Early Intervention

Lucy was evaluated by early intervention this past week. I was concerned with both girls' physical development in the early parts of the summer. It seemed most children their age were crawling and they still weren't. I texted a physical therapist I worked with and she offered to come look at them, but said that they were probably fine. I didn't have her come because I wasn't hugely concerned. Then Lucy broke her leg. 

Within the first week or so of Lucy getting her cast Clara started crawling. Although she's still not advanced by any means, Clara is still doing fine. She's currently crawling everywhere, moving in and out of sitting, walking behind a walker independently, and pulling to stand on everything. I'm no longer worried about her. 

Lucy, on the other hand, spent 5 weeks in a cast. The first night she came home she was moving all over the place. Since then she's been reluctant to do much. She's really not even rolling over consistently. She'll pull to stand if she holds on to your fingers but prefers to sit and play. She doesn't tolerate a lot of tummy time now. When she stands she's shaky and can't last long. Also, she has horrible posture and doesn't sit up tall like her sister. She has started to pivot and turn around while sitting. Whenever she does to much she seems to have a lot of pain at night. The other day W did a lot of standing with her and then that night was awful. She cried so much and was inconsolable. I think she was in pain as she just couldn't get comfortable. 

I do early intervention evaluations so I know how they work. I know a child has to have a "significant delay" in one developmental area as one way to qualify for services. I had a feeling the sooner after getting the cast off that I had her evaluated, the more likely she would qualify. Considering I was concerned with her physical skills prior to the cast it's no surprise I was looking to physical therapy as a good thing. So, the day after the cast came off I made a referral to early intervention. 

Her evaluation was this past Wednesday. I honestly had no idea whether she would qualify or not because I don't evaluate kids when the concern is their physical development. I evaluate when the concern is their speech and language development. 

Lucy qualified for physical therapy due to her not consistently rolling, transitioning in and out of sitting, getting on her hands and knees, etc. The therapist also blamed her poor posture on her having a weak core. Within the next few weeks a physical therapist will start coming to the house to provide services. I'm not sure how frequently at this point but my guess is that it will be once a week. 

I'm hoping Lucy won't take long to catch up and be where she should be with her physical development. I'm sure she and her sister will be running in opposite directions before I know it. 

Adjusting

Monday was one of the hardest days for me as a mom. W slipped and fell while going down the stairs and holding Lucy around 8 am. We weren't sure whether she was actually really hurt or not because she napped with me shortly after. She was upset and crying but also able to calm down and sleep. We called the pediatrician first because we didn't think it was necessary to rush her to the ER. We also have a super high deductible for ER visits so we were hoping to avoid that. The ped was able to get her in around 11 so I called my mom and she came over to watch Clara. W really wanted to go so he called his work and told them he'd be in late. 

We weren't able to see our regular ped because he is out of town so we saw a younger woman in the practice who I once saw and really liked (we are at a family practice that is also my primary). I nursed her as we waited to see the dr. As soon as we set Lucy down to get checked out it was obvious there was something wrong with her leg. To be honest, up until that point I had mostly just been holding her. Her leg was swollen and looked like it was at an odd angle. The dr was so nice and sweet about it all but expressed her concern and said she wanted to send us for x rays. She mentioned a pediatric orthopedic in Syracuse if necessary. 

We drove across town to an imaging center. As long as we didn't move Lucy she was fine, even smiling, babbling, and giggling at times. She would move and kick her left leg but held her right leg very still. 

When they brought her in for the x ray they told me I couldn't be in the room because of the radiation. I waited outside and listened to my little girl scream in pain as they moved and adjusted her for the right images. As I waited I realized I could see the screen. I looked up as the picture loaded and immediately saw a big break in the middle of her femur. I was heartbroken. When W came out with her I told him. At that point we both started to cry. We sat in the waiting room again and waited for a disc of images to take with us and to hear from the ped as no one had confirmed the break at that point. The phone rang and W answered it. The ped confirmed that she had a broken femur and told us to head home and get some lunch and that we'd hear from her about a ortho appointment soon. 

We brought Lucy home and started to pack a bag. We grabbed a pack and play and made the decision to also bring Clara. W's parents were willing to meet us in Syracuse to help with Clara as I didn't know how long it would all take. We got a call from the ped and learned we had to go to the ER at the children's hospital rather than an orthopedic. Apparently only they had a special split that Lucy needed. We stopped for food on the way and I was amazed as I had Lucy giggling in the back seat on the drive. She ate a bite or two of my lunch and seemed generally happy. During this time we were sure to keep her dosed with ibuprofin. 

We arrived in Syracuse and parked so I could nurse Clara. Then W dropped me and Lucy at the ER while he took Clara to his parents house. 

