A broken arm and a healed heart

We are nine days out from what I certainly hope is the most traumatic event of our summer.  It was Sunday and, like usual, the kids dashed to the gym after the benediction, came back to scarf down a few bites of lunch, and headed back out.  When we are at camp, we attend the local church that is trying to be born.  It’s a smattering of people who attend weekly, bi-weekly, or once a month.  We meet in what used to be a public school building until it was closed because of being in a flood plain.  The local owners have converted the cafeteria into a restaurant and let people come in and use the gym out of the goodness of their hearts.  We meet in the curtained off section of the cafeteria and the kids love the ready access to the gym, especially since there is a carryin lunch every Sunday.  I like the gym, but I have feared that trampoline since the day we moved here.  One Sunday as a friend and I discussed some of the quirks of where we meet, she talked about how careful she is about her children heading out to the playground because of never knowing who is hanging around outside.  I said I wasn’t half as worried about anyone outside as I was the trampoline.  Then again, our boys don’t tend to hang out at the playground and her girls tend to avoid the trampoline. 🙂

I was dragging worse than usual that Sunday, partially from morning sickness and partially because I was emotionally not doing well with being here.  When we hit the one year mark in June I told David I felt like I was finally acclimated, but I was far from invested.  He reminded me that I might never actually feel invested here, since nothing actually involves me.  Good point.  Then I got pregnant and all my coping strategies disappeared in a hormonal haze leaving me with an embarrassing amount of meltdowns ending in, “I just want to move back to Virginia.”  When Adam heard me Saturday night he said, “Well, just think about the blessings of living in Maryland.”

“Blessings?” I said.  “Not one thing in my life has gotten easier or more fun since we’ve moved here.  In fact, it’s exactly the opposite.”

“Well,” he chirped, ” Just focus on the good things.”

Don’t you hate it when your parenting comes back to bite you? 😉

Sunday morning David suggested I stay home until after Sunday School so I did.  I grabbed my journal, fully expecting to unload a lot of disappointment.  Instead I found myself flipping through the pages, reading randomly.  The last year has been so hard in so many ways, but God has also been so REAL, so present, and so gentle.  Over and over I wrote the truths he was showing me about myself, about who He is, and about His heart for the world.  I’ve had scales peeled off my eyes about my selfish, Americanized version of Christianity.  I’ve had layers and layers and layers of selfishness revealed.  Unfortunately {as evidenced by the meltdowns} there are still complete stratospheres to go.  But as I read, I felt my spirit calm and re-equilibrate.  A long time ago at Faith Builders, Marie was speaking to a group of women in a little afternoon session.  I don’t remember the topic, I just remember the way she encouraged us to build God-altars in our lives.  When the children of Israel crossed the Jordan River, God told them to build altars so that when they would pass that way with their children they would remember to tell the story of His goodness.  My altars aren’t made of stones, they’re made of words; but when the darkness wants to take over, I am grounded again by the words of truth and light.  Every time I read those pages, I realize again that even if it’s hard, it is right.  In many ways, I feel as though I will never really know the reason for my being here except to learn simple obedience to Jesus.

I read through pages of truths, of revelations of the sin in my own heart.  Soon after we moved here I was reading through the Old Testament story of the children of Israel as they wandered about the wilderness.  They were so whiny and accused God of rescuing them only to allow their children to die.  I was so smitten because the words were hauntingly similar to my own heart.  You clearly led us here, only to ruin our children.  We have worried and prayed more for our boys safety physically, emotionally, and spiritually than any time in our short history as parents.  I had to come to the place where I trusted God to not only lead David here to work, but to do good things in our children in spite of what it looked like was happening.

When I finally headed to church, it was late, but I had once again laid down my own rights and said yes to God.

So there we were, a little over halfway through eating lunch when Liam came flying in to tell me that Adam was hurt.  I jumped, because it is always Adam coming to tell me that Liam got hurt.  I wasn’t five feet down the row of tables when a local teenager came to the door and said, “There’s a kid in there who broke his arm.”

