Tyler's Broken Elbow

I should have titled this post "Best Laid Plans", because all those fun adult-only plans we made for our week sans-kids did not happen. (Well, we did purchase our KING mattress, but that's a story for another time!) Long story short...Tyler broke his elbow in Clarksville and had to have surgery at Vanderbilt to set the break. Here's the very loooong version of how it all went down...

Tuesday night, Russ and I had dinner at Houston's and were in the middle of watching the new Avengers movie at the theater when I happened to glance down and my phone and see a missed call and a "call me now" text from my Mom. I literally bolted out of the theater leaving Russ and my purse behind. Russ was not far behind me because Granna called him after she couldn't reach me. She told me that Tyler had fallen and that her neighbor (who is a nurse) thought his arm was either dislocated or broken and that he needed immediate attention. Apparently he went to bed in the full bed in her spare bedroom and was playing with his blanket and threw it into the crib that was also in the room. He tried to climb the side of the crib to get it, lost his grip and tried to brace his fall with his arm straightened out. 

Granna's neighbor stayed with Caroline so she could take Tyler to the Clarksville ER. Since it was after 8p and nothing else was open, this was our only option unfortunately. We left the movie and headed home to wait for the verdict. It took a solid 2 hours of waiting in the ER before Tyler was even seen in triage! Ridiculous! Granna said it was slammed and that she went up and asked every so often if they had been forgotten. I told her next time she needs to say he is passing out to be seen quicker! Tyler was apparently a trooper the entire wait and just pitifully sat in her lap and whimpered a little every now and then. She tried to find him and snack and some lemonade while they waited, but the darn vending machine took her money and gave her nothing! 

When the triage nurse called me for permission to treat him around 10p, he said that Tyler had definitely done something to it and that he was taking him for x-rays and that the doctor would call me with more info. So more waiting! The whole time I was texting with Elisha (Tyler's Godmother who is also from Clarksville and also happens to be a pediatrician) and she just kept telling me to get him out of Clarksville to Memphis so a pediatric orthopedic could examine and treat him. And that if he was stable (i.e. had a good pulse in his fingers) that Tyler would be ok to make the trip. So I was feeding all this info to my mom while we waited to hear from the doctor. 

When the ER doctor finally called me at 11p, he said that it was broken and that Tyler needed surgery. I told him I wanted him transferred to Memphis, but he said that while his fingers did have a good pulse, he did not think he was stable enough to get him to Memphis. And that he recommended Vanderbilt Children's in Nashville. They planned to put in an IV, give him some morphine for the pain and transfer him by ambulance. I was definitely ok with this plan. Once we heard the news, I haphazardly threw some stuff in a bag and we were in the car and headed to Nashville by 11:05p! I kept thinking that if we had left when Mom first called me that we would already be there! Ugh!

Mom's phone was dying so she turned it off to save power and said she would call me when they got to Nashville. I was absolutely LIVID when she finally called me 2.5 hours later...not at Mom of course, but because they were JUST getting to Vandy! It is a 40 minute drive from Clarksville! I realize it takes time to do an IV and get the transfer papers together, but Mom said Clarksville had no ambulances to spare so one had to drive from NASHVILLE to pick them up! Ridiculous! I feel sorry for people who live in Clarksville and that they have to put up with this crummy care!! (Side note: The paramedics asked Tyler if he had ever been in an ambulance before and he said yes, when the turkey hit us. Ha! They gave him a strange look and my Mom had to tell the story. Ha!)

Because of the delay, we ended up getting to Vandy just a few minutes after the ambulance did, which actually ended up being nice so we could be there for this round of ER doctor consults and x-rays. Tyler was definitely glad to see us, too. It was our first look at his pitiful little arm, too. He was in really good spirits, talking and answering questions between watching cartoons on TV. But he did not want you to touch or move his arm and he was so tired...he slept a little on the ambulance ride, but not much else and it was 1a! The first thing the on-call doc said to us was "monkey bars, bunk beds or trampoline"? He said they see so many elbow fractures, but especially during the summer.

I went with him to x-ray and then we waited again for the peds orthopedic on-call doc to show and give us the verdict. Around 4a, he said Tyler needed surgery to set the break and that they would insert 2 pins into his elbow to stabilize it. He said that since his pulse was so strong that it didn't need to be emergency surgery (right then and there), but that it needed to be later that day and they would work him into the schedule. Their Chief Peds Orthopedist would be doing his surgery and he said Tyler would be in the best hands. He also told us that it appeared a nerve had been stretched by the injury because Tyler couldn't make all the finger movements he wanted. He said it didn't appear to be permanently damaged but a palsy that could take 3-4 months for him to recover full movement.

They wrapped it up to stabilize it a little better and we all got some shut eye.

Around 5a, they got us checked into a room and we all tried to get some sleep since we were running on nothing. That was easier said than done since Russ and I were sharing the pull out sofa bed and Granna was in a chair. We roused around 7:30a and I sent Russ to get us some breakfast. Tyler was asking for juice and food but he still wasn't able to eat or drink anything. Poor buddy. Around 10a, they came to get Tyler to prep him for surgery. Russ and I got to go with him to the holding area and stayed with him until the anesthesiologist came. Tyler was kinda grumpy at this point and did not want to be messed with or talk to anyone much (I don't blame him). But, whenever people asked how old he was he would say "3, almost 4" and then he started telling them about the Spiderman birthday party he was having at the park. It was so cute.

