MaryAlice and Roy arrived around 8:30 with the required chocolate donuts. She fed MaryVic and got her dressed after laying down the law about pajamas not being appropriate storytime garb. William was a little easier since he can’t get away. Once we were ready, we loaded up and headed to the library.

The children had time to play on the computer for 10 minutes before the 10 a.m. storytime. I left MaryAlice with them in the activity room and went to take care of some library stuff. I came back at 11:05 worried that I had taken to long. No one was in the department other than staff. I stopped and asked about storytime and Ms. Kristin said that they were still in there. Really ???

I went in and they were all there busily making books. I sat down and helped MaryVic finish her book. MaryAlice worked with William on his book.

We left the library at 11:15 and drove home to pick up Poppa and Daddy for an early lunch. MaryVic decided it was imperative that she have an Icee and almost melted down in the car over it. I don’t know where that stray thought came from to her head.

We had a quick lunch at Panchos. MaryVic stayed at the house with Poppa and Grandmomma while Daddy, Momma and William went to Vanderbilt. It broke William’s little heart to leave Poppa at the house. He cried, “Poppa, Poppa!!” until we reached the interstate then passed out.

We reached Vanderbilt after a bit of traffic. Thankfully we had left early enough that we were still there early. They had one of those wooden boxes with the bead maze on top so I sat there with William laying across my lap and playing with the beads. Greg and I chatted with some other parents from Hopkinsville, KY with a baby with clubfeet. They seemed to reassured somewhat in talking with Greg about it. Greg had issues with his feet as a baby too. Not nearly as bad as this kid, however.

A quick trip to x-ray. There is something about going into that dim room that sets William off. He screamed through the process. It was over quickly and we were back in the waiting room with the toy. Daddy got a turn with William across his lap.

We were called back to the cast room where we sat for a good 30 minutes before the doctor came in. There was a little girl maybe 6 or 7 years old who had just had her cast off, fractured wrist. Clubfoot baby had his casts off and was having his stitches checked. Another older boy was getting a cast put on his arm. Scooby Doo was on a t.v. so all the children were entertained.

Dr. Martus came in and showed us the x-ray pictures. You could still see the break but the bones were starting to ‘bridge’ and grow over the break. He didn’t see any problem with taking the cast off. He cautioned us to take it slow with William. He would be sore and stiff from being in one position for so long. Let him proceed at his own pace. Put him on the floor to wiggle around, etcetera. Keep carrying him around. Do we have any questions? Hmmm… There is only one pair of headphones on the wall? Do the parents get a set while the cast is coming off?

So now the cast comes off. You would think the little boy would be thrilled but no… Apparently he had bonded with the cast and the two year old rule of ‘MINE!’ was firmly in effect. The headphones were for him to keep him from being so scared of the noise from the saw. Would he wear them? No that was just another instrument of torture that was being inflicted on him. The child life specialist was called in but no toy was going to comfort him. He screamed, turned red, and reached out to Daddy, Momma, the child life specialist, not the guy with the saw…he was just evil at this point. “NO, DON’T, MOMMA, DAAADDDYYY!!” This last as Greg says for about 4 years of our lives. Finally the cast was off and Greg was able to scoop him up.

William snuggled in immediately. The saw guy came back to see if he was forgiven. Nope, lifetime grudge rule in effect. William came to Mommy while the saw guy tried to figure out if we were free to go. Greg saved the bar part of the cast, just the fiberglass – no steel rod, fyi. William and I looked at the dinosaur pictures and he gradually perked up

The skin was flaky but not as bad as we were expecting. We also didn’t notice any obnoxious smell either. There was just the hotspot on his back that we already knew about it and one spot on the back of his knees that was starting to get really red. It wasn’t great but so not as bad as expected. I could see that if he’d had to wear it much longer, he would have easily had more hot spots and it would have been a lot worse. The child life specialist told me to give him a warm bath when we got home to help ease the stiffness of his joints.

We ran into Dr. Martus inbetween rooms while looking at the dinosaur pictures. I asked him if we could go and he said yes. We proceeded to checkout and were told someone would be with us in a minute. An RN with other patients came up behind us and started chattings. She told me to do 2 warm baths or more a day over the next few days to help William deal with the discomfort of being mobile. She talked to the receptionist and we were finally able to go after promising to call the Cool Springs facility for a follow-up appointment in 8 weeks.

