Perils of the Playground.

I suppose it was bound to happen the way she swings around on those monkey bars.  Last Friday after school I got a call from my husband that she fell off the monkey bars and probably broke her wrist.

You know that sudden feeling in the pit of your stomach you get when you know something is wrong? That’s the feeling I got when I heard my husband’s voice. He is not one to panic or think the worst so for him to say he thought it was broken I knew it was serious and I knew he was probably right.

I’ve never broken a bone so I have no idea how painful it is but I know it hurts. I’ve seen both adults and children with broken bones.  When I got home and saw my daughter’s tear-stricken face and the tell-tale swelling of her little wrist my fears were realized. She was cradling her arm so carefully and refused to allow us to touch it or put it in a sling. My heart broke for her. I never wanted her to experience that kind of pain. What parent does?

The six-hour wait in the ER was long. She wasn’t allowed to eat in case she needed conscious sedation to set the fracture. It took two hours after the x-ray to see the doctor who ushered us into the orthopedic room where the casting supplies were. The ER doctor was a lovely young female resident in her second year of training and she was very calm and comforting to my daughter.  I asked her how many casts she’d done that day and she smiled when she answered. She’d done five including my daughter and all were children who’d suffered injuries on the playground.   My little girl was so brave and admittedly scared when the cast was being applied. She didn’t want anyone touching her arm because it hurt.  Thankfully the doctor ordered some Advil and Tylenol to take the edge off a bit and it seemed to work.

She suffered what appeared to be a greenstick fracture of her distal radius. From www.kidshealth.orga greenstick fracture is a partial fracture in which one side of the bone is broken and the other side bends (this fracture resembles what would happen if you tried to break a green stick). It is a common fracture in kids and is considered an incomplete fracture as their bones are softer than adult bones. Children’s bones are more likely to bend than break completely.

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She was put into a thumb radial gutter cast because she had a bit of tenderness in one of the wrist bones as well so the ER doctor wanted to make sure to immobilize the thumb in case there was a second fracture that wasn’t visible on the x-ray.  It is a temporary cast and is open on the ulnar aspect of her arm in order to allow for swelling.  In a week or two we will go to the fracture clinic where she’ll have another x-ray and likely be put into a fiberglass cast for a few more weeks.

I’m thankful that she landed on her left arm as she is right-hand dominant and loves to draw. Within 12 hours of the cast being put on she had already started decorating it.

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My little girl is one tough little cookie.  While I never want her to experience physical pain ever again, my husband reminded me that this was an important lesson for her to learn.  She is vulnerable and can get hurt.  I hope she is a little more careful the next time she climbs those monkey bars again but I realize that every time she falls off, she will be determined to get back up again, even if I want don’t want her to.  If I had my way, she’d never climb those monkey bars again!  ;)

Open Letter Wednesday

Dear You,

I know you’re there. You come from all over the world. Some of you are oceans and continents away and some of you are around the corner. Whoever, wherever you are this is for you.

I appreciate the time you take out of your busy life to spend a few minutes reading about mine. I hope I provide you with a little perspective on what it’s like to be an urban doctor and a mom. I don’t pretend to have all the answers. I strive to be as honest as I possibly can with myself and with my writing. I don’t pretend to be a prize-winning writer – far from it actually –  yet that doesn’t seem to matter to you and I love that about you.

Don’t be a stranger. Tell me what you think. Challenge me!

Sincerely,

Dr. Mom

 

http://dailypost.wordpress.com/2013/08/13/open-letter/

Ten Thoughts Tuesday.

It must be really hard to make an on-call schedule for thirty-five physicians.

It must be even harder to admit you made a mistake on said call schedule, then attempt to rectify the mistake, only to make another one while fixing the first one.

Sometimes I wonder how some people can be so utterly incompetent. It really makes my head hurt.