Oh. my. word.  You don’t have to be good at Math to put those two together and you don’t have to be a rocket scientist to know that if someone can diagnose that authoritatively it means we’re not talking about a simple fracture.

Adam was sitting on his knees next to the trampoline, crying and swaying and cradling his mis-shapen arm across his legs.   David was only ten feet behind me and quickly left to get our wallets and cell phones since neither of us brought them along to church.  The guy who came with the alert went to find supplies and I sat there numbly holding Adam wishing for all the world I had a clue what to do.  He was in absolute agony and I was afraid to touch him and equally leery of calling the squad because of how long it might take them to get there.  The guy got back soon with a paint stick, something that seemed to be a cross between paper towels and cloth, and an ice pack.  I have no idea where he found them, but sometimes I wonder if he was an angel.  I lifted Adam’s arm enough to get the paintstick underneath and very loosely wrapped the cloth a few times without actually splinting it because his pain with movement was unbearable.  By then two men from church came to see if they could help.  One went to bring our van to the back door and the other lifted Adam off my lap and carried him out for me.  I asked someone to please call ahead to the hospital to tell them we were coming because I was sure they wouldn’t have adequate staff in house.  David still wasn’t back and Adam was in too much pain to wait another minute so Brian drove us in … or flew us in.  I spent the trip praying desperately for pain relief for him in one breath and begging God for a good doctor with the other and slowing down Adam’s breathing when he started to hyperventilate from all the pain.

It is incredibly hard to find a good doctor in the area.  My extended family who has used the hospital some has regaled me with tales of horror and warned me to stay out if at all possible.  You know, like the grandma who had a stroke and broke her hip and the type of care she received while admitted and then worse, the fact that the hospice nurse discovered a broken shoulder that had either never been treated or had happened in-house.  We’re just going back to Virginia for wellness checks and the one time I did have to make a sick visit with a local pediatrician I asked him, “So tell me about the hospital here.”  He paused a minute then said slowly, “Weeeelll, it’s Western Maryland …. but we don’t let anyone else see our patients.  We cover for other doctors, but no one covers for us.”  Why did this not make me feel one bit more comfortable?

After what felt like an endless trip, we arrived at the ER and Chief Brian went in to get help.  Out walked transportation with a wheelchair.  He was shaking with either Parkinsons or drug withdrawal (lets hope the former) and my blood pressure shot through the roof.  Adam’s arm was not stabilized and I was totally upset at the idea of this type of transfer.  “You don’t have a stretcher?” I asked with more force than I meant to.  “I can take care of him,” he shot back.  It was a battle of the wills as I repeated my question and he repeated his statement a little more icily and started grabbing for Adam on the side of his broken arm.  I was so upset and wishing a gazillion times David would be there to transfer him carefully, but he wasn’t; and I’d had too many pregnancy scares to lift his full body weight myself.  I repositioned him as much as I could and at least asked him to get him from the good side instead of grabbing the painful one …. and then I watched in horror as he simply plopped him into the chair.  Adam went white and still as his arm just flopped down into his lap and the transportation guy rolled him over the bumpy part of the sidewalk to take him inside.  My stomach still goes in knots, remembering.

They made us stop at the front desk to answer questions and wheeled us into a room where Adam was transferred into a bed and his arm was finally holding still.  And then we got our first miracle.  His nurse was extremely competent and managed to get a 20 gauge IV in his arm AND draw his labs through it instead of sticking him again.  As soon as it was patent, Adam got a dose of morphine.  As expected, there was only a nurse practitioner on duty and we waited on x-rays and then waited on the surgeon to arrive.  Meanwhile, I discovered that Adam had blood on his shirt.  I didn’t lift his arm enough to see under it when I slid the paintstick underneath, but I did lift it enough to see there was no blood at that time and at the rate it was dripping in the ER, there should have been significantly more blood on his shirt than the spots we saw.  I will always wonder if the puncture part of his wound happened during transport at the hospital.

