Monday, January 8, 2018

The Cast

So.... around December 15th, around 10pm, we had to do a blood sugar check for Michael-- who had a bit of a stuffy nose.  Usually, he doesn't wake up for blood sugar checks at night.  But this night, due to his stuffy nose, he woke up.  Then he got frustrated in his half-awake half-asleep state, and couldn't figure out how to breathe through his mouth and still suck his thumb (I know) and not breathe through his nose.  During this frustration, he kicks the wall with the side of his heel.  We didn't really think anything of it at the time, but the next day he started limping.  And he limped all day long.

For a while, we thought maybe he bruised his foot and would get over it soon enough.  But the limp continued into Sunday.  Five year old's can't milk something for that long.  The limp was real.  We checked his foot and it wasn't swollen and we didn't see a bruise, so we sent him to school on Monday.  His teacher and the nurse texted me separately and told me that Michael couldn't walk on his foot at all.  I called our pediatrician at that point.

The protocol at our pediatrician office is to send families straight to the After Hours Urgent Ortho clinic rather than having families come into the pediatrician office first.  So after Aaron got home, my mom came over to watch Noah and Avery while Aaron & I loaded up Michael and headed into the city to go to the after hours clinic.

They did x-rays, which showed no break.  But with children, orthopedic doctors treat "aggressively and conservatively."  I found out that this means-- cast. So, Michael got a short leg cast.  It came up to about halfway up his calf.  He chose blue as his color, to represent Auburn Tigers as well as the Seattle Seahawks. :)



He got a boot also, and the doctor is telling us that he can walk as long as the boot is on.  However, the doctor was not actually in the room after the cast and the boot were put on.  So after the cast dries, etc, and the tech gets the boot on, Michael gets down from the table and still can't figure out how to walk correctly.  In fact, Aaron carries him out to our van.

Since no visible break was seen, Michael only had to have the cast on for two weeks.  We made a follow-up appointment to be seen at the clinic in our own town.

Fortunately, Michael only had to make it through one full day, and then a half day at school before he'd be out for Christmas break.  He had such difficulty walking at school that they brought a wheelchair for him to use when going back and forth to the nurse's office for blood sugar checks.

He eventually learned how to get around in the boot.  He chose to walk on his toes mostly, even though we were trying to coach him on walking correctly in the boot.  He also had to call me every morning to help him get out of bed so that I could put his boot on him so he wouldn't put any weight on the cast without the boot on.  It was also torture trying to figure out how to bathe him.  We'd wrap his leg with a garbage bag and seal it with duct tape.  Then we had him sit on one of the styrofoam coolers that his insulin comes in through our mail order pharmacy.  This elevated him enough where he could prop his leg on the edge of the tub.

So, bath times were difficult.  Bedtimes were difficult (trying to get comfortable with a cast on is hard!) Walking was difficult.  Basically, Christmas break with a cast was disappointing.  It was even hard on us as the parents and that made Christmas break hard for me.  (But I am really glad that he was off of school for the brunt of this cast journey.)

At Avery's 4-month appointment (which was 3 days after Michael got the cast put on), I asked the pediatrician about the "aggressively and conservatively" treatment of Michael's foot.  She said that there is a major growth plate in the heels of children and a broken growth plate won't show up on x-ray until a week after the break, when the ossification would show up.  So, she says that orthopedic doctors choose to cast kids just in case the growth plate is broken.  I'm glad she told me that because it made the cast journey more understandable.

Last week on Wednesday, Michael and I went to our local ortho clinic (a branch of the main clinic) to get the cast removed and follow up x-rays done.  All of our family members were excited to get this behind us!!! Michael was very curious about how they'd remove the cast, and I was very nervous about how he'd react to it!  I had my other mother-in-law on standby, my father-in-law on standby, and my dad on standby just in case Michael bowed up and refused to get the cast off.  In the waiting room, he kept asking me what the process would be, so I cautiously looked up a picture of the cast removal tool and showed him and we read about the process.  That helped a bit.

He actually did really well during the removal, although I did have to hold him down a bit.  I thought Michael's foot looked rough.  I talked to him about the fact that he might have to get another cast on, and that made him teary. We saw a different doctor (even though I was told we'd see the same one).  So I had to tell the story again.  The doctor pressed lightly on Michael's heel and Michael cried out in pain.  We got follow-up x-rays taken at that point.  The x-rays still showed no visible breaks, which is good.  It's possible that Michael just incurred a deep bone bruise that will have to work its way out.  The top of his foot was yellow bruised from the pressure of the cast.  The side of his heel was horribly purple and swollen.  Apparently both of those things are normal though.  The doctor wanted to see Michael walk, so Michael walked across the exam room and the doctor was satisfied enough that he chose not to recast Michael!  This was such a praise!  He wrote a note to excuse Michael from PE for this first week back at school (started today).  He told me to call him back if Michael was still in pain in 10 days.  That time line will be up this Saturday.

I pulled out his sock and shoe (really hard to remember to bring the extra shoe after going two weeks without having to put it on him!) from my purse.  (My mother in law actually reminded me to put his shoe in the van just so I'd have it with me.  That morning, I transferred it from the van into my purse).  He let me put his sock on, but not his shoe.  He tried, but it was just too painful.  He limped out of the clinic the same way he had learned to walk in his boot-- on his toes.  I didn't make him put on a shoe on Thursday, Friday, or Saturday.  He put on his shoe to go to church yesterday, and to school today, so that's a major improvement!



The heel looks much better yesterday and today.  It's bright red, but not purple anymore.  Also, Aaron has been working with him a lot on walking correctly, even if it means going slowly.  Michael is pretty stubborn (gets it from me) and can easily believe that he can't do something and we almost have to trick him into trying, and then praise him extensively when he does it so that he sees that he can do it!  He finally believed yesterday that he could walk correctly.  We've been watching him play since Wednesday, and can see that he can put weight on his heel when he's not thinking about it.  But when he thinks about what he's doing, he freaks out and doesn't believe he'll be able to walk on it without pain.  So it's been a test to get him to the point of walking on it correctly.

I can gladly say that school gets out in 6 minutes, and I've received NO CALLS from the nurse or teacher today regarding his heel!  This is SO GOOD!  I'm anxious for Michael to heel completely so that this journey can just be something we think back on, and not something that has followed us for any length of time.

Until Next Time,
Much love, Reba





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