Code Blue: Momma Bear in the ER

Well, the good news, ” she said, “is that Tucker is going to have a great scar. The bad news is that he was hit in the face by the fence gate as it was closing, and we need you to come get him. S-t-i-t-c-h-e-s are a y-e-s.”

She’s the best school nurese ever. And believe me, we give her reasons to know us well.

“Yes? You said yes to the stitches?” See, I had the freedom fromspelling because Tuck was sitting next to her, not me.

“Yes. Yes, definitely.”

Say no more. I’m on my way.

I made phone calls on the way – pediatrician to tell them we’re on the way, after schoolchildcare for Tyler since there’s no way I’ll be back in an hour, and my parents for updates and SOS calls.

(What would I do without a support system? This past weekend I met a widow whose story is very similar to mine, except that she doesn’t have a support system. She doesn’t have the go-to people to call, the ones to help her fill in the gaps and create some margin and run the errands – or just remind her that it’s okay. And she’s clinically depressed. With good reason.)

I came into school with my healthy, happy, optimistic voice. It’s the one that’s meant to convince mostly myself that we are so okay and we can do this thing. If it helps anyone else, that’s a bonus. But really I just need to hear my own voice not panicking.

Sure enough: a deep and wide gash across the cheekbone.

Which prompted me to make a second call to the pediatrician: ‘So, remember when you told me that if there was any exposed flesh from the inside of the wound, then I should take him directly to the ER? Yes, I’m calling to let you know you I’m not coming to you. Thank you for your help and familiarity and short wait, though. I’ll see you the next time we have an ear infection.”

It is by far the busiest I have ever seen that ER. (And if you’ve been reading a while, then you know I’ve visited that ER under various levels of panic, anxiety, duress, and emergencies.) In all my visits, they’ve never told us in triage: “I’m sorry to tell you, but there’s a long wait in front of you.”

Tuck and I settled in for a rousing and competitive game of War, which distracted us from the woman in loud labor and the man who was shouting obscenities and asking for someone to call an ambulance, though I’m not sure where he thought the ambulance would take him.

I think it was roughly two hours before they were ready to see us, and then we had a double room with a kid who was getting stitches in his eyebrow, followed shortly by a woman who had fallen at Walgreens and broken her hip and nobody could bring her pain medication fast enough.

I always make friends with the medical staff, for just oh-so-many-reasons. They’re working stinking hard, often with people who have little patience or coherence. I’d like for our room to represent a delightful break from the routine, such that the nurses will want to visit more, hang out with us as much as possible, and get this job done. Plus, it never hurts to make friends with the one who wields power over the IV needles as well as the popsicles.

All of that to say, I’m the kind of mom you want to have in your ER.

Unless, that is, you’re going to make promises to my son that you cannot keep, and if you’re going to make your decisions based on what is true for other children, not one who is resistant to lidocaine.

Well, then. I might not be your best friend by the time the night is done.

They began with a topical anesthetic cream that was guaranteed to numb him up. “You won’t feel anything, buddy. I promise,” she said. But then she irrigated the wound, and I will tell you what, he felt something.

And let me just say this: Tucker’s hurting face looks exactly like Robb’s hurting face. The red-faced, white-knuckled fortitutde of “I haveto just do this, go go go, please don’t stop until you’re finished but get it right the first time” – that’s the face I saw on my son.

“That’s hurting him,” I said. “I’m not sure he’s numb yet.”

“No, it shouldn’t hurt.” And she went right back to flushing the wound, and he went back to the red face and white knuckles.

“But it is. Listen to me. It is hurting him.”

I know what she thought. She thought I was a helicopter mom who would like for her son’s experience in the ER to be largely about vending machines and teddy bears. She thought he was afraid and dramatic and neither of us could be trusted. What she thought couldn’t be further from the truth.

So she poked the wound with a needle. “Can you feel that, Tuck?”

“Yes. It hurts. It’s sharp poking in my face.”

She was quizzical. “Huh. Well, it shouldn’t hurt.” Except it does.

Enter eye contact from this mom. The one that says “Do not move forward with this procedure until he is numb, and don’t try to tell me he should be because the truth is he isn’t.”

So the nurse comes back and applies the topic cream again, we wait again, and they begin the procedure again, she promises him it won’t hurt again, she begins poking his open gash with a needle, only to learn that is not yet numb – Again.

“Huh. This is just puzzling,” says the pediatrician. “Well, I’ll be back with some lidocaine. We’ll give that a try.”

She came back with lidocaine and a partner. I’ve been here before and I know this scene: my child is about to be restrained. And bless you for bringing a nurse to help you, because I learned long ago that I will not hold my child still so you can hurt him. I need for him to know I’m on his team, even though we’re all on the same team with the same goal toward his wellness. But, as much as it depends on me, he will not associate the fear of being restrained with the feel of my hands on him. Nope. This body comforts his. That’s my rule. So, good call bringing back-up.

So the nurse holds Tucker while the put the needle right into his exposed tissue, and I take my post of keeping his eye contact and counting for him. He knows that when I’m done counting, this present horror is over with. And he knows he can count on me.

