1.14.2006

A little boredom might be nice

This is not the post I set out to write on Thursday morning. I was formulating another miscarriage rant as I prepared to jump in a long, hot shower. MZ was on her way to story time. And then the phone rang. There'd been a fall. Something about stairs, and heads, and I could hear her screaming in the background. I considered leaving the house in just a towel, and found myself pulling my shirt on as I raced down the stairs, to the dismay of the construction crew two doors down.

I was not calm. I was not grace under pressure. My heart was racing and I snarled into the phone as I tried to determine what to tell her pediatrician while I drove to the library, buttoning my shirt.

I got there and her cries guided me downstairs. She calmed a little when she saw me, but as I learned more about the fall, I did not calm. Down a stair onto a linoleum floor, on the back of her head. Still crying after 20 minutes. A big goose egg on her head, but already signs that she'd prefer to go right to sleep. An unwillingness to make eye contact, no visible awareness of what was going on around her. Constricted pupils.

It took three calls to her pediatrician for us to agree that we needed to go the the ER. I would have been happy just to take her to her doctor, but she didn't want us to have to drive back across town if a CT scan was required. A CT scan. I hadn't gone that far.

She cried all the way to the hospital. The emergency desk had our information when we arrived, and we were admitted to triage fairly quickly. In the meantime, MZ stopped crying and began to pay attention to what was going on around her. When she cried when they attached a pulse monitor to her foot, I began to breathe again. She was well enough to be pissed, that's always a good sign.

From triage, it took 2.5 hours to see a doctor, and in that time she flirted with people in the waiting room, got fussy, and fell asleep in my arms. The doctor explained brain bleeding and CT scans and why he thought she was doing well. And then he looked at her eyes, which were still constricted while she slept, and said, "You're going up for a scan."

Here I'd told R, stuck over 45 minutes away at his office, that everything looked good, and now we were talking about subdural hematomas and how to evaluate for signs of coma in a sleeping child. And a CT scan! Should I have told him to come here as soon as we were on our way? Did I over-manage this emergency?

The pediatric nurse walked us upstairs and got us settled. MZ was fast asleep in my arms, but woke just as I laid her down on the CT scan bed -- right on her bump, of course. She began to cry and I began to talk to her, calmly, playfully, as everyone else left the room. I zorbitted her and she laughed, so I did it again, and then made all her favorite animal noises, while waving the nurse's stethascope at her, hoping she wouldn't sense my fear and begin to fight her way out.

She didn't, and the tech told us we did really well, he had everything he needed. The nurse walked us back down, explaining that she liked to walk babies up because the techs "aren't patient, and if the babies fuss, they want to sedate them." Sedate a baby I'm supposed to be observing for signs of coma?!

Long and the short: The scans came back fine, and after 48 hours of monitoring, including checking her every two hours at night to make sure she responded to stimuli (we had an escalating list from rubbing her back to picking her up), we think she's okay. She still has a painful bump on her head, which we remember every time we need to change her, but she's seems to be her old self.

Thirty-six hours past and done with the monitoring for *brain bleeding*, I'm acutely aware of how much worse it could have been, and supremely grateful that she is back to being our happy, healthy MZ. And I realize I learned a ton about how to deal with a bonk on the head, because this won't be her last. And something you might want to know, too: how to observe a baby when the pediatric nurse says "Don't let them sleep too hard" (like there's any other way):

Here's an escalating list of stimuli to try on a sleeping baby or child. If you get a response from any of these, you can stop, but keep going till you get a response:

1) Pat back or chest
2) Touch cheek or forehead
3) Touch eyelid or place finger at entrance to ear
4) Pick up the baby or child
5) Attempt to wake
6) Call your doctor immediately

After hearing those instructions just after her fall, wondering wildly how I'd be able to tell, I was grateful to a very calm, very cool ER doc for passing this on.

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