Location #1: Urgent Care #1Today was time to get Joseph's sutures removed, so Chris took him this morning back to the original pediatric Urgent Care, where we had received excellent service and the suture removal would be free. The original doctor was not working today, so a different doctor tried to remove the sutures and, by all reports, this did not go well. The doctor got one stitch removed before calling off the procedure, saying that the event was becoming too traumatizing for Joseph and that he needed to go somewhere for sedation. She recommended our going to a hospital Emergency Room.
|Mary painted a picture of Daddy and John accompanying Joseph, |
who is wrapped like a burrito on the examination table while the doctor works on the sutures.
Location #2: Hospital Emergency RoomChris next took Joseph to the nearby Emergency Room, although we were loathe to face paying many hundreds of dollars just to walk in the door. Chris spoke to numerous officials at the hospital and all said that (1) we'd have to pay the full ER fee (even though the Urgent Care centers are an extension of the same system as the hospital) and (2) that they would not sedate Joseph for removing two stitches.
Chris came home after hours and we let Joseph take a nap. Meanwhile, he placed so many phone calls seeking help: a hospital advice line, plastic surgeons, a pediatric general surgeon, and so forth. All said that they would not sedate Joseph and one finally explained (more eloquently than this) that pediatric staff really should know how to restrain a two-year-old for a rapid removal of sutures.
I've been placed on modified bed rest for high blood pressure, which means lying in bed and in peace as many hours per day as I can with Chris or babysitters watching our children. But I came up with the idea that I should go with Joseph back to the original Urgent Care; whether it was pride at my importance or an accurate assessment of Mama's comforting presence, I thought I should try going with him for a better result.
Location #3: Back to the original pediatric Urgent CareI drove Joseph there at four o'clock, thinking naively that we might even be home for dinner with the family. There was nobody in the waiting room, so this was going to be a breeze! However, the doctor spoke to me and would not even try with Joseph. Honestly, I did not like the attitude I perceived. She seemed to put the blame on Joseph for 'throwing a tantrum': what else is a two-year-old going to do when he is wrapped as a burrito and having sutures ripped out of his face? She emphasized that Joseph would need sedation and had no explanation when I told her how many medical staffers had told us today that they would not sedate him.
Location #4: A second pediatric Urgent CareThe doctor sent me to another pediatric Urgent Care center across town where they were expecting me. God's graces were shining on us in that, again, there was no waiting time. The Physician's Assistant took one look at the sutures and went to get the doctor for consultation. Here I felt clarity for the first time all day: The doctor showed me that Joseph's stitches had become embedded in the flesh. The doctor approached me as a mother herself. She said we had brought Joseph back within the number of days assigned, that the laceration was deep enough that we could not have brought him back any sooner for suture removal, and that this was not our fault. She said that the sutures becoming embedded is a known complication that she estimates happens in about one of fifty cases: Joseph's face simply healed really well and fast!
Additionally, she explained that Joseph might well not need to be sedated, but that he needed an adequate number of pediatrics staff. At her pediatric Urgent Care, many of the staffers were absent that day and the substitutes were trained to work with adults. She had done suturing on a two-year-old earlier in the day using the adult medical staff and "it did not go well." She said this removal would be technically more difficult because they might need to do a "secondary laceration" (cut it open again!) and she did not want her non-peds staff working on him. I so greatly valued her honesty.
Clearly we weren't going to make it home for dinner with the family, so we refreshed ourselves with dinner at Panera Bread Company. Joseph at two-and-a-half is in a that chatty stage in which the child vocalizes everything passing through his mind, including describing his own actions. It's so important developmentally and very cute. With no siblings for competition, he and I chatted nonstop all through dinner: I loved it.
Location #5: the Pediatric Emergency RoomLastly, I took Joseph to the Emergency Room at the local pediatric hospital. The staff was very helpful as this lumbering Mama and her sweet boy moved room to room, hurry up and wait, hurry up and wait.
|Numbing gel takes 20 minutes to take effect|
A wonderful Child Life Specialist came in and made friends with Joseph. The doctor told me that she really did not want to sedate Joseph because this would be a ten-second procedure, so she didn't want to give him sedation that would require an hour to wear off. I thought saying it would be a "ten-second procedure" was an exponential exaggeration, but that it might go quickly, as in taking several minutes.
Well, it really was about ten seconds! The room filled with pediatric staff, the Child Life Specialist helped Joseph be distracted, and the doctor's hands worked lightening fast. Joseph screamed his head off, to be sure, but it was for all of those few seconds. As soon as the staff took him out of the burrito sheet, he exclaimed, "I want my fire truck!," referring to a fire truck toy brought in by the Child Life Specialist.
|Happily playing with the fire truck toy,|
after his trauma and before being given a Popsicle
All in all, I was out with him for five hours--a big difference after lying in bed for days--and was oh-so grateful to get back home to resting and being off my feet. Kudos to amazingly well-trained pediatrics medical staff!