Meanwhile, I am feeling the familiar heat rising up my neck, the tunnel vision, all the things that mean my own consciousness is about to give up. No. No. I’m not fainting. I will not. I ask for water and I take off my sweater, and we do what is in front of us. Because that is all there ever, ever, ever is to do.

We wait again, and they begin the procedure again, she promises him it won’t hurt again, she begins poking his open gash with a needle, only to learn that is not yet numb – Again.

“Huh,” she says. “I’ve just never seen anything like this.”

Meanwhile, Tuck is ready to climb right out of that bed. She’s ruined his trust, and with good reason. He sat up, ringing his hands, leaning into me with all the courage I’ve ever seen. I’m telling you, that boy. My hero.

Then she said, “Well, should we just do the stitches? I mean, the pain meds aren’t working, and it’s just three stitches.” (It turned out to be five stitches, by the way, so add that up to the list of false truths.)

“No,” I said. I was cradling my son’s head against my chest, letting him catch his breath and cry. “No, you are not doing stitches if he’s not numb.”

I looked her squarely in the eye.

“Here’s what’s going to happen. You have one more try, so it better work. Either choose a different medication, a stronger one, or give him every last drip of this one. You get one more try. I’m going to count to five, and when I’m finished, the shot will be over with. We will start when Tucker says he’s ready. I promise you – I know this child, and he will cooperate when he’s ready and he knows teh plan.”

I looked at Tucker. “Buddy, you can do this. One more try. If this doesn’t work, I won’t ask you to trust them again.” (I didn’t know what I was going to do instead, but I was prepared to raise some holy hell. This is modern medicine, people. And these are stitches, for crying out loud. Get. It. Right.) “I will count to five, and it will be done. Let’s practice. I’ll count and you breathe.”

We practiced. And we decided he didn’t need to breathe, just blow. Inhale, exhale – that’s too much to remember. Just pretend I’m a birthday candle, lovey. And blow me out.

“You ready, kiddo? Because you can do this. I’m on your team.”

The doctor and nurse were patient. Wisely patient.

And then Tucker said he was ready, which in itself is an act of courage that makes me want to crown him King of the World.

The nurse held his head. I held his hands. The doctor started the injection. I counted to five.

And blast it all, she wasn’t finished at five. “Six… seven…” and then she was done. But then she said, “One more!” and injected again. (One MORE?!) And I counted more slowly, determined to let my son know he could trust me. When you hear five, we are done with the worst, buddy. I promise you.

I’ll tell you what: every single one of us needed recovery after that. That’s when I realized my mom had come behind me, and she was massaging my shoulders. She was the mom taking care of her baby while her baby was taking care of her baby. “You’ve got this, Trish. You’re doing great,” she whispered to me.

And, would you believe? Just as I promised them, Tuck was absolutely cooperative and still and a total trooper – once he was numb. He didn’t trust them, and I couldn’t blame him. The doctor said, “One more stitch, I think.”

And my sweet boy laughed and said, “You think? You think.”

Mental note (and a physical note in his chart from this day forward): Tuck is resistant to lidocaine. Bring out the big guns from the start, because this? Cannot happen again. Ever.

Ladies and gentlemen, he was a rockstar. And, might I say, I owned that room.

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5 thoughts on “Code Blue: Momma Bear in the ER

  1. Oh I can hear Tucker asking “you think?” and it makes me laugh and makes me annoyed at the same time. I had to be put in the kiddie straight-jacket…Sylvester and Tweety on it. I never felt the same towards those two again.

  2. My heart breaks for both of you! I have a redhead and have had the same issues regarding pain medication. I was researching a topic for a paper in a class recently about redheads and their tendency to bleed more and ran across some interesting info regarding redheads and pain tolerance & pain medications. This may help explain what happened and give you some ammo for the professionals in the future. – A mutation to the MC1R gene causing the red hair and fair skin also influences the body’s sensitivity to pain. Redheads typically need 20% more anesthesia that people with dark or blond hair.
    Here are a couple of links :

    http://abcnews.go.com/Health/PainManagement/dentists-tread-gingerly-redheads/story?id=8293620
    http://science.howstuffworks.com/science-vs-myth/everyday-myths/redhead-anesthesia.htm

    Give your little man a big squeeze! ((Hugs)) & love to both of you!

  3. My four year old daughter sustained a large gash to her leg when she was climbing up on the change table to look at her baby brother. I took her to the hospital where the doctor froze the leg. Same thing happened to Sarah as happened to Tucker. Only the doctor didn’t listen to me or to Sarah, who was calm between stitches and gasping and sobbing in pain with each stitch. I said, “She can FEEL it.” Doc said, “No, she can’t feel it.” I was ready to punch his lights out when he continued with the EIGHTEEN stitches it took to close the wound. I kept saying, “She can feel it” but he pressed on, thinking she was just being silly. By the time he was down to the last five, she was calm, because the freezing had taken effect.

    Let me tell you, that NEVER happened again. I learned to insist that the doctor WAIT. My kids were always great with wounds, and never panicky or bratty. They were so brave that on more than one occasion the doctors said “We ought to videotape this so that other kids can see how to behave!”

    I’m glad you did it right, Tricia. Way to go, Tucker, for being so brave!

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