Wednesday, March 24, 2010

Deferred Pain (Now THATS a bellyache)

“It only takes a second.”

“No home is ever completely safe.”

Yeah, you know what I’m talking about. We all worry about it a little, but you can’t hover over your children. And, the truth is, it wouldn’t really matter. Some things are just going to happen anyway.

“Mom, I jumped too high on the trampoline and now I have a belly ache.”

Gladys came upstairs on Monday morning around 9am. She had been in the basement with a friend.

“Okay, Sweetie. You okay now?”

“My belly still aches.”

“Let’s take a look. Yeah, I see a little reddish mark actually. Did you bump into the bar?”

“Yeah. I jumped tooooo high.”

“It looks okay, Honey,” I replied, kissing it, “Just lay down for a few minutes if its bothering you.”

She went to rest on the couch, and I went to check on the other kids. They were fine. Gladys continued to hang out on the couch. A little while later, she was in the bathroom throwing up.

“You okay, Honey? Let me get you some water. You really do have a belly ache, huh?”

“Yeah, my belly still hurts a bit.”

I called the mom of the other kids. Gladys must have a stomach bug, I thought. We were all sick – even my husband was upstairs in bed. I expected Andrew’s elementary school to call any moment, surely he would be sick as well. We turned on a video and spent the better part of the day on the couch, watching and reading. After noon, Gladys complained of intense pain in her shoulders and neck. I called the Cleveland Clinic, and mentioned the throwing up, the bellyache, and the strange pain in her neck. I may have said that she was on the trampoline earlier, I can’t remember now. Anyway, her belly didn’t hurt so much anymore. She had barely a fever and intense pain in her neck and shoulders. Gladys asked for juice, so I ran to the store (my husband was home) to buy her very favorite.

Around 5:30pm, Gladys became very hungry. She wanted the spaghetti and meatballs I had planned. I assumed she was through the worst, considering the good appetite, and began cooking. As the meatballs simmered in the pan, Gladys screamed.

She screamed. She thrashed. She gyrated herself off the couch.

My husband and I ran to her like the house was on fire. I had scooped her off the floor, but handed her off when he came running into the room. She wanted more ice for her shoulders – RIGHT NOW. I scrambled for ice as I dialed the Cleveland Clinic.

“Is that her in the background?”

“Yes. She has intense pain in her shoulders and neck. She isn’t a dramatic child. She is clearly in a lot of pain.”

“I see. Does she have a fever? Vomiting?”

They asked all the questions and I answered them. Gladys had calmed down, but she needed me to carry her to the bathroom. I carried her out to the van and we drove to the ER.

I carried her into the hospital, but by the time we were taken to our little room, she seemed cheerful again. We used the restroom, twice. She kept climbing up and down off the bed, investigating all the handles and buttons and St. Patrick’s Day decorations. She enjoyed the Popsicle, Gatorade, and goldfish: no fever, no serious complaints.
But, she told them the same story.

“I jumped toooo high on my trampoline and got a bellyache.”

Her urine had a high sugar count. Her blood showed elevated sugar and high white blood cell count. They couldn’t find anything wrong. Finally, they considered appendicitis. The doctor tapped on her back: nothing. She put her chin to her knees: fine. She raised her legs: no problem. Finally the doctor asked her to get off the bed and jump as high as she could.

She claimed it didn’t hurt so badly, but the look on her face won her a CAT scan.

By 2am, we were in an ambulance on our way to Metro Health Trauma with a Level 3 ruptured spleen. That is NOT a bellyache. That is internal bleeding. Even the sack around the spleen was broken. She had been bleeding into her abdomen all day. The pain in her neck and shoulders was “deferred pain” caused by her bleeding spleen.

Holy Cow.

Our entrance into Metro Health reminded me of those scenes on T.V. The doors opened automatically and the well-rehearsed transport team wheeled her swiftly into a very brightly-lit room filled with doctors who sprang into action.

They were soooo nice. They knew her story. They asked all the expected questions. They also asked if she had siblings and how she hurt her belly. They answered her questions about the ‘rainbow colored drawers.’ I held her hand, and for the very first time she shed a few quick tears.

By 4:30am we were settled into the Pediatric Intensive Care. They monitored everything. They answered my various “and then what would happen” questions that mothers are likely to ask. I fell asleep on the pull-out couch in disbelief.

The next few days were all about recovery. You could tell she was in pain, but she didn’t complain much. The nurses told me that the typical spleen ruptures were high school football players, who usually screamed in pain every hour and a half or so. Gladys required medication about every six hours. I was impressed, yes, but tried to convince her to ask for more pain medication. I could tell by her heart rate she could not be comfortable.

And, that is exactly how I could tell when she finally turned a corner too. One afternoon, we were both asleep when her heart monitor alarm rang. I assumed she had rolled over onto a cord, as she had before, but when I looked at the monitor I could see her heart rate steadily decreasing. Where it had been in the 130s/140s, I saw it decrease from 90 . . . 89 . . . 88 . . . 87.

I sprang off the couch.

“Gladys? Gladys, Honey? You okay?” I tried to sound real calm and sweet.

She rolled over and looked at me. “Yeah, Mommy.”

87 . . . 93 . . .95 . . . 94 . . .94 . . . 94 . . . 94

“Okay, Sweetie, get some rest.”

Her ‘deferred pain’ had finally subsided.

Now the only ‘deferred pain’ is mine – every time I see her jump.

As for the trampoline, we left it on the curb. No one asked why.