Monday, March 19, 2018

A Full Rich Day

Here at the 4077th Casa Auntie J, it's been what we like to affectionately call "a full rich day."

In other words, I've run me off my own feet.

Since 6:10 a.m., I have done the following:

  • Woke up and checked on Oldest, who had gotten sick in the middle of the night. Still sick. Texted her ride to say she wasn't going in.
  • Got up again with the twins. Middle informed me that she didn't think she could do a full day of school today (it was supposed to be her first). Okay, half day.
  • Drove Middle to school. Forgot phone.
  • Came home and copied new crock-pot recipes from web browser to Word.
  • Called Middle's school nurse back to confirm that I had, in fact, not given Middle any Tylenol for her persistent concussion-related headache yet this morning, because I am already frazzled.
  • Composed grocery list and checked grocery budget.
  • Got dressed in real clothes.
  • Got out of the house ten minutes late. Nearly forgot phone.
  • Aldi run. I have half an hour to shop.
  • Picked up Middle from school at the halfway point, but 15 minutes late. Darn having to pack my own grocery bags, but I saved a good $17 on my own estimate of my total.
  • Hijacked Middle and went on the second half of the grocery run at Walmart (including the big kid's birthday presents). Spent some time on the trip explaining why I shop on a budget and how I compare prices. (It all started because she speculated about having lots of money, enough to fund her own phone for 15 years.)
  • Didn't even leave the store when I realized we'd forgotten the sunglasses I'd promised we'd get Middle (they have a bunch for $2.50). Ran back in.
  • Got home in time to unload the car (yay, muscles!) and start putting stuff away before Dan had to leave for work.
  • Put dinner (new recipe) in the crock pot. (Lemon Garlic Roasted Chicken, if you're interested.)
  • Sliced my thumb open while trying to cut a whole garlic bulb in half. (Nothing a bandaid didn't fix. I'm fine. Honest. I did NOT pull a startling impression of my sainted mother. This was actually for tonight's dinner.
  • Prepped 15+ pounds of chicken for both fridge (tomorrow's birthday dinner) and freezer.
  • Prepped scallions for the freezer with Middle's help.
  • Realized I totally forgot to eat lunch.
  • Had a snack.
  • Wrote this post.
  • Realized Middle probably forgot to have lunch, too. (Mother of the Year award, here I come!)
And I still have to put in the potatoes to bake for dinner and make tomorrow's cake for Special Edition's 21st birthday (I will not have time tomorrow, that's for sure). AND I have writers' group tonight.

Wednesday, March 7, 2018

Hard Hat and Bubble Wrap, Stat

At Middle's follow-up with her doctor on Monday, she was referred to what's called the "concussion clinic," a part of the health group's practice that specializes a little more in concussions and their treatment.

We went there today. I had to hold her elbow again today as we walked into the building, much like I had on Monday when we walked into the doctor's office. She's still having trouble walking in a straight line.

I helped Middle fill out the demographic information on the computer screen, then concentrated on my own paperwork to fill out while she completed an assessment test designed to determine how impaired her cognition is, as well as gauging her symptoms. I was sternly instructed not to help with this part, so I didn't...with the exception of defining a few words that Middle had trouble with.

I couldn't help but think she might've been able to figure them out on her own, had her poor head not been in a jumble. She's such a smart cookie.

We went through the spiel again with both the nurse and the PA about Saturday's accident. When he asked me what I meant by "nonresponsive for 75 minutes," I told him she didn't talk or respond or say anything during that time, no matter how we tried to get her to talk to us. Basically unconscious, sir, with the exception of being able to see into her eyes a tiny bit.

Middle still couldn't perform the horizontal nystagmus (that's put-your-finger-on-your-nose, for you folks not up on your big words) today, just like Monday. She still had trouble tracking where a finger was located if asked to touch it.

The upshot of today's visit? Her concussion is severe. Recovery will likely be slow and take time. (These were not the words my notoriously impatient, let's-do-it-now child wanted to hear.)

