05 October 2007

The other side of the gurney

The Darling Wife was waiting outside the Y last night when I finished with Karate. I was surprised to see her, since there was no reason for her to be there (with the kids) at 9:30 pm. I figured something was up. It turned out that First-Born Son had fallen off the bed and hurt his wrist. He insisted that Second-Born Son had pushed him off the bed, but SBS dutifully reported that they had both been jumping on the bed and FBS "just fell."

One glance at the wrist told me that we were heading back in to the ER.A torus fracture of the distal radius. So now FBS is sporting a cool fiberglass splint which we'll have converted to a cast next week. He was pretty good with the pain and is feeling fine now, running around and back at school.

So, I have two boys and each has been to the ER once. Let's see, that is seven and a half years of parenting with one ED visit every 3.25 years. If that trend holds steady (if), then by the time they head off to college we'll have a total of eleven ER visits.


  1. As long as you maintain health insurance of course. Should you lose insurance, common senses or your rx pad it is likely your ER visits will increase dramatically.

  2. If that forecast does play out, I hope the ailments are as minor as can be.

  3. You even got the BMW X-ray and the fiberglass splint.

    Don't let the proletariat get a foothold or else it'll be a Chrysler X-ray and a couple of wooden spoons taped together.

  4. I like the red radiology thought control marker :-) I am an Orthopod and have had my two tikes in for various fractures over the years. Last time the ER doc (an out-sourced company) refused to let me go until he put on the splint himself. When I told him I was going to my office across the street and have my tech cast him he wanted me to sign out AMA!!!

  5. Westie Ortho --

    We call the arrow the "Dumbshit sign" but inasmuch as this blog is read by a lot of non-medico's I thought it was a nice idea to show folks where the fracture was.

    The real question I have for you is why you took your kid to the ER in the first place. Surely you have an x-ray machine in your office?? Why not skip the whole ordeal?

    And I would have signed you out AMA too -- if you leave before I can splint it I get no fracture care fee and no splint fee, just a lousy level 3 E/M fee. Hell, I'd have had you restrained by security!


    Sort of.

  6. We are a university based group so X-ray is run by the radiologists and thus have radiologist's hours!

    Believe it or not he didn't touch my son, just sent us for XR, asked ME what they showed and billed out a Level IV plus fracture care---despite the fact that I walked out and went to my office.

  7. Don't even get me started on academic foundations. They suck so very badly.

  8. Teaching Hospital ER horror story:

    Last year, we took Son Two (there are three), then age 9, to the ER on a Sunday, since for the past day and a half he'd had a 103-105-degree fever that wouldn't resolve with OTC meds and he couldn't keep much down. I worried about his dehydrating, so off we went.

    After looking him over, the attending doctor and his intern, who was from the Cote d'Ivoire (charming accent, but I had to translate for the husband and Son Two), determined that a spinal tap would be necessary to rule out meningitis. Before that, they would need to rule out any other problems of the brain and spine, they said, so a CAT scan was ordered.

    Hours later, after we three had watched a tape of Cuba Gooding in Snow Dogs some three times over and placed numerous calls to backup babysitters for the other two, they took him in for the scan. Then, the intern came in to our curtained-off room looking grim. He said there was a mass on the pons area of the brain, and they were going to admit my precious boy and do a full neurological workup, including an MRI, in the morning.

    While husband stayed for the admitting process, I raced home to get his clothes and favorite toys, stopping for five minutes to Google pons brain mass, at which point my heart nearly stopped. No pons tumors are are good--it seemed that was just about the worst place to have one.

    I cried all the way back to the hospital, bargaining with a god I wasn't sure I believed in, asking him to take me instead.

    The single MRI machine was booked for most of the day, and they only got around to doing my son's MRI late in the afternoon, but at least he was in bed with a saline drip and some analgesics, not getting dehydrated. Bored, yes. And hungry: no food until after the MRI, which would require sedating him, they said.

    Of course, by the time that was performed, it was late in the day and the radiology staff and head pediatric neurologist had gone home; we had to stay another night, with me curled up in the plastic armchair next to Son Two's bed, not wanting to leave his side, not knowing if he was going to be with us that Christmas, not wanting to live myself but realizing I would have to, somehow, for the others.

    Heavy, heavy stuff.

    The next morning, a woman with waist-length hair and a Grateful Dead t-shirt introduced herself as his doctor; she was the head of the neurology dept. There was no mass--the CAT scan had simply been blurry at that point of the image, which looked like a mass. The opthalmologist who'd examined his eyes concurred: there no sign of any tumor exerting unusual pressure in or near his eyes, either. Brain fine; mother limp with relief.

    The fever was probably caused by a non-specific virus, they said. Some kids throw up a lot when they're feverish. The infectious disease doc would be up to visit shortly, and would I please put on this mask when I left the room now, since we were on the oncology floor.

    For two days I thought the worse. Then, it all spun around. I was so grateful for the happy diagnosis, it never occurred to me to be angry or upset at having had the living shit scared out of me, or for that matter, my husband.

    The bill exceeded $30K, once all the professional fees were added in; our insurance covered 80% of the after-deductible portion, and there were certain things they refused to pay for that we had to cover entirely. I wondered what would've become of us if we didn't have that insurance. I felt guilty for being upset about the experience, too, because here we were, taking our beautiful boy home, knowing he'd be fine. (He was.)

    All I can say is, may you never, ever have to go through something like that. A doctor friend whom we recounted this to told us the teaching hospitals tend to do everything "by the book", following proscribed steps, and that's why one thing had led to another that way.

    It was a virus, one they never identified, and Son Two was better within a couple of days.

    Mama and Dad, however, needed a bit more time (and a lot more wine).

  9. Defensive medicine is expensive. Don't let anyone try to convince you otherwise.

  10. Heehee... they take after their Anti's! one trying ot blame the other and the little one telling the truth.. no wait... the other way around... crap... now I'm confused... well, give them both hugs and kisses for me!

  11. Westchester -

    If you're an orthopedist, you're acutely aware of why he had you sign out AMA. I recommend care, you choose to leave before that care is finished, I cannot be held accountable for anything that happens from that decision. I know it's just a torus, and that I could probably trust you. But this is the society we live in. I can certainly imagine a worst case scenario, and the distraught parent chooses to sue...and, b/c this distraught (and furious) parent is an Orthopedic Surgeon, is VERY convincing in whatever he's trying to sue about.

    So..."against medical advice." I advise you to let me put on a splint. You choose not to. That is against my advice.


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