Saturday, June 30, 2012

The Incident

As I'm sure most of you are aware, the worst day of our lives occurred last weekend. Collin has a penchant for saying things like, "this is the worst day ever," or "this is the worst part of this day," every single time he's annoyed over say, not getting a popsicle, or the wind rustling his hair askew. In other words, he says it all the freaking time. It's pretty annoying, especially when he says it after a day at Disneyland when he's been spoiled endlessly and he says it because he didn't get to watch a movie in bed, or some other nonsensical reason; but, I digress. This really was the worst day ever.

You see, we were all settling in to watch a movie together and Collin decided that we should all share some cookies. Really, he thought that I'd be more apt to allow him to have some if he brought me a few as well. So, he went to the kitchen, got out two bowls and a sleeve of Girl Scout Thin Mints and trotted back to the family room. Our family room is carpeted, but our kitchen is hardwood, and the family room is one step down from the kitchen; all of these things are apparently hazardous if you are wearing socks, and you are five years old.

He slipped, dropped the bowls, which both broke, and then fell on top of the shards. Hearing the commotion, Bryon immediately scolded him for running in the house (which he wasn't--just ask Collin!) before he realized that he'd been hurt (i.e. in the millisecond before he squealed). It's funny how when your children are hurt, really, really hurt, time suddenly speeds up and slows down all at the same time.

From the time we heard him suck breath and let out a squeal, I don't remember how Collin got to the counter or even seeing him move. The next thing I heard was Bryon yelling to me to call 911. I've never called 911 before, and I really hope never to do it again. I am actually pretty proud of how calm I was on the phone and how well I followed directions, considering that I was pretty sure my son severed an artery, otherwise my very calm husband never would've suggested such a drastic measure. The operator told me to gather his medications (thankfully, I did, because when the EMTs asked me what he takes, he might as well have asked me who is in charge of Zimbabwe. My brain had shut down to all but survival mode).

The ambulance and fire truck was there within five minutes (probably less). They barely pulled back the amazing wrap and compression that Bryon did before rushing him out to the ambulance. Bryon did a really good job stabilizing the bleeding, so he was safe on the way to the hospital, which was comforting. The EMTs felt that he wasn't in immediate danger from blood loss, so Collin was slightly disappointed that they didn't turn on the siren, but they did realize that it was a big, big deal and tried very hard to rush the triage nurse into putting him to the top of the list.

Unfortunately, because his bleeding was controlled, the triage desk assumed we were over-reacting parents who called 911 for no real reason, and ignored us for quite some time before putting us in the fast-track treatment waiting room (yeah, right...the kid had a tendon hanging out of his arm!). We waited for over an hour before getting a room. The first NP that game in about fainted when she pulled back the bandage. She ran out of the room like someone was chasing her, picked up the phone and we could hear her basically shouting that she needed everyone, anyone, to come NOW.

A few minutes later, another NP came in with the attitude that the first NP was overreacting, and that she would probably be able to handle it. Of course, she was wrong. For anyone counting, that's twice now that Collin's had a dry bandage ripped off a giant gaping wound, and he's had quite enough of it. He was hysterical by this point because the wound was about 2 inches across the horizontal part of his wrist, then about two inches down his arm and then turned about another 2 inches down the other way, making a sort of backwards "C." The skin in the "C" was totally pulled back into a large flap and the large tendon closest to his skin was totally severed and hanging in loose piece outside of his hand. Pulling the bandage off was incredibly painful to him, and no one had given him anything for pain yet.

Finally, someone called a doctor who came quickly with about three attending physicians, who ALL felt they needed to look at the wound, and also pulled off the bandage. She rattled off a lot of jargon about severed this, severed that, lateral blah-blah-blah, but never spoke to me. She said he could have morphine, but it was hours before anyone brought it to him. So long as no one touched his wound, he was essentially "comfortable." He whined, whimpered and such, but he also chatted and dozed. Eventually, he got the morphine and instead of putting him to sleep, he become very animated and talkative.

Eventually, the nurse came in and told us that he was beyond stitches (duh) but that the surgeon on call at the hospital that we were at didn't feel comfortable operating on such a complicated wound, especially on a child, so they were transferring us to Fairfax where a pediatric surgeon was going to meet us. Collin was pleased because it meant our second ambulance ride of the day. I was terrified and happy at the same time. My little baby boy was getting emergency surgery but he was getting the best care possible.