We have a referral to a pediatric neurologist, just in case. We're starting that now, because it takes about two months to get in to see one. If we don't need it, we can always cancel the referral. But we don't want to be a month behind if we discover in a month that we do need that referral.

Middle is also being referred to physical therapy to help with her balance and dizziness issues.

The PA at the concussion clinic drew up a pretty comprehensive plan for Middle's return to school, based on her assessment today. She's out for the rest of the week, and goes back for half-days on Monday. I'm glad she doesn't have to go back yet, based on her continued balance issues and sensitivity to light and sound.

We go back to the concussion clinic for a follow-up in two weeks to see where we are.

In the meantime, I think I'm investing in a hard hat and bubble wrap for my kid, whose head is apparently not as hard as I thought.

Monday, March 5, 2018

Survey Says

I took Middle in this morning to see her doctor because she was still not feeling quite well and her head was still in a significant amount of pain. Middle had actually approached me last night, worried about going to school today. Well, I was worried about sending her. So when I called the doctor's office and was offered an appointment for Tuesday, I asked for something today.

When we arrived, I learned that the cardiologist from the hospital's affiliated group had already been in contact with our doctor and had confirmed Middle's diagnosis of the rare Wolff-Parkinson White Syndrome.

Apparently, the way it appears on the EKG is very distinct, and her EKG displayed the classic hallmarks.

Middle had a tough time performing some standardized tests, showing that she was still having difficulty with her balance. Her vision was still a bit blurry.

The doctor agreed that Middle needed to be off school today, and tomorrow, and referred us to both the concussion clinic as well as a pediatric cardiologist.

With her Wolff-Parkinson White Syndrome confirmed, our next step is going to be meeting with the cardiologist and seeing what treatment options he suggests.

Sunday, March 4, 2018

We Don't Do Anything Halfway

Middle and Youngest are involved in bible quizzing at our church this year. It's their first year doing it, and they're having a blast. They're also learning a lot, having memorized lots of verses from the end of Genesis (they're studying Joseph's story) and Ruth. They have quiz meets once a month at various churches around the area, and this month's quiz meet is at our home church.

To that end, yesterday the kids from our church's quiz team had a "fun quiz" in the youth room at the church, just to have a good time, play some games, and get ready for next weekend's quiz, which will also be at our church.

The bunch of us trundled off to the church yesterday, where I discovered we all didn't have to stay, just the twins. To that end, Hubby brought the rest of us home, where he took a nap, Oldest watched some TV, and I decided I would do some second-round editing work on a project of my own.

All was going swimmingly until I got a phone call from Curly Sue, Middle's coach. [Mark time: 11:54 a.m.]

Once again, let me say right here at the outset, Middle is fine.

"I'm here in the restroom with Middle," she explained. "She's not feeling well. She got a question wrong and got upset, so I had her go to the bathroom to wash her face. When I came back to check on her, I found her on the floor. She fell and hit her head. I'd like to put her on the phone with you."

Well, absolutely.

Curly Sue put me on speaker phone, and I talked with Middle as best I could, given the tremendous echoing acoustics that bathrooms are known for. Middle wanted me to come get her.

I was already putting on my shoes.

I ran upstairs to wake Hubby and tell him I was leaving to get Middle and why. In retrospect, I should've made him come with me.

But I digress.

I drove the twenty minutes to the church. [Mark time: 12:23 p.m.]

Curly Sue met me at the door and led me back to the girls' bathroom in the children's wing where Miss Easel sat with Middle on the bathroom floor.

Conveniently, Miss Easel is Youngest's homeroom teacher at school, and teaches English/Language Arts and Social Studies to both girls. (I love this valley where we live and its faith history.)

Middle was awake and alert. I could see the nasty red welt on the left side of her forehead. She explained she'd tripped over one of the stools by the sink and hit her head on the counter. "My face feels like a mask of pain right here," she said, drawing a line down the middle of her forehead and off to the right, under her right eye.

"Did you hit the right side of your head when you fell?"

Middle nodded.

Curly Sue concurred. "When I found her laying on the floor, she was on her right side. I touched her leg, and she came awake, and started crying."

