin won't be happy about that.  At all.

Today we are going to the orthopaedic center - the same place I had my shoulder surgery done - to see a specialist.  Unfortunately the pediatric guy was booked solid, so Colin will be seeing a 'bone specialist' instead.  This is probably a good thing, because the fracture line is awfully close to the growth plate at the top of the tibia, and this could lead to some serious problems as Colin grows - like uneven bone length kind of stuff...  We'll know more in a few hours.

Not happy to be here...  "Stop lookin' at me!!"

Daddy helps with the popsicle

He looks happy here.  Which totally does not make sense.

A close up of his x-ray.  The length of the fracture is hard to determine here.  The top of the tibia is called the metaphysis.  The gap is the epyphyseal plate (growth plate) which is filled with epyphyseal cartilage, and the smaller section above is called the epiphysis.  The metaphysis and epiphysis eventually fuse together, and ossify, in the late teens.  The growth plate is where new bone growth takes place.  The further you travel down the bone shaft, away from the growth plate, the harder and more mature the bone.  Fractures in young children often take place at the ends of  long bones, where the bone is very fragile still.  Fractures in this area are problematic because they can interfere with the growth plate doing it's job in producing new bone.