The care at Vanderbilt has been excellent. The only thing I would say is that we were surprised at the lack of follow-up advice after the cast came off. I guess we expected there might be a sheet or something. The warm bath suggestions were great but were totally asides as we bumped into staff. Warm baths sound completely logical but you know, not everyone does the logical.

So we went home. William was chatty on the way and seemed comfortable.

We spent more time at the library than planned. I needed to look for something for a co-worker which I couldn’t find in my office, of course! I spent some time in the office and the kids played very nicely. MaryVic shredded part of my ‘to be shredded’ stack and William did tummy time on the floor. Afterwards we walked around and touched base with co-workers.MaryVic got her first library card and checked out books. She was thrilled. I guess she takes after her mother’s reading tastes right now as she insists on checking out Halloween books. I like the scary stuff, good ghost stories and thrillers too. She was nice and checked out 2 board books for her brother.It was after one by the time we left the library so to apologize to the kids for having kept them there so long, we went to Sonic for milkshakes. They could not have the shakes in the just cleaned minivan so straight home. William fell asleep on the way but he did eat his shake after nap.After he woke up, ate lunch and I was finally able to get them moving. Well, I did give up after an hour and just bagged the chicken nuggets to go with us to the grocery store. We did the grocery shopping. I was very amused with MaryVic. We passed the store’s blood pressure check machine and she started going on about my arm. After spinning in circles 5 times trying to find what was on my arms?!, I figured out she was reminding to check my blood pressure which I had forgotten about. She sat in the cart telling me that she’d give me another sticker for checking it. I had already received two Kroger stickers because I was a good mommy (much to the Kroger pharmacists amusement). Blood pressure was fine: 117/50 and 106/67.The only other thing of note on Monday were I called Vandy again to double check about Williams appointment. Dr. Martus had said that April 1 was too soon to remove the cast and to either go to Vandy on Friday or come back to the Cool Springs office on Tuesday, April 8. The nurse called me back and said Dr. Martus needed to see William 3 weeks from the last appointment which would be April 2. The cast may or may not come off then. We have decided not to hold our breath hoping and just go with the flow.On Tuesday, MaryVic went to school with not a lot of fuss. William and I stayed home for the day. He was very good as I went on a small cleaning spree. Americare staff were back at the house again baiting the outside for the ants.We picked MaryVic up and went to Chik-fil-A for dinner. She got a pink and purple armadillo and William got a green alien man from the Balloon Guy. The alien guy was as big a hit as the train and he attacked Momma and stomped on dinner.The ants have found our primary garbage can in the garage. Of course, this is discovered in the evening, long after AmeriCare Pest Control is gone. Greg sprayed the corner of the garage down with Home Defense. So the Ant Wars wage on…All is well otherwise. We have an outing to the Apple store today, Wednesday, to see about the shift key on my laptop.

William is healing very well. The bones appear to be well within the tolerances the Doctor wants. So, we have a choice:

• We can go to the Children’s hospital in Nashville on April 4th and have the cast removed
• We can wait until the following Tuesday (April 8th) and go to the Franklin Branch and have the cast removed.

Tough choice. Drive to Nashville and have the cast removed Friday, or not drive to Nashville, but have to wait until after the weekend to be rid of it.

It took both of us about 3 seconds to choose Friday. I think William took less time than that.

The doctor is definitely trying to prep us for a “hope for the best, prepare for the worst” situation with him walking. He’s definitely taking the stance of “He’ll walk when he’s ready, and don’t worry about it”. I just don’t think he wants to give a timeframe and then have us turn around and say “you said x days, and it’s not happening right this minute.”

My dentist’s daughter was in a Spica just before 2 years of age about 8 months ago, and he was saying that his daughter was up and walking almost immediately. It was nice to talk to someone who had been in the same situation, and to hear a very matter of fact tale, as if it was no big deal. Just reiterated the same stuff we heard already, no lasting effects, small limp for a little bit until completely healed.