The waiting room certainly had its share of interesting characters. Luckily the dr had called ahead so we were taken back to triage fairly quickly. 

When we got back Lucy started to get really upset. They hooked her up to a pulse oximeter and tried to take her vitals. The alarm kept going off because her pulse would get high under distress. It was a horrible memory of our time in the nicu with dinging alarms. 

W arrived after about 45 minutes. We spent a long time in that room. We spoke with so many people and many of them questioned us over and over about the story. They were unable to load the disc with images so the x rays had to be repeated. That was when I snapped this picture of the screen 

After quite a while a team of two doctors came in to splint her leg. This was so much better than worrying about moving and handling her with a broken leg. She wanted to be held and comforted and I tried to support her leg the best that I could. 

Around 5:00 W's parents brought Clara to nurse and to see Lucy. Not much after that the drs came and told us she was going to have to get a spica cast under anesthesia and that we'd be spending the night. 

They moved us to the children's hospital on the surgery floor. A new set of doctors/surgeons came to talk with us. They said because she had the few bites of my lunch we were going to have to wait 8 hrs for anesthesia. They discussed waiting until the following day for the cast. We really voiced our preference to have it done that night. They came back and said the surgery team would go home and then return at 9 pm for them to do the procedure. Unfortunately the nurse on this floor was not very pleasant. Whenever we asked her for anything she acted very put out. W's parents hung around and then went and got dinner. While they were gone I pumped since they wouldn't let me feed Lucy. We ate and then I fed Clara before his parents took her to their house for the night. 

We then hung out with Lucy. We had the iPad with us so were able to put on some baby Einstein for her. She was such a trooper despite it being about 9 hours since she had last really eaten and it being an hour past her bedtime. She showed me a few times that day that she knew the sign for milk by requesting spontaneously. I felt horrible that I couldn't feed her. Lucy picked purple for her cast when they brought us the colors to see. They didn't think she would want to or be able to pick, but giving them choices is something I do regularly. 

Around 8:30 the surgery team came to get her. They sent us to a waiting room and told us it would take between a hour and an hour and a half. Since it was a children's hospital there were games and toys in the waiting room. I found a game of memory and made W play with me as we waited. 

Eventually the dr came to tell us they were done. The dr said everything went well and discussed about a month as a timeframe for the cast. She talked about diapering while in the cast and looked at me with doubt when I said I still planned to nurse. She left the room and told us they would call on the phone when we could go down and see her. It took what felt like a long time, but they called after a few minutes and we headed down. When we saw her I found that same bitchy nurse giving her a bottle. When I said I wanted to try to nurse she rolled her eyes and walked away. To me nursing was what we all needed. I know it relaxes and comforts her and I felt like we needed that time together. 

Pretty quickly they moved us upstairs to where we would be staying the night. We got to our room around 10. The nurse gave me a tour of the floor that included a sensory room, a play room, a lactation room with pumps, a Tim Horton's down the hallway, and the kitchenette area. The hospital was so amazing and nice. No one should ever have to be there but it's so amazing for those who have to. We had a large private room with a bathroom and pull out couch for us. 

I nursed Lucy awkwardly with the help of a pillow or two and she fell asleep in her hospital crib. 

When the nurse came in around 1 to check her vitals she woke up. She nursed in our bed but then wouldn't go back down in her crib. At that point we did what we do most nights at home. We put her between us in bed and went to sleep. I was a little nervous about co sleeping at the hospital, but everyone was great. They came around 4 am and tried to take her vitals without waking us up. 

The next day was filled with drs coming to check, physical therapy and occupational therapy coming to talk about caring for her in her cast and the possibility of an adapted car seat. We were able to squeeze her into her own car seat and left around noon. 

We are all adjusting at home. We bought a bean bag chair and cut a bumbo seat to fit her. She's been so tough and I think her sister is having the hardest time with it all. 

Diapering is a challenge. The cast is open  in the crotch and basically you stuff a smaller diaper within and then put a large one on the outside. I'm trying to figure out some kind of cloth alternative for the outer cover rather than a huge disposable one. 

We've had a ton of help and support. Thank god for friends and family! 

Broken

Unfortunately little Lucy has a broken femur. After our X-rays we were sent to the children's hospital. We spent quite a bit of time waiting and had to get more X-rays taken. The surgeons talked with us and other people questioned us over and over again about what happened. They put her in a temporary split and didn't let her eat. 

They just took her into the operating room. She needs to go under anesthesia to get her cast on. It's called a spica cast and will cover about half of her body. 

I can't believe that a little slip on the stairs  caused so much damage. I feel so terrible.