Tuesday, September 24, 2013

The "Stitches at Wake Med" Story

Lots of people say that as a mom of a boy, I should get used to him hurting himself.  Apparently getting stitches is some sort of rite of passage for little boys.  I figured those people meant it was because boys are so active and go-go-go all the time.  Well, my son needed stitches from an injury he sustained while pretty much standing still.  Not quite what I had imagined...

The scene of the crime:

I was sitting in the computer chair, James was standing up beside me and had wedged himself between the laundry baskets and the computer chair.  What happened next is still somewhat of a mystery to me.  He was standing up, and then he was abruptly sitting and WAILING, and the laundry basket was on its side.  I think he may have tried to step up on the side of the laundry basket and it tipped over, sending him rapidly to the seated position.  
Somehow, in a freak of nature way, the semi-rounded edge of the chair's arm caught his forehead in just the right way and busted his head open.  He frequently overreacts to non-serious falls and such, so I figured this was another one of those times.  I reached down to pick him and then OH EM GEE THE BLOOD.  As I am a trained healthcare professional, when I observed the blood I calmly assessed the situation I quickly recognized that this was the exact time to freak the heck out.  Pretty sure I said "Oh my gosh, oh my gosh, oh my gosh, okay buddy, it's okay, buddy..." over and over.  When he moved his hand long enough for me to see the wound I knew immediately it was going to need stitches.  I thought, "I need help!  I need to call my parents!  Oh wait...my son's head is bleeding, I should deal with that first..."  (see, top notch healthcare professional skills to the rescue...please note sarcasm)  I carried James to the kitchen and reached for some paper towels to hold on his head.  While reaching for the paper towels I noticed how badly my hands were shaking.  I was thinking "These paper towels aren't sterile!  I need something sterile!  But wait, I'm at home, it doesn't have to be sterile at home, right??  Oh I don't know...wow that's a lot of blood..."  I decided at this point that James was not going to quit freaking out if I didn't tone down my own freaking out.  I pressed the non-sterile paper towels on his head, sat down on the kitchen floor with him in my lap, pinned his arms down with my free arm wrapped around him and told us both to take some deep breaths.  I talked in a soft voice.  Told him it would be okay.  He calmed pretty quickly after that.  We both did.  I reached up to the kitchen counter and grabbed my purse that contained my phone.  Hands still shaking, I noticed.  Found my phone, called my dad, not my mom.  I needed a calm response and very quickly.  Dad's the man for that.  

"Are you at home?" - me.

"Yes." - calm dad.

"James hit his head and he's going to need stitches and I need help RIGHT NOW." - me.

"Okay, we'll be right there." - calm dad.

I don't know how long it was in reality, but it felt like TWO SECONDS LATER, there's a knock at my door.  I opened my door to find my mom in tears and out of breath.  She RAN from her house to mine (usually about a 6 minute walk).  James' head had stopped bleeding, he had stopped crying and he was calmly walking around.  Meemaw came in, scooped him up, held him tight and cried, rocking him in her arms, praying as she did so.  Just watching her I knew this hurt her the same as it did me.  I guess grandmas are wired that way.  I rubbed her back and told her he was okay.  And also, she needed to squeeze him a little less tightly because she was making his head bleed again...

Where was Reese during all of this?  I honestly don't remember.  On the floor, NOT bleeding from the head.  That I do know.

Dad showed up minutes later.  I put some gauze on James' head and secured it with bandaids.  I made a couple of quick phone calls (Scott being one of those calls).  Dad and I dropped off Mom and Reese at their house and the rest of us headed off to Wake Med Raleigh to the emergency room.

 Our brave little patient...

Within a very few minutes of arriving, we were put in a room.  A few minutes after that, the doctor came in to look at his head.  The next step was putting some goop on his wound that would numb it up before the stitching procedure.  He tolerated all of that fairly well.  He frequently cries the minute a doctor or nurse comes into the exam room when we are at the pediatrician.  I expected that to be the case here.  But he actually did really well.  He was nervous about the people as they came in, but until they touched him, he didn't get too worked up.  These people work with kids all the time, so they know not to touch the kid unless they have to! They asked questions while standing close to the door, as far as possible from James.  I really appreciated that.  We could answer their questions without James completely freaking out.  

The numbing goop had to sit for 20 or 30 minutes on his head.  We watched some Lion King on the ipad while we waited.  Several more staff people came and went during that time.  One nurse gave him a dose of fentanyl (a spray up his nose).  That was to help take the edge off for him during the procedure.  I wanted some of that too...  

One nurse and one doctor came in to do the actual stitching procedure.  They swaddled him tightly, arms down, and strapped him to a papoose board.  He LOVED that, as you can imagine.  Let the wailing begin.  

About 6 minutes later, James had four stitches in his head.  

He didn't cry the whole procedure, just at times, which let me know he definitely wasn't feeling pain from what they were doing.  He would have jumped and wailed and objected a WHOLE LOT more than he did if he was feeling pain.  He seemed to mostly be upset by being restrained. Understandable.  I was so glad the worst was over.  Just for the record, my dad was very brave as well.  He didn't cry AT ALL during the procedure.  Nor did he pass out at the sight of blood.  Good job, Dad!  Thanks for being my moral support!

Just after the procedure was done, a nurse came back to do our discharge instructions.  Clean his head twice a day with half-hydrogen peroxide, half-water combo, bacitracin, bandaid on top.  Stitches would absorb in 5-10 days. 

We left the emergency room 1.5 hours after we arrived.  That is unheard of!  Fastest ER visit in history!  I was soooo grateful.  I put James down for a nap when we got home and checked on him frequently.  He threw up twice after the ER.  I'm blaming the fentanyl for that.  It can cause nausea.

The ER gave James a new teddy bear.  I didn't think he would care anything about it since it wasn't his beloved "bankit" or a Lightning McQueen race car.  I was so wrong.  He loved that thing.  He slept with it.  Asked where it was if he wasn't holding it "Beer? Beer?" (how he says bear)  The volunteers who made that sweet little bear have no idea how that made James' day.

The twice a day dressing changes went much better than I expected for the next ten days.  He ate a LAWT of marshmallows during those mini-procedures.  

Today, 18 days post-injury, his little scar looks great.  You can barely see it!

What I learned from this experience:
1)  This nurse who works with babies for a living is almost COMPLETELY worthless when it comes to her own children.
2)  Ditto for James' Meemaw when it comes to one of her grandbabies. :)
3)  My dad is a ROCK.  A solid person to lean on in crappy situations.
4)  Wake Med Raleigh was efficient, proficient, and just plain kind to us during our visit.  Much, much appreciated.
5)  Little boys do not have to be in motion to harm themselves.

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