.... to the pediatric orthopedic doctor. [please note sarcasm, lack of sleep, high stress level, and severe exhaustion].
If you've been following my posts about my 19 month old son having broken his KNEE, there's more.
He negatively progressed all day yesterday to the point my gut was screaming 'this isn't right'. I called the ortho after hours number (it was like 5:30), and they had me bring him to the ER.
ER re-xrayed him... not only does he have a hairline fracture of his knee, he has a closed fracture of his TIBIA, the main weight bearing bone in his little leg!! I feel like such a jerk. NOW I'm CONFIDENT they'll cast him (which is a good thing, I just want him feeling better and back to his own naughty self!)... I really think this new xray changes things.
Here's my dilemma... what if they STILL WON'T cast him? I feel very strongly that he did much better with the splint that he did with nothing. I'm pretty quick to debate if need be, but I do put a lot of faith in medical professionals, and usually wave my little white flag, admit defeat, then go along with what they say... then, like yesterday, but gut instinct kicks my butt.
What should I do when we see them today? We're leaving Sunday for the beach... this can't wait to get worse, you know? How do I dig my heels in and really let the doctor know what *I* think might be best? Like I said, I think once they see this other break, they'll change their minds, but what if they don't? I'm so tired. I just want little man on the road to RECOVERY!! :(
LOL CHERYL, you're the best :) I actually already thought ahead and bought him a cast cover for the beach/bathing :) I've had way too many casts of my own to not know what to do, LOL!!
THANK YOU LADIES SOOOOO MUCH, I don't feel like so much of a spaz now :) I called the office... the doc was in surgery, but was able to pull up my son's new xrays in the OR... yep, we go in at 3pm for his CAST :) I feel better now, knowing he'll actually be HEALING. Thank you all so much!! HUGE sigh of relief!! :)
Here is the thing, if you DEMAND! they cast him and it really isn't the best thing for him they will still put their foot down. No doctor will do anything that is not in the best interest of the patient no matter what their parents say or do.
Demand away, it won't hurt anything.
R. - I think I told you in my other response to one of your posts that my dd was in a similar situation. The Dr. initially said no cast and I was persistant with him about how clumsy she is and really felt it would be best. After I continued to persist she was casted for the 2 weeks. I also called the E.R. and our family dr. before heading to the orthopedic to make sure I understood correctly that there actually was a break and they also felt she needed a cast. So I kept telling the orthopedic - This other Dr. agreed with me on the cast.
If you dont like their answer ask for a 2nd opinion from another Dr.
TELL them to splint or Cast it.
Remember, yes Dr.s are smart and know what they're doing, but they work FOR YOU. They are YOUR doctor so, really they have to listen to what you want. Obviously within reason ;)
Like Cheryl said, Garbage bag and duct tape for the beach.
If the hospital or doctor is not a pediatric specialist, find one. Friend's son was initially treated locally (at a hospital with a pediatric wing) and then finally transferred to Children's. The later doctors found out that the first ones did not set his leg right (something to do with needing a wedge in there to be straight) and the kid (teenager, really) needed additional surgery and treatment to straighten his leg out. What I learned from that is if my DD ever needs treatment and I can make the 40 minute drive to Children's, I will be doing so.
For the duration of his treatment, make sure you have updated medical records for your travel, just in case you have to take him to the ER local to your trip.
The doctor works for you!!! If you feel casting is best then let them know that. You are the best judge for your child's needs. I learned from my mom when a doctor told her my brother was "faking" a sickness and needed to see a shrink. My mother told him he was an idiot and he was fired! This doctor was one of the head guys at Cleveland Clinic!!! Come to find out my brother was allergic to an additive in kool-aide which my mom was pouring down his throat!
Remember, doctors are service providers! In the words of Donald Trump "Your fired"! Good luck! Our dd was in a cast for 8 weeks when she was 19 months old. She learned to walk and run in her pink cast! Trust me, he won't be down for long!!!
We dealt with a fracture at 11 months...I knew something was wrong when she fell Friday night, but didn't get her to the doctor until Monday morning (my husband kept telling me it was just a sprain and that toddlers don't break bones that easily...ha, he ended up telling me, I was right about five times).
Anyways about the fracture in the tibia...with "toddler fractures" (that is what they are called) sometimes the break will not show up on xray for several days or up to a week until it starts to heal.
So my delay in getting my daughter to the doctor actually made it easier for the doctor to see it on the x-ray. I have had friends who's children's breaks didn't show up until the third set of x-rays.
Trust your pediatric orthopedic doc...he or she will cast or not cast as they see fit. We were in a cast for three weeks.
Sending you a hug!!
They will probably end up casting him and you won't have to even have that conversation with the doc. If he doesn't cast him, make sure you ask him to explain the reasoning behind his decision not to cast. You seem like a completely reasonable person and will know if his reasoning is in the best interest of your child. Also, make sure you tell them you are going to the beach. They put a Gortex cast on my son, that he could get wet. WARNING: it does get stinky , though.
Oh no, your poor baby!!