While David and Adam went to radiology the nurse came back to see if I was ok and I said I was fine, I was just worried about who the surgeon is because healthcare in this area is very different from what we’re accustomed to.  I mentioned that I couldn’t find a local obstetrician I liked and she said, “Oh, I know.  And now I hear all our cardiac-thoracic surgeons are leaving.”  Great. I thought.  Just great.  Not that we hope to need them.  It just speaks loudly for a hospital’s reputation when they can’t keep doctors.  She went to see which ortho was on call and came back with miracle two.  “It’s Doctor Q.  And if it was my child, that’s who I would want to do the surgery.  He works in Annapolis and does call time here on the weekend.”

I think I exhaled completely for the first time since the accident when she said that.  After more waiting, the surgeon finally looked at the films and said he wasn’t touching it.  Adam needed a pediatric orthopedic surgeon and would need to be transferred.  When she was telling us, I asked where this meant because I certainly hoped it was not Morgantown.  Adam saw an orthodontist and an oral surgeon there who both treated patients like mechanical textbooks instead of humans and who seemed to think that pain medication was as unnecessary as smoking.  I have no idea if the ortho department is as much of a rodeo, but I wasn’t really interested in finding out.  She said she was going to suggest the University of Maryland in Baltimore.  I mentioned Hopkins and then in a moment of clarity asked David what the difference is in driving time between Baltimore and Charlottesville.  He said it was only half an hour and had the presence of mind to think about the fact that Adam would likely have follow up appointments, so we asked if there was any way Adam could be transferred there instead.  As long as they have a bed and a surgeon, I’ll be happy to send you there.  We were both so enormously relieved.   It was so much easier to go somewhere we knew was competent and had the benefit of family close by to help with Liam.

They flushed Adam’s puncture site and splinted his arm.  I was worried about swelling because of how tightly they wrapped him and because the plaster was going to get warm as it dried, but they insisted it wouldn’t be a problem.

It was 7:30 by the time we finally made it to UVA.  The ER doctor examined Adam and discovered numb fingers.  When she quietly had an attending take a look, they both left the room for a minute and she returned and immediately took off the splint.  Adam immediately felt blood rushing into his arm and hand and fingers.  The ortho resident apologized when she heard the first hospital didn’t use conscious sedation to flush his arm and later she apologized for “all the ridiculousness you had to go through.”  At that point I really just wanted to read the chart to see what atrocities I’d missed; but I was so relieved to be in good hands I just smiled and said, “We’re just glad to be here now.”

Adam has what is called a Monteggia fracture which means the ulna is broken and the radial head is dislocated.  At first they thought they’d have to do conscious sedation and get his radial bone back in place then do the surgery on the ulna the next morning, but then they changed plans and did it all that night in the OR.  Surgery ended up taking longer than they expected because the broken ends of the ulna were pretty messy, but they aligned them and inserted a rod that will stay for three months.  By 11:30 David and I were in the PACU gratefully looking at a sleepy, but more comfortable child.  That night I lay next to Adam’s bed listening to him breathe and thought back to the long ago morning when God had fed me those words of truth and grace.  I felt so overwhelmed at His kindness and graciousness.  So many times we hear that grace is given to us when we need it; but in this case, it felt as though He filled my soul with grace and then He gently led me through the hard parts of the day.  While it’s one of the more severe types of forearm fractures, Adam could have snapped his neck.  And while there have been plenty of episodes of rough play and bullying, this was pure accident.  Strange as it may sound considering it would be the first day of the summer I’d choose to erase, I couldn’t help but worship God for his incredible goodness.

Adam’s recovery has been so much easier than I expected.  After a dose of narcotics on the way home Monday night, he’s only used Advil occassionally.  He is learning to eat with his left hand and today he started transitioning to going without his sling.  We had to go back to see the surgeon on Friday so they could x-ray and give him a real cast.  It feels much safer to see him plastered instead of splinted and ACE wrapped.  On Friday we go repeat x-rays …. thank goodness for husbands who think about follow up visits and wives who don’t like to navigate new cities. 😉

Thank you, thank you, thank you to our many friends who surrounded us that day with prayer and who continue to pray for Adam’s complete healing.  The feeling you experience when dozens of people pray at once is a feeling that I am positive would change an atheists heart.  It is not a gift we hold lightly.  So thank you from the bottom of our hearts!

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