Month: November 2005

As most of you know, we aren’t in Utah right now. For only the second time since we’ve been in Michigan, we’ll be having Thanksgiving at our house. So what’s keeping us here? Well, it was our second trip to the ER in less than a week that has delayed our trip out west. So here’s what happened (WARNING: this story is not for the squeamish, read at your own risk).

The night before our trip, we were getting the kids ready for bed. It was about 8pm. Nick was going to the bathroom and he had the door closed. Ashlee decided that she wanted to be in the bathroom also. She pushed the door open, and Nick slammed it closed. The third time this happened, the tip of the pinky finger on Ashlee’s right hand got caught in the door as she was pulling her hand away. This pulled off the tip of her finger from the nail on up.

I was sitting on Nick’s bed only a few feet away and I jumped up and rushed over to Ashlee, who’s hand was bleeding everywhere. She was crying, “I need to go to the hospital!” I cupped her hand and pulled her into Nick’s room, then asked Becky to get me something because Ashlee was bleeding. When she handed me some toilet paper, I told her I’d need something more so she rushed to bring me a paper towel. Becky didn’t yet know how serious Ashlee’s injury was. I told her that the tip of Ashlee’s finger had been pulled off and that it was on the floor in the bathroom doorway. She scooped it up in a plastic bag and put it with some ice then dialed 911. Ashlee only cried for a couple of minutes before she calmed down.

The EMTs arrived (they were only a couple of blocks away) and we pulled away the toilet paper and paper towel that I had been holding over her finger. They then bandaged her up with some gauze and we decided to drive Ashlee to the hospital ourselves. So all four of us piled into the car and we were off to the ER (again).

We were quickly ushered to Pediatric Urgent Care, where the same nurse who had helped treat Ashlee the previous Sunday for her head laceration recognized us and said, “Ashlee, you’re back?” She took us into one of the treatment rooms and took Ashlee’s history and vitals.

After a little while, one of the residents arrived and gently unwrapped Ashlee’s bandages to have a look. He took a quick look, covered her finger back up, and told us the hand surgeons would probably want to come down and take a look, and that they most likely wouldn’t be reattaching the tip of her finger since it was pretty much just her skin and nail that had been pulled off. Since Ashlee had last eaten around 7pm, we’d have to wait at least until 11pm before anything could be done surgery wise. Nick got a look at her finger at this time also. Becky asked him what it looked like and he said, “It looks straight across.”

At about 10:30, they came to get Ashlee for an xray. I went with her while Becky and Nick waited in the treatment room. At radiology, we unwrapped her hand all the way for the first time since the EMTs treated her. Ashlee finally saw her finger and was a little apprehensive. I helped her hold her hand still while they took three separate views of her pinky finger. After we finished, I bandaged her up again and we went back to the treatment room. After returning, they started to get Ashlee ready for the surgeons. They had to put an IV in her left hand and wrap it up so she wouldn’t try to pull it out. It reminded me of when Nick was born and was in the ICU for about 12 hours with his tiny hand wrapped up with an IV. Once again, Ashlee was very tough through the whole thing. She finally fell asleep shortly after that at around 11.

At about a quarter past 11, the hand surgeons arrived. Ashlee was given the sedative through her IV. I choose to stay while Becky and Nick went to the waiting room. They prepped her whole arm for the surgery. The xrays had shown that the very tip of her bone was exposed a little, but otherwise there was no bony injury. Next they injected lidocaine into her hand and the base of her fourth and fifth fingers as a localized nerve block. The surgeons closed up the wound as much as possible (luckily with biodegradable sutures), but told me that there was still a small area that was exposed but should heal up fine.

After closing everything up, they cleaned up her hand and arm, then wrapped her whole hand and wrist up with and gauze leaving only her little thumb exposed. They gave her antibiotics through her IV also. Everything went well. Becky came back into the treatment room just as they were finishing up. I asked her where Nick was and she said he was still in the waiting room playing with some cool toy. For future reference, the Pediatric Urgent Care waiting room does have some fun things in it. Nick came in a few minutes later. He had stopped off at the nurses station on the way back and picked up some stickers, one of which was a cute Princess sticker he wanted to give to Ashlee (see picture below).

Now all we had to do was wait for the sedative to wear off, then try and wake Ashlee up. She had to show she could respond to stimulus and drink something before we could take her home. Often when children are coming out of their anesthesia, they’ll experience blurry or double vision. Ashlee was no different as she started waking up about a half an hour later and started to cry as I’m sure she was confused and disoriented. It took about 15-20 minutes for her to calm down. Then she gulped down some grape juice and we could finally get ready to go home. Nick finally jumped into Becky’s lap and fell right asleep just after 1am.

We got our discharge papers, script for her antibiotics and pain meds, and instructions on caring for Ashlee’s finger until her follow-up visit with the plastic surgeon. With Ashlee in Becky’s arms, and a sleeping Nick in mine, we finally headed home. We got back just after 1:30. Ashlee got to sleep in our bed that night.

Ashlee sleeping the morning after surgery

The prognosis: The finger should heal just fine. There is a small possibility that Ashlee’s pinky may need a couple of “touch-ups” so it looks like a normal finger when it’s totally healed. She most likely won’t grow a finger nail on that finger either. If some sort of nail does eventually grow, the surgeons said we’d probably want it removed for cosmetic reasons. We have a follow-up 1st post op visit with the plastic surgeon the day before Thanksgiving. So, we’ll be having Thanksgiving in Michigan.

We do wish we could get Ashlee to be more cautious of her hand. She’s been running, jumping, tumbling, and twirling around as if nothing’s happened. She is having to adjust to eating, coloring, painting, and using the computer with her left hand. But hopefully, after our next doctor’s visit, she’ll only have her pinky finger bandaged and can use the rest of her right hand again.