The hardest part for me during this whole process was when we had to leave him before surgery. It was only the 2nd time I teared up during this whole ordeal. I am sure it's the worst for all parents, but as I looked around the pre-surgery area, I couldn't help but think we were so lucky. He was there for a broken elbow and there was what looked to be a month old BABY waiting for surgery in the bay across from us. :( Thankfully before we had to leave him they gave him some "happy juice" in his IV that made him get really tickled. It was the first time we'd seen him laugh and smile since the accident. He kept pointing to Russ' face and saying "I see your nose!" and giggling. We walked with him on the gurney until we parted ways - us for the waiting room and him to surgery where they would administer the rest of the anesthesia.

I was jonesing for a diet coke, so we left Granna in the waiting room and explored the cafeteria and gift shop. We got Tyler a post-surgery stuffed snake...we thought he would like it because of his recent encounter with the snake at Aunt Carol and Uncle Mark's house. Russ also got him a small toy tank, too. We went back up to the waiting room and Tyler was already in surgery. It felt like just 10 minutes later, they were calling us up to tell us he was in recovery! Dr. Greg Mencio did his surgery and met with us in the family room to discuss. He said that it went really well. That they had to put 2 pins in each side of his elbow to stabilize it and that they also had to make a small incision to release the fluid. He said that the break and the setting that they did with the pins did avoid the nerve, but that it was badly stretched and as a result he would likely have the palsy for several months that affected movement in some of his fingers before it fully recovers. But that he did expect him to fully recover. Whew!When we told him were were from Memphis and that we wanted to do our follow up at Campbell Clinic, he was supportive and made us feel good about that choice.

After that, Russ and I got to go see Tyler in recovery. He was still sleeping and his arm was wrapped up ion a soft bandage with a hard splint around it. They quickly took us back to our room that we were in pre-surgery, which was super nice, and Granna met us there. When he woke up, he was very out of it, but he wanted the popsicle we had promised him post-surgery! He also had some juice and apple sauce. We gave him his gifts from the gift shop and he was excited...in a dopey-drugged up way.

The surgery resident came by our room shortly after, went through post-op care and said we were good to be discharged. I asked for a sling (which was so terrible, I ended up buying a better one on Amazon) and he prescribed hydrocodone to be taken as needed for pain. It was so awesome that we were able to fill it downstairs at the pharmacy onsite and it only took 20 minutes! It was at this point that first saw a copy of the x-ray that showed his break! We knew it was a type-3 break, but we were seriously all in shock at how bad it looked! I am so thankful that I did not see this pre-surgery...I think I would have had a much more difficult time processing it all. My poor little buddy!! :(

On the drive back to Clarksville, I booked Tyler's follow-up appointment for 8 days post-surgery at Campbell Clinic with Dr. Warner. At that appointment, they will x-ray it and he should get his hard cast. I had the highest praise for Vandy and Tyler's care there up until this point. I asked for our medical records before we left the hospital (since we were doing our follow-up care in Memphis) and they said we didn't need it. He gave me the photo copy of the x-ray and some notes on what they did during surgery and that was it. Lesson learned....never leave without the medical records!! I spent hours over days to attempt to get them and I even had to get Tyler's pediatrician involved!

Ready to go home!
We stopped for a late lunch on the way...Tyler was excited for nuggets and fries!

Uncle Brian sent us this picture and told us that some good could come out his
elbow surgery! Ha! We loved Henry Roengarten in "Rookie of the Year" as kids!

When we got back to Clarksville, it was close to 5p. We were all exhausted from only having slept a couple hours, if that. Caroline was so excited to see us and Mrs. Bryant said that she was such a good girl while we were gone. We were so grateful to have had her help so we could give our fully focus to Tyler. Even though he was so tired, Russ had to get back to Memphis (sick he has no sick time and hardly any vacation - ugh!), but Tyler, Caroline and I opted to spend the rest of the week in Clarksville so Tyler could recover. We didn't do a whole lot...we rested a bunch that first day to recover from being up all night for the injury. I made Tyler take his pain medicine for the first 36 hours (even though he said he didn't want it) because I was terrified he would suddenly be in major pain and I wouldn't be able to help him. He pretty much stuck to his normal schedule but just took a little bit longer nap in the afternoon, too. We watched a lot of movies and played a lot of iPad, too.

After wearing a tank top of Granna's for 2 days, I finally went to Target
and bought some sleeveless shirts for Tyler...nothing else would fit over
his swollen arm!! He was pretty excited for this Lego Movie shirt.  

Granna drove us all back to Memphis on Friday afternoon. She ended up staying that weekend and the entire next week since Tyler's school was not comfortable with him coming back until he had a hard cast protecting his elbow.  We are so grateful for her!!I was also supposed to have gone to the FedEx 400 in Dover that weekend for work, but one of my awesome co-workers stepped up and went for me so I could stay home with Tyler.