I’ve had a sore neck and shoulders for the past month, on and off. I’m convinced it’s because I don’t have a supportive pillow but I cannot, for the life of me, find time to go find a new one.

All I can think about right now is a run.

And the cherry pie and vanilla frozen yogurt I’m going to have for dessert.

I think I might start training for 15 km.

And no, I’m not going to sign up for a race!

Humidity in October sucks.

My head hurts.

To A Marathoner.

My friend ran her first marathon today in Chicago. I’ve been following her training over the past 19 weeks and have been completely in awe of her. Her determination, perseverance and dedication is to be commended. She crushed her expected finishing time by 7 minutes.

I have been giddy with excitement for her all day.

When I started running 2 years ago, I’m not sure I even knew what a marathon distance was, let alone have any desire to run one! So tonight I wanted to honor my friend somehow. There’s no way I could ever run for as long as she did today but I felt I had it in me to try for a personal best for her.

I headed out for a 5km run. I pushed myself and gave it my all. I tried to run a sub-35 minute 5km but fell short by 45 seconds.

I’ve run 10km four times since July. Every single one was hard, but the last one felt different. I ran it 4 minutes faster (1:14:13) than the first time (1:18:20). I didn’t feel like everything hurt the next day. I actually felt stronger than ever before.

The very thought of running 42.2km has always seemed a little crazy to me. But suddenly half that distance doesn’t seem all that far. Maybe in a few years it might even be possible.

Never say never.

So to my friend GK, I say THANK YOU for inspiring me to keep going 1 kilometer at a time.

Our Final Moments With Fizzy.

On the evening of October 7, 2014 our cat Fizzy died peacefully at home.

He’d been diagnosed with chronic lymphocytic leukemia in December, 2013 after we noticed a slow but significant weight loss over the previous year.  He enjoyed one more summer basking in the sun and lying underneath the lilac tree.  He had a few more kitty fights with his companion Scully.  Over the past week, it was becoming clear to us that he was losing more weight, moving more slowly and the loss of muscle started to affect how much he could walk.

On the day he died he spent the afternoon lying in the sun in our backyard.  He drank some milk and got lots of cuddles from my husband.  While husband put the kids to bed,  I went to the basement to see Fizzy and found him in the final stages.  I ran up to get my husband.  Daughter knew something was wrong but we didn’t tell her what has happening.   After spending a few minutes with Fizzy husband went back to the kids’ room to ask them if they wanted to say goodbye.  They said no.   Meanwhile I stayed with Fizzy.  I stroked his fur and told him it was okay to let go. I told him that he had been a wonderful companion to husband and that we all loved him very much.  I saw him take his final breath. Husband returned and saw his paw move for the last time.  We lay with Fizzy for a few minutes then husband went back up to the kids room. By then our son had fallen asleep but daughter was still awake.  She heard her daddy coming up the stairs and said “Don’t tell me!”  She obviously knew what had happened.  He stood by the side of her bunk as she hugged him and stroked his hair.  After a while he said, “I have to go do what needs to be done.” She replied, “Yeah, dirty work.

We buried Fizzy in our backyard under the lilac tree wrapped in husband’s band t-shirt.

The next morning our son asked where Fizzy was and his big sister told him to be quiet, that daddy was sad and not to say anything.  Barely 6 years old and she was protecting her dad.  She drew a lovely picture of the family and wrote Fizzy’s name (she spelled it Feze) next to his picture and gave it to her dad.  She also made sure to give her daddy extra kisses that day because she knew he was sad.

The other night she asked me how exactly Fizzy died and if I was with him.  I told her that I was and tried to explain to a 5-year-old the process of death.  I told her that his blood was sick and that our blood is important because it carries air for us to breathe and food for our bodies to work.  I told her that finally Fizzy’s blood just couldn’t carry enough food or air and his heart couldn’t work anymore.  Once his heart couldn’t work, his breath would stop too. She seemed to accept the explanation and then told me “I think I miss Fizzy.  I think I loved him more than Scully.”

