On Sunday night, as we were saying goodbye to the Rosenthals, I saw William hanging upside down from the handrail. Naturally, I fussed at him as I took him down and told him not to do it, because he might get hurt. I walked into the other room to locate a pair of missing shoes, when I heard a thud, a short pause, and then a wail. I came out to find him lying spread eagle at the bottom of the stairs. While none of us saw what happened, I could wager a pretty sound guess.
I was comforting William as the Rosenthals left, but was a little worried about William, since he fell asleep on the floor right next to the door after he finished crying. Since it was well past bedtime, I was trying to get the girls ready for bed, but told Billy, that if William were to throw up, I was driving him to the ER. The words had barely passed my lips when he rolled over and began retching. = (
All 4 girls were super helpful and brought me towels, clothes, buckets, shoes, whatever I asked for. Billy loaded William into the car and I grabbed a few essentials (like a phone charger and socks.) Fortunately for all of us, my mom had just made the 3 day trip up from Texas and was on call to be me for my girls at home the next morning.
We had to go through a metal detector* on our way into the ER, which was a first for me, but they didn't delay. As we checked in, they offered William a wheelchair, which I graciously accepted, since I had carried him from the parking garage. The waiting room was busy, but we were sent on through to the pediatric waiting room.
There were a few patients in front of William, but we did not wait long. I sent Billy some updates, and then we were taken to the triage. When we stood William up to get his weight, he threw up again. = (
The nurse found him a room where we waited to see the doctor.
When the doctor came in, and started testing his neurological functions, he threw up a third time. This was very concerning for her, which in turn made me quite nervous.
Just before 11pm, he had his first CT scan. On our way, my phone chimed, Billy had not been getting my updates. I started emailing him, sadly it was all bad news.
Back in his tiny room, the doctor came in and told me that he had a fractured skull, and a crescent shaped bleeding in his head, a subdural hematoma. They paged the neurosurgeon to find out whether or not he would need to be moved to Grand Rapids (there is a dedicated children's' hospital there.) They set him up with an IV and monitors. He dozed in an out of consciousness. He had developed quite a large bump on the back of his skull. = (
Once the doctor heard back from the surgeon, the instructions were to wait and repeat the scan in 6 hours. They did one more scan before he could rest, to check for other trauma on his chest and hips. Finally, some good news, it was just his head.
Sometime around 3am, I joined him in his tiny ER bed, because I was unable sleep in the provided chairs. He was such a sweet boy and made a spot just for me. The nurse brought me in a pillow and blanket too. Despite the recommendation to avoid this hospital for our pediatric needs (except in emergency) I was super impressed with their pediatric staff!
At 5am, almost exactly, they repeated the scan. The bleeding had almost completely resolved, and was now a very minor epidural hematoma.
We were able to doze another hour or so before they moved him up to the PICU ward. But this little boy was one on the mend:
The neurosurgeon on staff, as well as the senior staff doctor, resident doctor and student doctor all came in to take a look at William and test his reflexes. He was much closer to being my normal little boy than he was the night before.
Sarah came by bearing gifts of coffee and some strawberry shortcake DVDs from my car! Morning talk shows are not very entertaining for recovering boys, and that's what I had left in the car from bygone days when it was the family vehicle. = )
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| 4700 ALP (marked "high") for reference: 149-369 is normal for his age |
After the doctors finish their rounds, they discuss each case in a conference room, bringing in the parent, if available. The only thing that did not impress me was when the lead doctor wanted me to look through a book of maladies, to see if William has a syndrome that has not been diagnosed.** It was like the cri-du-chat episode all over again. (spoiler: the twins do not have cri-du-chat)
When the doctor asked me about the hypophophatasia, he tried to correct me, because William's ALP level is so high, that he cannot possibly have a hypo- form of the condition. It was quickly righted by mention of his medication, but frustrating that I have to go through it over and over again with insurance all year, then with the doctor. I am thankful that he clarified, but I was easily vexed, from a night of little rest, and relief that William had improved so drastically in a short period of time.
He also pointed out that the fracture was along one of his old craniotomy lines. His bone is apparently thinner than other patients this doctor has seen, which is not surprising.
After the rounds concluded, a child life specialist came by, allowing William to play in the room for a bit, pick out a book, a box of toys to take with him to his room, and some William picked movies!
When we returned to his space, he had been cleared to eat, and his food was on it's way!
Avia and his sisters came up to visit and play, and bring me a non-hospital lunch! Having his sisters around made him feel more like himself, but also tuckered him out.
After they left and he finished his lunch, he fell into such a deep sleep, that the visiting surgeon had trouble rousing him. While my fears were mostly abated, this rest triggered another bought of fear, and when the doctors asked me to weigh in on going home, I agreed that one more night would be in order.
After a nice, lengthy nap, William woke up refreshed, and begging to leave. He asked me when he could take off his pulseox monitor, and I told him that it would come off when he was discharged. He replied "but I am charged!"
He stayed up watching his movies on repeat for the rest of the evening, and finally at 11, I told him it was lights out. Despite my history of not sleeping well in hospitals, I was out cold. William got a roommate in the night, and I didn't even hear them come in! I guess the poor sleep the previous night, combined with the security that he was being monitored by professionals, allowed me a good night's rest.
The next morning, he was 100% back to normal. The bump on his head was minimal, and rounds confirmed that he was ready to roll. My mom got my girls up and out the door a second time, so that I could be there with him.
Respiratory came in with bubbles to make sure that his lungs stayed clear.
He had to do one final CT scan at 10am, but it came back with just a remnant of his mishap, and of course the fracture.
His nurse, Dee, was the same as the previous day, and she was fantastic! She worked to make sure that we could get out of there as soon as possible. He was excited to have all of his monitors removed , and be able to put on regular clothes again!
She even ordered a copy of the CT scans for us to take to his day of appointments on Wednesday.
The hospital is right in downtown Lansing, and has a nice view of the capital from the west facing windows.
Here's hoping that we can avoid the ER for a while. I am pleased to report, he has not climbed back up on the railing since we came home. If I'm a little more grey the next time you see me, William is the reason.
later days
<what happened previously
what happened next>
*I'm not sure if it's a permanent installation or not, but I read about a shooting in a hospital in Kalamazoo (or somewhere) in the past few weeks.
** William has a very gaunt appearance, but he has my features and also bears a striking resemblance to Alice. Hypophosphatasia is William's problem. For some reason, doctors cannot simply accept this diagnosis, and keep attempting to add labels.
edited 10/22/17 to add forgotten details!
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