Curly Sue had explained that she'd sent Middle to the bathroom to wash her face and pull herself together after becoming upset over missing an answer on a question. Curly Sue and Miss Easel both suspected Middle might have been dehydrated after being sick the last three days with a stomach bug. Maybe, I suspected, but I know my girl, and she was likely mad at herself for missing it, and more distressed than normal because she's still tired from being so ill.

I studied Middle for a moment, not liking her ashen color under her caramel skin tone, nor the uncontrolled twitching of her legs and the tremors in her hands. "Do you remember falling to the floor?"


I exchanged glances with Curly Sue and Miss Easel. Oh boy. I was really hoping this wasn't going to result in an ER run, but it was looking more and more like that's where we were headed. "Are you dizzy?"


"Do you think you can walk to the car?" I pretty much expected her to say no; this bathroom was a long walk down the hall to where I was parked.

"No, I don't think so."

Curly Sue went to retrieve one of the church's wheelchairs while Miss Easel and I waited. When Curly Sue returned, Miss Easel and I had to lift Middle bodily and get her into the wheelchair—Middle could hardly help us. Not good.

We navigated out of the bathroom, and Curly Sue, amazingly attuned to Middle, suggested that we just wheel her all the way out, bypassing the multi-purpose room, so Middle didn't have to appear weak in front of her friends. Surprisingly, Middle wanted to stop in and have everyone pray for her. She also wanted to see her twin.

The gaggle of kids gathered around, and all three leaders prayed over Middle. As we prepared to wheel her back out, Middle said faintly, "I want to talk to Youngest."

Youngest had cried in my arms once she saw me, and I had held her as the ladies prayed, assuring her that Middle was going to be okay.

Middle whispered, so Youngest leaned down closer to hear her. "What?"

Middle tried again. "Have fun." [Mark time, 12:42 p.m.]

That was the last coherent sentence she said for more than an hour.

Curly Sue and I got Middle into the car, and I called Hubby for the second time, telling him I was taking Middle straight to the ER. She was lethargic and I had to buckle her in myself and everything was just lots of not right. If he could get a ride down to the hospital, I figured I could call Waffle and have her come get us home from the ER later.

We hung up; I drove the seven minutes from the church to the ER as fast as I could. As I made the turn onto Norland, I peeked in the rearview mirror. "Just another five minutes, honey."

When I turned on to Fifth, I realized I hadn't heard anything, and risked glancing back. "Middle? Are you still with me?" Repeated glances back showed me that her eyes were rolling back in her head. "Middle!"

I have never been so grateful to see zero cars in the drop-off at the ER entrance. I parked and threw on my hazard lights and ran for a wheelchair. I yanked the car door open and unbuckled her.

An ER tech appeared over my left shoulder as I was trying to figure out how I was going to get Middle out, since she was no longer responding to me. "Ma'am, do you need help?"

"Yes, I do!" [Mark time: 12:50 p.m.]

He hauled Middle out and into the wheelchair and took her right in, pushing her straight to the triage desk. I figured I'd deal with actually parking the car when I had a free moment and my kid was under care.

The nurse took one look at the tech's face and my child and stopped assessing the patient sitting on the chair next to her. "I'll walk him in myself. You take her. What's her birthday?"

I rattled off her birthday, flubbing the year at first then correcting it. I explained what happened and the nurse printed off a wristband, and then the tech was taking us back to the room the nurse was going to assign to the patient still waiting on her scale.

The tech and I got Middle out of her clothes and into a hospital gown and hooked up to an O2 sat monitor. "Middle," he asked, "can you tell me what day it is?"

Middle looked at him blankly.

"Can you tell me what year it is?"

Middle didn't respond.

"Okay, the doctor will be right in," he assured me.

I looked at my stuff and wondered if I should go move my car yet, and the curtain pulled back.

"I'm Doctor Q."

Guess I'll wait to move the car.