She’s very interested in the xrays of her hand I brought home from work yesterday. When she first saw them she said in her little sad girl voice, “Oh, the pinky got cut off.” She often asks to look at the xray of “Ashlee’s bones”. Maybe she’ll be a hand surgeon when she grows up.

These pictures and the movie clip were all taken after returning home from the hospital.

Ashlee doing the same thing she was doing when she slammed her head against the hall corner.

Her poor little scalp.

Close up of the injury.

You can get an idea of where on her head the staples are located.

View the video clip. It’s an mp4 file, about 35 seconds long, 320×240, 1.6Mb. If your web browser won’t display it, right-click (or control-click) on the link and save the movie to your desktop then open it with QuickTime player.

Our little princess has a history of treating every kind of “boo-boo” as if she’s just lost a limb. Always half-crying without stop until she gets a hug and a kiss (didn’t you know Mommy and Daddy’s kisses contain special healing powers?). So in an effort to “toughen” her a up a bit, we’ve been giving her her treatment, and telling her, “That’s a big girl, you’re tough.”, and she walks away feeling better. Lately, she has decreased the amount of carrying-on when she gets an owie, as long as we acknowledge that yes indeed, she has an owie, she seems satisfied. So now just asking, “Are you OK?”, she’s been replying, “Sure, I’m tough!”, and goes on her way.

The past couple of days, she’s been squatting down and moving about on all fours and barking, acting as if she’s a puppy. Not hands and knees, hands and feet. If you’ve seen the most recent Planet of the Apes movie, it’s something similar to what the apes look like when they’re running. She moved like this yesterday through the parking lot from the church to the car. So last night, we think she was having a puppy race, her against Stella, with the living room and the hall the arena. Racing down the hall as fast as she could on all fours, we think she somehow slipped (which happens often when she’s moving like this, and not all by accident mind you), slamming the back of her head against the sharp corner at the end of the hall.

She started crying (an indication that this owie was for real) and we both rushed to her to survey the damage. Becky (who, by the way just happened to be wearing a very nice white shirt), reached her first, scooped her up, and cradled her on the couch. She cried for a little bit, but had started to calm down when Becky looked at the hand that had been holding Ashlee’s head and noticed a bit of blood on it. She moved Ashlee’s head away from her body and sure enough, a nice pool of blood had collected on the front of her shirt. I started looking for the source, and after a bit of a search (that girl has a lot of hair), I found about a 1.5cm laceration near the back of her head. It looked deep enough and long enough for sutures. We called the nurse on call at her pediatrician’s office who also confirmed we should probably have her checked out. So I bandaged her up while Becky got a snack bag ready for us. Then Ashlee and I headed for the ER (we live only about seven minutes away).

By the time we got there, Ashlee was basically her usual self. Although shy with everyone asking her questions, you really couldn’t tell anything was wrong when it was just me and her. She did look a little confused being around the medical staff as I’m sure she was wondering why she was there since she had just seen the doctor for her yearly check up only a couple weeks ago. When the check-in nurse asked her to rate her pain on the 0-10, happy face to crying face scale, she pointed to the 10-crying face. We only waited in triage for a couple of minutes before being taken to Pediatric Urgent Care.

Once in our room, the nurse came in do the primary survey, followed by the resident who took Ashlee’s history and performed a very thorough neuro and secondary survey. Ashlee was really good, even opening her mouth so the resident could see inside without even being asked. When the doctor asked her to say, “Ah”, no sound came from Ash. Two more times she tried but again no sound. Finally I said, “Ashlee, say ah.” And the tiniest “Ah” you could imagine finally emerged. The decision was made that the laceration needed to be closed, so some “numbing” cream was applied.

Then Ash gulped down the two Gogurts Beck had packed for her, and we watched a show on HBO Family with a little baby conductor in diapers, orchestrating different animated images to classical music. We were waiting for the attending physician to come in and decide sutures or staples. When Ashlee’s show was over she turned the station to the football game and said, “There you go Daddy.” I love that girl!

Only a couple of minutes later the attending arrived. He decided two staples should do the job. So the resident irrigated the wound next. I explained to Ashlee what was going to happen but I’m not sure how much she understood. I don’t know about her but this was the part I was most worried about. I’ve had sutures in the back of my head, and it’s not a fond memory. Staples have got to be worse. So Ashlee looked down, and I held her head, her cheeks cupped in my hands. The resident put the first staple in and I don’t think Ashlee felt very much if anything. I told her we were almost done, only one more to go. I think she felt the second one a bit, I could see her whole body tense up as if to say, “You didn’t tell me you were going to do that!”, but nothing came out. She shook it off and didn’t cry at all. Our TOUGH little princess.

Ashlee happily ate up a popsicle while the doctor wrote up the discharge note and got me a staple remover since we’ll be in Utah when the staples need to come out. We drove home, Ashlee back to her usual self. She had me keep changing the radio stations until we found Let’s Get It Started. We didn’t find it by the way. Not five minutes after getting home, what did we catch her doing? Picking up the puppy race where she had left off.

I’ve put up a post with a couple of pictures and little movie taken after we got home from the ER. Squeamish people need not follow. You’ll hear Ashlee give her, “I’m tough”, line after slipping near the end of the video clip. I don’t know how she’ll remember it, but the toughest time for me was watching my poor little baby get that second staple. Looking back at the whole thing after the children were in bed, Becky and I were actually surprised that this was only the first visit to the ER for Ash. We remember thinking that between ages 2 and 3, she was destined for the ER.