I am a firm believer in gut instinct and second opinions. As parents, we can't ignore our gut instinct, because most times it is right on!! On the other hand, we are not doctors, we did not go to medical school, nor do we have years of experience dealing with broken bones! If you do not agree with the course of treatment bring your son for a second opinion. If that second opinion is the same as the first, then perhaps it is the right thing to do.
We had a similar situation with our son. Certainly not as serious as what your son is going through. Our 18 month had, what we were told, was an ingrown toe nail that was constantly getting infected. We were referred to a podiatrist. He wanted to perform a procedure to fix the nail that would require putting our son under local anesthesia!!! My husband and I were really reluctant to do that for a toe nail!! So we brought him for a second opinion. You know what that doctor said??? There is absolutely nothing wrong with his nail, not ingrown at all. He must have smashed it on something, it got a cut and got infected. It makes my stomach turn thinking that we almost put our son under to get a totally unnecessary procedure.
Good luck, I hope you get the care you are looking for
I'm sure they'll cast it but if they don't ask them why and don't leave until you understand the reasons and feel comfortable with it!
My son borke his leg last summer when he was 20 months old and it didn't show up on the xrays either. They said that's just how it is with toddler fractures. It was on a Friday and they didn't cast it but said to come to their office on Monday if he still wouldn't walk on it, so we did and it still didn't REALLY show up on the xray but they saw something that looked questionable. They said that even if it wasn't actually broken, he was still hurt bad enough to cast it since he wouldn't walk on it or use it at all, so they did a cast. He had it for 4 weeks I think and when the took it off and did another xray THEN they could see where it had been broken! SO.... they made the right decision to cast it. :o)
Hope all goes well for ya'll! Let us know!
You just say nope. Not moving till you give me something! Tell them that you tried it there way (no casting) and now you'll try it YOUR way, thank you very much. His favorite color is .... for the cast. =)
I'm sure with the discovery of the additional fracture, they'll know what to do.
Why didn't this show up originally? I'd be pi$$ed if something was missed. Same ER? Was it missed because of the swelling? Or is it a new fracture?
Explain all that has happened from beginning to end, including your vacation plans and your inability to travel away from his doc without the reassurance of the support he needs.
Good luck.
I wouldnt demand they put a cast on. If there is still any chance of the leg swelling, a cast would restrict it and could cause a problem with circulation and he could lose toes or the whole leg if the blood supply is cut off for too long. We all know you dont want to take that chance with your little guy. I feel Drs know this but might not tell you. So if by chance they dont want to cast it yet, ask why not. And maybe they have a good reason. Make sure they know how active he is and how hard it has been to keep him still and not putting weight on it. They might find a better solution for him.
First realize that children's bones look very different on xrays than adult bones do. My nephew (then age 3) broke his pelvis years ago - the othopedist at the hospital sent him home. A few days later they called and had him come back in becuase once the xrays were dry they could see things unique to kids' bones that showed a hairline fracture. (BTW my nephew scooted around on his butt, he wouldn't get up because he knew it didn't feel right. Now as a young adult he's perfectly fine - no permanent issues.)
Make sure the ortho you're going to is board certified pediatric orthopedist. You can find this online when you google his name.
If you're not comfortable follow your gut - ask lots of questions. You're the mom, you're ultimately the one responsible for your son - don't be intimidated. Get a second opinion if you want to - who cares if you feel like you may offend the MD - he won't care - and 5 years from now it won't be a blip on your screen of life.
Bring a small pad of paper - write things down as they come to mind - questions, doctor's instsructions, information, etc. I have found over the years (with my mom's cancer, my husband's spinal injury and my daughters mental health issues) that having a notepad is invaluable. ;o)
Best of luck mama - and have a great vacation!
If the doc doesnt want to cast or splint him tell them you want them to "convince" you as to why not. I do know kids bones are very soft and heal very quickly and maybe since it's all hairline stuff they are figuring it will be just fine. If you think his activity level is too high and something you cant control maybe you could pick up your own pediatric sized knee guard thingy at the pharmacy, that would hinder his movement some and make you feel a lot better.
use a pediatric orthopedics doctor....it's amazing how much better they are. Kudos to you for being persistent....we are our children's advocates.
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Ask questions and make demands. They are doctors, but you're M. and know best. I'd be upset that they missed that tibia fracture on round one for sure...but now all you can do is fix it going forward. Insist on a cast and prepare for fun at the beach!!!
I know I'm late, but I thought of one thing when I read your post (I think of it a lot, since I have a tendency to do the same thing):
He who forsees calamity suffers it twice over.
Chill out. When the doc says "no, we won't cast him," THEN have a freak-out about what you'll do next ;)
dont wave that little white flag when it comes to your kids. visualize yourself as a mother bear that has just been poked with a stick. unforunately, doctors are not real inclined to take mothers of young children seriously, but they will pick up the phone and call social services on you in heartbeat for even a perceived problem with your kid(s), even if they could have done something about this perceived/potential problem, whether it be a accidently forgotten sippy cup ( see an earlier posting), or a broken bone. dont back down about demanding proper medical care for your kid(s).because its going to YOU thats going to be entertaining some social worker when and if your kid(s) dont get proper medical care, and its going to be the doctor that refused to give your child that care that is going to calling social services, think about it
K. h.
