I was at home waiting for Brian to get back with the kids after school on Friday when he called me from the hospital (of course, he had left his cell phone at the house ) to tell me that he was there with Nathan, and that I needed to call Vern (a friend) to come and get the kids, bring them home, and take me to the hospital (we still have only one working car).
Nathan was playing while waiting to be picked up, and was sitting on the handrail. He saw a teacher coming and scrambled to get down (they aren't allowed to sit on the railings ). In his haste, he fell, face first, into the concrete, and knocked out his 2 top front teeth. Brian got there JUST as it happened, and was able to find the teeth, put them in milk, and take him to the ER. They were able to re-insert the teeth, and sent him for a CT scan.
Vern came back with the kids, I got them settled, and went back with Hannah to the hospital. By that time, Nathan was resting with an ice pack, and they had given him a shot of penicillin and a dose of some narcotic ( Brian couldn't hear which one). They had gotten the results of the CT back, and he had a fractured mandible on the right side, up by his ear. Since this is the most complicated joint in the body, they told us that they needed to send us to Iowa City to be seen by the pediatric orthodontic surgeon (at University of Iowa hospital, an hour and 15 minutes away). He would most likely need immediate surgery, hopefully that night or early Sat. morning, and he would have his jaw wired shut for 6 weeks. They gave is a packet with a CD of the CT results and the rest of his chart. They also told us that since he showed no signs of a concussion, didn't lose consciousness, and was stable that we could take him ourselves, and didn't need an ambulance.
Vern and his wife Judy were at the hospital with us, and left at that point to go get pizza for the kids while we were discharged. We came home to pack enough for an overnight for us and for Hannah, and to get the kids settled with Vern and Judy, who were going to stay with them until we returned.
We got to Iowa City within 2 hours of being discharged, but by that time (7 p.m.) Nathan was in serious pain, and dry-heaving, b/c of all the trauma and blood he's swallowed. He was a trooper, though. At UofI we had to wait to be seen in the ER, get triaged, and wait again. By this time,he was pretty miserable, but we found that Lego Star Wars computer game also doubles as good pain management for a 10 yo.
Since it's a teaching hospital, I lost track of just exactly how many Drs. we saw. The nurse, the physician assistant, a resident, the chief ER resident, the pediatric orthodontic surgeon, and his boss, who I *think* was the head orthodontic surgeon. After several exams and consults, and reviewing the CT scan, they sent Nathan up to radiology for a panorex x-ray (360 degree shot of his mouth) to see it from another angle.
So we had to wait for radiology to clear, and after a bit Brian went out to the front to make some phone calls to update people. While he was gone, they came to take him up, and he wanted me to go with him. So I had to carry Hannah in her carseat, the laptop, and the diaper bag all the way up to radiology. I swear it was like a half-mile. They take him in, and do the x-ray, and then bring him right back out. As soon as he starts to climb back onto the bed, he pukes up blood. LOTS. From when he swallowed it earlier. All over the floor. Fortunately, he missed me, Hannah, and the diaper bag. But he did feel a lot better after that. By the time we got back to his room, my shoulders were pretty much dead, and I had blisters from carrying the carseat. Of course I had forgotten to bring the sling...
So we waited some more while they reviewed the results, and watched the Olympics. It was about 8 or 9 pm at this point. Finally, everyone comes back in (3 docs, I think... ) and gives us the prognosis.
HE DOES NOT NEED SURGERY! He fell perfectly straight down on his chin, so his bite is still straight. If it were an adult or older teen, they would have wired the jaw even though it was a clean break, but b/c he's so young, it will heal on its own. He will need cosmetic/reconstructive work on his teeth, though, and there's anywhere from 50% to 99% chance that the teeth will die anyway, depending on who was talking. We were set up with the pediatric dentist resident and his student, who came in for another consult.
By this time, since he didn't need surgery, they agreed to give him more pain meds. It was 10 pm, and his last dose had been at 4:17. He got a Vicoden, and we waited for it to work while the pediatric team got their stuff set up. After about 45 minutes, they decided to go ahead and take him over to their own building and work on him there. We all walked over together - I swear (and I'm NOT exaggerating) it was close to a mile. It was about a 15-20 minute walk. Nathan made it about half way (bless his heart ) and broke down and asked for a wheelchair. He had refused one earlier...
Once we got to the pediatric dentistry building, it was a little after 11. They took some more x-rays, bite-wing this time, and said everything looks good. So they then proceeded to splint his front teeth by glueing a wire onto his 4 front teeth, which he keeps on for a week. We got our scrips, and were discharged. We finally got home around 12:30 am.
He's on a liquid-only diet for the foreseeable future, maybe able to add soft foods in a few weeks He's taking Tylenol 3 for pain, and doxycycline to prevent infection. He also has a rinse to use instead on toothpaste.
It's nothing short of a miracle that he's ok. A fraction of an inch either way, and he *would* have needed the surgery. And 3 inches either way, and he would have been killed by his jawbone piercing his brain. I am so incredibly thankful. Bad as it is, it could have been SO MUCH WORSE.
He's doing fine, today. He woke up around 6 this morning in considerable pain, but a couple of advil took the edge off until we got the scrips filled. The codeine is working wonders, but it seems to be making him hyper, though...
I am still in a bit of shock. Still processing it all. He was so brave, though... I was-so proud of him! But this was one of the worst things I've had to go through in all my years as a mom.
So if all of you could pray that his jaw heals, and that his teeth re-implant and survive. We have to go back to Iowa City on Wednesday to see the oral surgeon, and on Friday to the pediatric dentist. We'll be burning through a lot of gas... And our insurance isn't all that great (high deductible, only pays 50% of ER costs ), and we don't have dental coverage. We've been assured that it will all be covered under our medical, but you know how insurance companies try to avoid paying for anything... So who knows how much this will cost us... And things are already stretched thin...
But all that matters is that he's ok, and we got out of this with the best possible scenario. I am trusting that God will provide, just as he sent us a miracle in keeping Nathan from worse harm.
ETA - Went to the oral surgeon yesterday, and got good news - nothing has shifted, and they want to let it heal on its own, and treat any remaining bite issues with orthodontics later. Surgery would have little benefit, and many more risks. So he's on a liquid diet for another week and a half, and soft-chew after that. Back to the oral surgeon on the 12th. I am still in awe over the miracle that he didn't hurt himself worse...