Finished up with a trip to visit the Cow for Family night. William scored well with the Balloon guy again:

William and I had breakfast and then he sat in a baby vibrating chair while I showered. He was really good. We came downstairs and did tummy time. Played cars, ball and blocks until Daddy came home for lunch. We had lunch and loaded up for the follow-up trip to the doctor.

The doctor visit went quicker than we thought. We were in and out of x-rays and talking to the doctor in 15 minutes. Everything looks to be going well. The bone still is obviously broken in the x-ray but together and the doctor was very pleased with how it looked. He told us that the next visit would be the one that decided if the cast needed to be adjusted or a new one applied, etcetera. He did say if things stay the same, it is highly unlikely they will do anything to the cast.

Then he started talking more about after the cast comes off. Greg and I have slightly differing perspectives on the discussion but it doesn’t matter because we can ask more next week and however it long it takes William to recover, it will take that long. I had been thinking that he might be up and around in 2-3 weeks, walking again. I guess I also thought the healing process would alleviate any limp too. I was a little taken aback when the doctor said 6 weeks or longer to walk again, talking about rolling, crawling and pulling up. And yet again, when he said there would be a pronounced limp but it would alleviate over time with his normal growth rate to next to nothing.

I guess I was being overly optimistic about things and got a reality check. Greg thinks William could still walk again in 2-3 weeks and the limp will be gone in just a couple of baby growth spurts. Ah well, mothers worry…and this one will look for more on the web about it.

We took William to Home Depot afterwards and looked at ceiling fans with lights. William is in favor of replacing the bonus room fan with the earth light and fan with rockets. I’m afraid we’ll be going with something a bit duller

We went to daycare and picked up MaryVic who had a good time at school. Mrs. Kathy came out to see William. She reminded me that gymnastics is on Thursdays and dance on Mondays. MaryVic is only signed up for gymnastics but sometimes attends dance on Mondays to make up for missing a gymnastics class. She said they are making a huge card for William. The kids are putting their footprints on it so it was currently drying. Apparently a major production, toddlers with paint on their feet, and now that I think about it, a little ironic? Sweet thoughtfulness though. She said they pray for him at daycare at breakfast and lunch.

I got an email from Nashville Parent while waiting for Greg to get MaryVic. Seems I won the February drawing and we have two weeks to come pick up our dvds, Charlie Brown’s Valentine and a Bob the Builder dvd. I had to laugh when Greg joked I should have bought a lottery ticket. I think this may be one of the few drawings I’ve even won.

William fell asleep on the way home. We were home for just a little bit then loaded up again to go to Costco and then our favorite Tuesday night hangout, Chik-Fil-A. The kids had a blast. The balloon guy made William a super duper Mickey balloon hat that he loved and MaryVic got a dolphin. MaryVic played in the playground and danced and sang. She even dragged Daddy up there to dance with her. She really got into the music and all this time, letting her ice cream melt until it was tossed. William wiggled and danced along to the music too. We took tons of pictures with our iphones so we’ll have to see how they turned out.

You would think the kids would have been tired through and through but no… We finally got William down and I had to go snuggle MaryVic. Finally both of them were asleep for the moment if not the duration.

Spent a large part of the morning doing some research, everything from childcare licensing requirements to SPICA care and feeding. Grandma came up. I’m surprised she was able to hold out this long. She brought a blowup chair that we thought would be good for the configuration of his cast, but it just wasn’t stable with him in it. However, it was Pink with Princesses on it. Plus it has a color changing LED inside. So it’s not like someone in our family isn’t going to grab it immediately. I was surprised she didn’t try to pull it out from under him to begin with. She hadn’t seen the Princesses at this point, so that’s probably why.

We setup the appointments for William’s followup visit. 3 weeks of Vanderbilt on Tuesday. We can only hope that all is going well. The first one is next week. I’m sure there will be chastising of our care. It’s not that I feel like we are doing a bad job, it’s just I’m sure that there is SOMETHING that we could do better.

You do something better when all he wants to do is get OUT of that thing (pushing down on the cast and crying “Stuck, STUCK”. If it wasn’t so sad, it’d be pretty darn funny.)

Took William out for a walk… That was a hit. He seemed to really enjoy getting out of the house.