I ran through the spiel again. Tripped over a stool in the girls' bathroom at church, hit her head on the counter on the left side (there's a mark), fell down and hit the right side of her head on the floor, doesn't remember the fall, mask of pain on the right side. Coherent before; not so much now. Yes, she was having trouble moving her neck. (Miss Easel and Curly Sue had wanted her to look up at the lights and Middle said she couldn't lift her head that far.)

Hubby called. I said I needed to call him back. I answered a few more questions for the doctor, who ordered a CT scan and some blood work, and called Hubby back when the doctor left.

Hubby asked if I could contact the ladies who help me out with rides home from work to see if they could get him down. He'd already talked to someone else, who wasn't available. I said I'd try.

Two nurses came in and started hooking Middle up to a cardiac monitor.

"Middle," one of them asked, "can you tell us your name?"

Middle made a tiny grunt but didn't say anything.

They asked her another question. No response. "I'm gonna start a line," one of them said.

I made a fist and rubbed on her sternum, hoping the pressure point would stimulate a reaction. "Middle?"


The nurses started taking stuff down. "She's going to CT now."

Okay then. [Mark time: 12:58 p.m.]

I decided this was a good time to get my car out of the drop-off lane, and Waffle called as I was moving it. I'd messaged that I might need her to come down, but I'd not gotten back to her to say any more than that. I explained the situation and what I might need, but that I still needed to see if I could find a ride for Hubby and I needed to arrange for something for Oldest if we were going to be here a long time and several other details that required my attention. She said to keep her posted and let her know what I needed.

I parked the car and made the first call as I walked back in and got a security pass to get back to Middle's room. My friend could not, so I figured I would make the next call after I spoke to registration, who was waiting for me with Middle when I arrived back. After I finished with registration, I called my other friend, who said she could give Hubby a ride. She'd pick him up in 15 minutes. Hubby's Facebook post about needing a ride had gotten him a faster response, so I called her back to say someone else had beaten her to him. And then I called my mother, down in Florida, to let her know what was going on, leaving her a voicemail message.

The nurse put in an IV line and drew the blood for the labs the doctor had ordered.

Then I settled in to wait, watching tears occasionally leak out from Middle's eyes and wiping them away.

This was so very different from our previous concussion adventure last spring. Middle had not done this then. She had been able to answer questions when we got to the hospital.

Minutes ticked by like hours. Middle was no closer to being responsive, and I started thinking about what I might need to do if she was admitted. I have what I need with me if I need to spend the night. What if it stretches longer? Am I supposed to work Monday? I'll have to call off... What about the other kids? Oy... I sent Hubby a text with our room number.

"Can you squeeze my hand?" I asked, tucking my hand beneath her left. I watched as her ring and pinky fingers tried to curl around mine. Well, I know she can hear me. That was good news.

"Mom's right here with you," I told Middle a few minutes later as I rubbed her arm and wiped more tears that were escaping, hoping that Hubby would arrive soon. "Daddy's on his way."

Through what seemed like clenched teeth, I heard her whisper, "Uh-huh."

It was the sweetest whisper I'd ever heard.

Hubby arrived a few minutes later. [Mark time: 1:40 p.m.] Shock crossed his face as he looked at our very un-Middle-like child, laying there in the bed. He snagged the stool stamped with the words "STAFF ONLY" and sat down on the other side of the bed, holding her hand. "Daddy's here, honey."

Nothing. Just Middle's eyes, remaining at less than half-mast, like they had been for more than the last hour.

We talked quietly for the next few minutes, me catching him up on how things had gone since we'd gotten here. "You know," he said after I'd explained how fast things had moved, "people complain about how bad and slow this place is, but when it counts..."

"Yeah. I've been very pleased with how they've cared for Middle today."

The curtain rattled open as another tech came in. "Hi." She greeted us with a smile. "Doctor Q ordered an EKG."

Okay then.

It took her longer to hook up the leads for the test than to actually run the EKG, but she spoke to our daughter like she was actually there and comprehending, rather than nonresponsive.

Hubby watched the tech work. "This is not normal. She's very ticklish, especially on her sides."

I watched Middle's eyes. They were now about at half-mast. Improvement. "Her eyes are more open."

