Sunday, January 8, 2012

E.R.



We had our first E.R. trip today -- Matthew fell at the gym and gashed his head, and had to have a bunch of stitches. (And he wasn't even doing anything dangerous -- Mike had both the boys out with him so that I could do some work, and Mattie was playing with some other kids near the window. According to another mom, her kid pulled one of the foam toys away just as Matthew was reaching for it or moving it or something and he fell down and hit the sharp window sill.)

I came (getting a call from a stranger that starts out with, "Your son has had an accident" is never good) and the ambulance came and the paramedics looked at him, but by that time the bleeding had slowed down, and he didn't have any signs of a concussion.  So we took him to UNC, and they brought us right back to the pediatric E.R.  Mattie protested being put in the car because he wanted to go home instead of to the doctor, but by the time we were there, he was chatting with the nurse while she was taking his vital signs, was very pleased to get a train sticker, and was pretty much back to normal. 

(Jamesie was with us too, of course, and he was mostly fine -- although when the doc came in wearing scrubs and putting on gloves, he got scared and started to cry a bit!  Poor baby!  He got over it fairly quickly, though.)

It was a deep cut and probably two inches long, so they paged their specialist on-call, who turned out to be ENT.  (Apparently they rotate between ENT, plastic surgery, and one other specialty for this kind of thing.  Bummer that it wasn't the day for plastic surgery!)  That doctor was leaning toward doing the surgery under sedation, which meant we would have had to wait until 8 PM because he'd had milk to drink on the ride over.  The emergency docs didn't think there would be a problem doing it with just local anesthesia and having someone hold his head (with his arms restrained) -- apparently they do that all the time and the kids are usually fine with it because the area being worked on is numb. But this was a bigger laceration than usual, thus the debate. (The ER doc said that Mattie was very calm and mature so she thought he would cooperate. I was not at all sure about that when it involved being restrained and having someone pulling and poking at his head.)

We decided to give it a try, because the doc said that if he was moving too much we could always stop and finish it under sedation. 

They gave him Fentenyl instead of Versed to relax him for the procedure, which in my opinion (and the ENT doc's) was a mistake, but once it was done it couldn't be reversed (you can't give both at once).  Mattie was really really upset at the start of the procedure, but I was standing by him and talking to him and holding his hand through the sheet.  I tried singing and telling him stories and that didn't work, but finally we started talking about vacuums and he calmed down and started answering questions for us and talking to the doctor.  The procedure took kind of a long time (20 minutes, maybe?), because she had to do two layers of stitches (internal and external).  Once it was done, Mattie was fine, and happy to be able to eat!  I was mad at first because I thought it would traumatize him (the great thing about Versed is you don't remember what happened after you have it), but I think the fact that he was talking and as cheerful as could be expected under the circumstances for the last part means that he won't have terrible memories of it. He really was an extremely good boy!

Mattie goes back for a followup sometime later in the week.  He has to see ENT for that, so we mentioned that James was already scheduled there on Thursday -- and it turns out that the doc (resident) who did the surgery is doing research with James's ear doctor on auditory neuropathy!  (Small world!)

[There was a lot of waiting around between all these various stages, so that SuperWhy game on my phone really came in handy!  Much entertainment value for the boys!]

2 comments:

Ann said...

Oh my!! I remember my first trip with Chris to the ER at four months old. They were more concerned about me than him, of course, he did not have a gash in his head like poor little Matthew! Surprised the parents didn't need a sedative!!!! Give Matthew big kisses and hugs from the North!!!! And just going to believe that is the one and only trip to the ER and they do not take after Chris!!! Blessings to you all and just remember how blessed you are with those two little ones!!!!!!

Niki said...

Sounds like he did a great job and no matter which sedative was given, he probably won't remember this as an adult any way.
What you didn't tell us is what sedative they had to give YOU.