Yes, that’s a wagon designed by committee. It’s not pretty, and we’ll need to work on the support and stabilization aspect. I think some good gas shocks , five point harness and maybe some train horns are in order.

But he was pointing at runners, Ducks, and anything else he could see. It was 20 minutes because Mary had to go to the Dr., but he definitely enjoyed it. We’ll be doing this again. I had to stop with Mary and take her in the van, but Jeff and Grandma took him up for a bit longer.

Mary is doing ok, but ever since last week, she’s been coughing up a storm at night, and randomly coughing during the day. When we took William to the Pediatrician, He told us to bring her in Saturday and they’d get her a prescription to help out. Of course, 20 minutes after that conversation we saw the fracture, and that pretty much sealed the end of our Weekend. But since Mary was still coughing, Jeff made her an appointment, and I executed to that appointment.

We got to the clinic, and it was packed. Mary enjoyed playing around in the waiting room, looking at the fish and tapping on the glass. The lady sitting next to us was quite taken with her, and we struck up a conversation. I mentioned that it wasn’t this packed on Friday, and explained about William. Shortly before we went in the back, she had passed through and had came back with two sealed Dvd’s from an children’s artist – a friend of hers. “I know he’ll be in the cast for quite a while, and hopefully this will help entertain him some.” I was extremely touched by this. It was completely unexpected, and a very gracious act.

Mary was a bit shy with the doctor, but warmed up. We got a prescription to take care of her cough, and it does seem to have helped quite a bit… I haven’t heard her cough tonight. She fell asleep going to Target to get the script filled, so my shoulder got another workout today carrying her around.

We did not have a good night getting everyone down tonight. Mary was goofing off at the foot of the bed, fell off and bumped her toe. Looks up at me (Did he see me do that? yes? AAAAAHHA !!! ) “You did that yourself, and I’ve been telling you not to. Come here settle down.” AAAAAAAHHHHH! Grandma! I’m hurt too, pay attention to me now! – She seemed to say. Of course, William has not been cooperating with anything tonight. He was pretty fussy during the washcloth bath, so I went and got his lortab. We’ve tried to get him to go to sleep a few times now, and every time we think we have it, he’s woken up crying, screaming and being VERY upset.

I finally was able to move him into his crib, but it took me and Jeff. I moved him, Jeff managed to calm him when he woke up after the move. He’s woken a few times now. He didn’t get a significant nap today, and may be overtired. We’ll definitely try to get that tomorrow. It doesn’t seem like it’s going to be a good night.

And now, they are talking storms tonight. I think Jeff’s Blood pressure medication is going to have to be renewed if this keeps up. It’s a tight squeeze in that bathroom with 4 of us… Now let’s consider William’s cast, AND Grandma.

Positive thoughts. Tomorrow is another day, and a day closer to the cast coming off.

Thankfully the storms went south of us. I don’t know what happened. I came back downstairs to clean the floor and set up again for the next day and William was asleep. Next thing I know he’s screaming bloody murder, none of the 3 adults can calm him. He finally started screeching ‘BED!’ and I laid down with him and he fell asleep. We finally got him in his crib. I went running the first time he woke up, laid my hand on his little face and he closed his eyes, went back to sleep. Now when I tried to move my hand, he wrapped his arms around my arm and pinned it. After the first few times of this, Grandmomma took over soothing him down and we made it through the night. Greg and I were about ready to head back to the ER with him.

So, let’s spend Friday Night at …. The Vanderbilt Children’s Hospital’s Operating Room!

A spot opened up at the OR, so once we had everything processed, we moved up to the OR’s prep area on the Third floor. This time, I got to be pushed about in the wheelchair, as William had taken a permanent station on my shoulder, pressing deep into the side of my neck. The attendant undoubtably wished that Jeff had been holding the child.

Cool thing at Vanderbilt that William missed the first time through: The Patient transport elevators have a LARGE hand crafted and painted Duck on the ceiling, surrounded by fishes and stars. It’s a great touch.

PACU

Staging area for the OR, we answered the same questions over and over.

“No, he’s not allergic” “They tell us he fell down” “Yup, Broken Femur” “No, I’m not comfortable, but he is”

Vanderbilt really does pay attention, and given the number of people involved, and checks to make sure that the information is correct. From verifying that the parent knows what the treatment is (and making sure there aren’t any mixups), to doublechecking anything that may be fuzzy, there is a lot of repetition.