Fairfax was about a 40 minute ambulance ride, and chatty-morphine-boy enjoyed every second of it. When we got to Fairfax, they met us at the door and within minutes a doctor was in the room with us, aided by a play-assistant, a person that works at the hospital for the sole purpose of entertaining children who are scared at the hospital. She sat on his bed and played Star Wars with him, let him push her with the force and read to him while the surgeon pulled the bandaging off one last time to get a good look. She explained everything to us in real, understandable terms and she was incredibly reassuring and she made sure he got immediate pain control.

He was up to the OR within thirty minutes of arrival. There's no way to describe what it feels like to watch your boy get groggy as he goes into surgery, during which he might lose the use of his right hand. Through the course of the day, I didn't allow myself to think, really think of what was happening until he'd been in surgery for well over an hour. That's when all the "what if's" started to push through my imagination, and I couldn't control my stress, or my body. I started pacing and couldn't sit down until Dr. Root (his surgeon) came out to get me. Once I saw her smile, I felt completely better. Bryon had to go home for a bit to let the puppy out (more on that later!), but he was back only moments later.

Overall, he was in surgery for about two hours, which was pretty good. Dr. Root had warned us that he could be in surgery for as little as an hour, or as long as all night depending on what she found when she went in there. Thankfully, the major tendon that was damaged was what she called a "superficial" tendon, which means that while it's large, it is not terribly useful for motor function. Sure, it's nice to have, but when people need tendon repair in their elbow, for example, they often use that wrist tendon because it is a bit superfluous. Regardless, she was able to repair it, and it's in tact now. We couldn't see  it when it was so bloody, but he'd also damaged another tendon that she was able to mostly repair. She says that he will likely have limited use of the lower knuckle of ring finger, but that's pretty amazing. She'd never seen a wound that large with such minimal damage. He'd opened up the area of his arm where, other than his artery, there are major nerves that would have severely impacted the future function of his hand. The anesthesiologist just kept saying, "wow."

He took about an hour to come out of anesthesia, which was a little stressful because when he'd had his tonsils out, he woke up hysterical. This time, he was quite calm and even funny. The minute that he opened his eyes, I told him he looked like a robot because he was hooked up to so many wires, and he did a little robot dance with his arms and said, "I am a robot" in a crackly voice, which delighted the graveyard shift to no end. He remembers none of this, of course.

He's in a cast now that goes up to his shoulder because Dr. Root doesn't want him to be able to move his arm or his hand while the tendons repair. The major tendon that he damaged runs past his elbow, so bending his elbow would risk the healing process and his fingers need to rest so his wrist heals. He was in a heavier, softer cast for a few days, but it unravelled quickly and she replaced it with the hard one sooner than she'd planned. He likes his hard cast much better than the old one, and so do I. It's lighter and easer to manipulate and he doesn't need his sling nearly as much as he did before (not that he wore it anyway!). He will be in this cast for three full weeks and then, he should be fine.

I saw the wound when they changed casts and it looks amazing compared to what it looked like before. I could only see the vertical portion of the stitching because Dr. Root was diligently holding his wrist bent so that he wouldn't move. But, it looked clean and already remarkably healed. For all those who have been curiously asking how many stitches he ended up with, Dr. Root said she'd never even counted because it was a little ridiculous to do so. There were a few too many too count! So many on the tendons themselves, then internal, then on the outside too. She pretty much said that in a "how many stitches have you had contest," he'd win.

Now, it's just a matter of waiting for the cast to come off, rescheduling swimming lessons (duh), and hoping he doesn't bash the heck out of anything with the big, heavy thing. By the way, did you know that casts are scratchy? And, I'm referring to the outside of them. His hugs hurt now because his arm is so abrasive! Oh, and we are practicing the art of "not getting the cast wet."

Anyway, that's the story of the worst day of our lives so far.

He's back to his usual self, including a big ol' bruise on his face from fort building today. I've never been a nervous mother, hovering over him when he runs, jumps or plays, but I've suddenly become a lot more terrified. I need to stop that, I know. It's just that I've suddenly realized that the world is capable of damaging him.

Wednesday, June 13, 2012

Goodbye to our Good Boy

As I'm sure everyone is well aware, we had a rough week last week. Eddie, our wonderful and faithful companion, finally let us know that it was time to let him go.

He got sick about six months ago with Cushing's Disease, which is a relatively treatable condition affecting his adrenal gland. He's been on medication for quite some time for that, but he never really responded well to it. Shortly before our trip to California, it seemed to get significantly worse, despite the fact that all his lab work measuring that specific condition (which we check regularly) indicated he should be fine. So, I took him in for a once over at the vet. She did some blood work that wasn't Cushing's specific and an overall exam. She called while we were in California to let us know that Eddie had Leukemia, in addition to the Cushing's.