And then her little brother asked, “Is Fizzy died?

Losing a pet is hard.  I lost my first cat when I was 23.  It doesn’t get any easier.  Now that I’m a parent I’m not just dealing with my loss, but also now having to explain death to my kids.   When she asked me to tell her about how he died and why he died I found myself wanting to dodge the question, telling her it was too late and time for bed. I wanted to protect her from knowing too much too soon. She’s not even 6 years old!  But she’s so much smarter than me. She knew I think, that I was dodging the questions and she wouldn’t take no for an answer.  I worried that my explanation wouldn’t be enough but when I was done she seemed satisfied and we said goodnight.

Ah … Fizzy, we will miss you.

fizzy

First, do no harm …

Yesterday, a news story came up on my FB feed.  I’m still thinking about it and trying to figure out how I feel about it.  I decided to write about it, hoping it might help me process my thoughts.  It’s about a 29-year-old woman with stage 4 brain cancer (glioblastoma, the same kind of tumor that Dr. Greene (Anthony Edwards) on ER had) and she is going to die on November 1.  She lives in the U.S., in a state where, apparently, there are laws in place that allow patients to take their own life when terminally ill.  She states she’s not committing suicide, rather, she is taking control of her illness and deciding when and how she will succumb to it, not the other way around.  Most of the comments posted after the article are all like, “Wow, what a brave woman”, “Good for her”, “I’d do the same”.

Really?  I was kind of surprised that no one seemed to question the ethics here.

I can’t even begin to imagine what this woman is going through. To be diagnosed at such a young age with terminal cancer, it’s truly heartbreaking and tragic. One of my colleagues said she’d probably do the same if she were in that situation.  I’m really not sure I would, to be honest.  Or maybe I would? How can one ever know until faced with the reality?

I have three children.  This young woman has none.  Would her decision change if she had kids?  How would you explain to your children that you are going to end your own life before the cancer gets a chance to?

Death is a natural part of life – granted, dying at 29 doesn’t seem all that natural.  Dying at 90 on the other hand, does.  Still, we are all going to die, none of us can ever know when or how, that is, unless we are diagnosed with a terminal illness and even then, no one really knows how long we have.  Last spring, I visited a patient dying of prostate cancer. I saw him about 12 hours before he passed, peacefully, at home, surrounded by his family. When I spoke to his wife the following morning, she struggled with the fact that she was asleep when he died.  I wondered if it would have been easier for her to witness his death? I’m sure it would have been difficult regardless.  To the very end, my patient hoped and prayed for a miracle.  It was never stated, but you could see it in his eyes. He didn’t want to die; he didn’t want to leave his wife and children. He should have had more time. He kept fighting to the very end.  I admired him for that.

I have a hard time knowing that this young woman is going to actively end her life. That she picked the day she was going to do it, much like one picks a wedding day.  It’s two days after her husband’s birthday.   She has been told there is no cure, that her final days will be spent in pain, perhaps with multiple seizures and it’s not something she wants her family to witness.  I understand that, I really do, but there are ways of helping dying patients be more comfortable in the final stages of life.  It’s the whole reason Palliative care exists.  The process of dying has to remain a natural part of life, once we start helping patients to die, we no longer adhere to the Hippocratic Oath, in my opinion.

First, do no harm.  A physician, in good conscience, cannot be a party to the death of another human being. I can already hear those on the other side of the argument – NOT assisting a patient to “die with dignity”, causes harm.  I don’t believe it does and I don’t think this is what Hippocrates had in mind when he wrote the Oath.  I don’t wish for any individual to suffer on their deathbed, far from it. Medicine has come a long way in the past 150 years – expected death can be painless for the vast majority of patients.  I think we are actually inviting more harm to patients, their family, and society as a whole if we decide that assisted suicide, euthanasia, dying with dignity – whatever you want to call it – is okay.

It’s just not.