"All right, we're done!" Middle must have flinched as the tech removed the sticky electrodes from Middle's side, because the tech apologized. "I'm sorry. Sometimes they pull the skin."

The tech left, and Middle began to slowly start coming back to us. She started talking again, first in single words, then short sentences.

Dr. Q swept into the room. [Mark time: 1:50 p.m.] "Well, she's certainly looking better. I was beginning to think she might be staying if she didn't show any improvement."

Yeah, me too.

"How is she, compared to normal?" he wanted to know.

"She's back to about fifty percent," Hubby said.

"Fifty percent?" Middle questioned, sarcastic disagreement seeping into her tone.

Despite her sarcasm beginning to making a comeback, I agreed with Hubby.

Dr. Q nodded. "Her scans are back and they look good. No fractures that we could see, no bleeding in the brain. So it looks like it's just a really bad concussion." He paused for a moment. "Did you know she has an extra delta wave in her heartbeat?"

Say what?

Oh, yes, look at our faces. These are two parents definitely in the know.

"It's called Wolff-Parkinson White Syndrome. Because of that, I'm waiting on a consult from our pediatrician on call. I want to see what he says before I release you." He studied Middle, who continued to improve as we talked. "How long was she unresponsive?"

This resulted in more math than I was certain my brain could handle at the moment, but between Hubby and I, we determined Middle had been unresponsive for somewhere around 70-75 minutes. A scary long amount of time to watch your kid like that. (Five minutes would've been scary. 75 is crazy scary.)

Feeling very sneaky.
After Dr. Q left, Middle decided she'd like to actually hear the TV that had been on since we arrived in the room, but she quickly determined the air fryer infomercial was not to her liking. We moved on and settled on Fixer Upper. Hubby and I debated the merits of Chip and Joanna's style choices at the end of the one show while Middle grabbed Hubby's phone and tried to figure out how to bypass his password lock. She couldn't do that, but she did figure out how to get into the camera, which doesn't require a password to access it...

She also made several videos, mostly just of her breathing. We couldn't exactly complain there. We were glad she was. Oh, and there was giggling. Lots of giggling as she played keep-away with her dad's phone.

It was half an hour before Dr. Q returned, having consulted with the pediatrician on-call. He said he was sending us home. Obviously, if Middle had worse or recurring symptoms, we were to return right away.

Do not take my picture, Father.
Twenty minutes later, the nurse came in, I think a little surprised that we were still there. "Didn't he give you your discharge papers yet?"

Um, no.

She returned momentarily with them, and I asked about a gym excuse. The last time we'd done the concussion rodeo, the ER doc had given her a week with no gym.

"I'll go ask Doctor Q about that."

While the nurse took off to see about that, I flipped through the papers. Follow-up with our family doctor, to be expected. I'd make that call on Monday. Referral to the hospital medical group's cardiology practice...yup, we were gonna need that. I had texted Special Edition about Middle's adventure, and Mr. Nurse had said sometimes EKG leads can give a wonky diagnosis if they're not placed right. I'm not necessarily doubting Dr. Q's reading of the EKG, but until I hear a cardiologist confirm that my daughter has the rare Wolff-Parkinson White Syndrome, I'm not gonna call it a firm diagnosis. In fact, the cardiology practice may well refer us to specialists an hour and a half away just because of the rarity of WPW, and, well, Middle might need a pediatric cardiologist. Those you're only going to find in bigger cities, and we don't live in one of those. Our hospital is located in the county seat, which boasts a population of 18,000+ in the borough. It doesn't qualify, either.

The good news about WPW is that it's 100% treatable, even curable. And, for the most part, if Middle has it, it doesn't seem to affect her daily life too much.

By the time we were ready to leave, Curly Sue texted me and asked if she should just bring Youngest to meet us at the hospital. So we met them outside in the parking lot. Curly Sue was relieved to see Middle upright and more herself than she'd been three hours before.

We can only hope now that next week's quizzing event isn't nearly as exciting as yesterday's fun quiz.