William’s anesthesia was administered by Resident Jesse James. I thought that was a great name for someone who puts people under.

William had shifted several times by now, resulting finally in me bent over backwards, him laying across my chest, head on the opposite shoulder. Before we sedated him, it had gotten to the point that I was staring at ceiling, barely supporting my head on the crib with a pillow folded several times.

We were shown into the Sub-waiting room while William went into OR. Now then, the actual procedure has been done before in Trauma, and really isn’t that complex. William was not operated on, there were no incisions. He was put under so that he wouldn’t suffer during the reseting of the bone, and the subsequent application of the SPICA cast. Once the bone was reset, they took Xrays of the area to make sure the alignment was good, and started the casting.

I took Jeff down to the 2nd floor and picked up a couple of subs for dinner. We then took the bounty back to the waiting room. About an hour later, we talked to the doctor.

1. William will be fine.
2. He’s in the cast for 6 weeks, and we have to return to Vanderbilt every week for the first 3 weeks minimum to make sure the bone is healing correctly.
3. If it’s not, they can do significant adjustments with the cast alone, otherwise, they’ll put him under again and reset.
4. It’s likely the bone will ‘shorten’ due to the fracture, but the increased blood flow in the area due to the injury will encourage the bone to grow more rapidly and lengthen.
5. When the cast is removed, it’s quite unlikely that William will walk immediately. This is normal, due to the length of time he won’t be walking. He’ll walk when he feels comfortable doing so.
6. The Injury itself: “It’s not uncommon.” The doctor’s are trained to look for abuse, and I have to take the opinion of the Pediatric Orthopedic doctor for Vanderbilt pretty seriously. For an adult, this bone is almost impossible to break. In a child Williams age, it’s still growing, and this type of fracture can happen.
7. Simply put, 6 months from now, and there will likely be zero ramifications on William from this.

Back to PACU, and we see William and the cast.

It takes a while, but he finally wakes up again (They wake him after operating to make sure he comes out of the anesthesia alright). “Dink!” “Dink!”

He’s coming back to normal, ordering us to get a sippy cup for him.

2 containers of apple juice down, and they put him on a fluid restriction to make sure that he doesn’t get sick. Popsicles are ok.

Actually, that’s the BEST popsicle in the world. William devoured that sucker once he realized he wasn’t getting anything else. And he got MOST upset with the Nurse who took us to our room when she decided that it would be good to take the remains away. She quickly got him another. She didn’t have a choice.

William finally got to see the Duck on the ceiling this time, as we went up to the 8th floor for observation. “DUCK!” Point! Point! The elevator beeps with each floor, and William starts pointing at the buttons…. He wants to push buttons. He’s feeling better already (The Morphine helps, I’m sure).

We arrive in the room, and start trying to get settled down. More repetition to the Nurses on this level, but after some examinations, William falls asleep… With the popsicle stick still in his hand. Several times in the night, Jeff and I are amused to see him open his mouth, raise his hand, and try to lick the popsicle that has long since gone away, never waking in the process.

But who cares about us? It’s all about William. And rightly so.

William slept through the night without needing any additional pain killers. The last thing we had was some morphine the previous night. The nurses and resident both said that he would burn through the morphine very quickly – within an hour or so.  The nurses changed his diaper twice while he was asleep.

So when he woke up (around 5ish) he wasn’t feeling very good, so we gave him another hit of morphine.  He woke up crying and I ran over then hit the button for the nurse.  They came in and asked if he was hurting.  He replied back ”Uh-huh” and cried some more.  As soon as the morphine hit him, he fell back asleep after a little juice. 

The Resident came by around 7, said that the Dr. that did the surgery was very happy with the results, and once we switched him to Lortab instead of morphine, he’d be good to go.

William’s first encounter with the cast was really this morning, as he was pretty dosed up last night. He tried to push the cast off a couple of times. Thankfully, Mickey Mouse came on Tv, and that was pretty distracting.

Breakfast was ordered for him, and I went down to the Cafe to get some breakfast for Jeff and I.