This was devastating news, of course. Leukemia in a dog is terminal in nearly all cases. In an acute case, like Eddie's, it comes on quickly and within weeks to about a month, the dog succumbs (sometimes, Leukemia can come on more slowly, and develop over a period of months, but it is still ultimate terminal, but this isn't what happened to Eddie). There is chemotherapy for dogs, but in acute cases, if it works, and that's a big IF, because it only works about 30 percent of the time, the dog's survival rate is only increased about 1-2 months beyond what was originally expected.

So, we had to balance the risks/costs/quality of life scenario and decided to just let nature take it's course. We got home on Sunday night and by the following Monday, we had to put Eddie down. I took him to the vet to have her check in on him and determine how long we might need, but his health had been steadily declining. He wasn't able to walk far, as in no further than up or down the hallway, without getting exhausted. And he was drinking 6-8 bowls of water a day. He was having trouble breathing and he was exhausted.

The vet explained that his organs were dehydrated from the cancer and he was having trouble breathing because his blood was becoming thickened from the size and number of the cancer cells, which were now outnumbering healthy cells, making his blood too thick to pump through his heart. She heard fluid around his heart now, and explained that it was time. While he wasn't acting as if he was in pain, merely tired, she said that he was suffering significantly, and it was time to say goodbye. Right on target, from the time he started acting sick, to the time he was succumbing to his illness, it was less than a month.

I called Bryon and told him that he'd better come home from work early, and we went to the vet as a family that evening, and we all sat with him as he left us. He was quite calm, and Bryon and I never stopped petting him for a second. They gave him a sedative before they put him down, which made him very calm, which he was already, but it also made him lose a little control of his tongue, which he was trying desperately to use to lick us in appreciation for all the attention. So, his last act was an attempt at kisses, which was both sweet and a little sad, because he couldn't control his tongue enough to put it back in his mouth, so it kept sticking to the floor. He seemed happy because it kept making us giggle through the tears. Every time we'd help him, and put it back in his mouth, he'd try to kiss us again, and it would flop back to the floor. Silly Eddie with his constant kisses. He was a lick monster, right up until the end.

And then, before we knew it, he was gone. The vet was wonderful and let us stay with him for as long as we wanted. I didn't want to ever leave. I laid with him for a long time and just held him and scratched him and we cried for a long time. She even came back in, just to hug us. Being a vet must be a wonderful and terrible job, all at the same time.

Collin asked to be there, and I was a little nervous about it, but he's never known a day of his life without Eddie and I decided to let him come. I can still remember how the crib rail on Collin's crib was all scratched up from Eddie standing on his hind legs to peer in at him all the time. Or, how Eddie always knew when Collin was about to wake up when he was an infant; Eddie would pace outside Collin's door before he ever made a peep and then lay down and wait for me to get there, as if to tell me, "please come get your baby, he needs you!"

When we got there, I think he was a little unsure of how to handle it, especially when he saw his parents so upset, so he decided that he'd better just play Angry Birds on the phone. So, we let him. He's been okay with the whole situation ever since. We read him Rainbow Bridge and he mentions the Rainbow Bridge about once a day, and makes sure to ask me if we'll all end up there to find Eddie, eventually. He's dealing with it in his own five year-old way. On the way home, while we were still sobbing, he said, "Why is everyone so upset? We can get a new dog, right?"

The first few days were very sad. Every time I came through the door, I fell to pieces. There was no thumping tail waiting to be let out of his kennel. There was no slobbery kisses of excitement to see me. There was no goofy jumping dog, gleeful to see me. There was no bark at the doorbell. There was simply, nothing. Even Homer seems to feel the void. He roams from room to room and simply moans.

Eddie was my first dog. I'd wanted a dog every day of my life and when I was finally on my own, I got him. I visited every local kennel in the area and I was disappointed at each one because no dog there seemed to find a corner of my heart. I was sure that the minute I could have a dog, I'd be happy with any dog I had, but it just wasn't true. There was no connection. The minute they opened Eddie's cage, he bounded out and jumped on my shoulders and licked my face. From that moment onward, he was my dog. I'm glad for every second I knew him, no matter how silly and crazy he's been.

He's been afraid of ceiling fans, he's been afraid of doggy doors, he's chewed countless papers and bits of trash. He's only liked octopus toys and he's cost me an arm and a leg in specialty food. He's also been the only friend I've had sometimes and he's been there when I met my husband, he's been there when I brought my baby home from the hospital and he's been there when I sobbed all night when my friend David died. He knew when I was happy and when I was sad. He wasn't just a good dog. He was a great dog. He will be missed every day.