Vanderbilt does MANY things well. Scrambled Eggs are not one of them. Neither Jeff or I could eat more than a spoonful of them.

William ordered French toast sticks, a Banana, and some Yogurt:

You are seeing about as much as he ate… It wasn’t quite what he wanted. He did like the Bacon Jeff and I got.

Bad Picture, but I really can’t say enough good things about Vanderbilt’s Children’s Hospital. EVERYONE (with the exception of the Lady that sold us the Eggs… Perhaps a cause/effect?) was extremely nice. The Nurses, residents, Doctors, Trauma ER personnel, EVERYONE.

The room was designed to help kids. (note the Stars built into the ceiling tiles) They give a decent bed (better than any other hospital guest bed), and every floor has a huge playroom. William obviously couldn’t take advantage of this, but their attention to details and trying to make the kids feel better is very evident.  William really loved the elevator with a duck and fishes on the ceiling. 
But our time with Vanderbilt was coming to an end. We were given a prescription for Lortab, instructions for care of William in the cast, and discharged.

I went to get the van, warmed it up and parked at the entrance. It was 32 degrees out, and William was wearing just the cast and a hospital gown.  The moment I saw them, He saw me, pointed, gesturing “Daddy”, and I scooped him up and put him in the car seat.

Which doesn’t fit. The straps do not give enough to wrap around, and the fit of the cast is such that you can’t sit them well anyways. Top buckle only, and really careful driving.

A pitstop was made to pick up Ms. Mary Vic from her slumber party. She had a great time, and we are so thankful. Many questions were asked, all were answered, and very few were understood. But she did understand that brother was hurt, and the cast is going to help him get better. The details past that escape her, but that’s ok.

We’re home now, and everyone will be ok.

Jeff takes him inside the Emergency room while I race into the adjoining parking garage. They tell me later that I should have left the van outside and let the valets take care of it. I didn’t see any, and didn’t know about it then, but it all works out. By the time I find a spot and get back to the ER, Jeff is in a wheelchair with William in her arms about to be rolled back.

We’re taken into the hallway to get treated while a room is cleaned. I don’t know what Jeff told them when she took him in, but it worked. We moved into an area, and they began to prep to put an IV in William. A Children’s Life Specialist (and intern… it is a university hospital after all) came out with Toys and tried her best to distract William as they began to put the IV in. You’ll note, I said, Tried. It didn’t work very well. The first prick of that needle, and William wanted nothing to do with her or the toys.

Unfortunately, William had been screaming and crying for quite some time today, so his little blood vessels were truly microscopic. We didn’t succeed in the hallway.

Trauma 2 had opened up at this point, and we were moved into it quickly. The RN on duty there gave it a shot getting the IV in, and after a couple of attempts, she was able to get a good stick. The Children’s Life Specialist tried to give the toys to William at this time, but sensing a trap, William wanted nothing to do with them. He got his first taste of Morphine at this time, which went a far way to helping ease his pain.

We talked to the Trauma doctor, and he immediately put in for a consult from the Orthopedic department. The general and fairly immediate reaction was “Get more Xrays” and “We’ll need to do a Spica”

Jeff begins to get ill at this point again. Bless her heart, she didn’t feel good when this started, and it seemed that every time we got into a hospital, she started to feel worse. I took William (and little did I know at the time, but I ended up keeping him the rest of the evening), and sent Jeffie out into the hall to get some air. They keep the trauma rooms quite warm since their almost always stripping the patients down for exam.

The Children’s life specialist was coming at this point to talk about the cast, saw Jeff sitting in the floor in the hall, and immediately went to take care of her. After some crackers and water, we were introduced to some pictures of the cast that would be part of our life for the next 6 weeks.

Xrays followed, which pretty much confirmed what the previous xrays showed pretty plainly. William was slightly easier this time around, thanks to the Morphine. The second xrays were important, however, because there was concern that something inate to the bone may have contributed to the injury, such as a hollow, or reduced bone mass. Thankfully, those fears were without merit.

Further conversations with the Orthopedic and Trauma doctors agreed that a Spica cast would be needed, and that they would be placing that cast on in the operating room when a spot developed.

We waited down in trauma 2 for another hour or so, William on my chest, head on shoulder.