Saturday, March 12, 2011

Our ER experience and a broken arm

Last night I was cleaning up the kitchen, while Courtney was reading on the couch and watching the boys rough-house. Abraham was climbing up on one of the boys’ back and grabbing his neck, when suddenly the older boy got up and bent forward, causing Abraham to thrust forward while his legs flew up in the air. Preventing a dive head first into the hard wood coffee table, the older boy grabbed Abraham’s arms and pulled him back onto his back. Abraham screamed. I came out of the kitchen and picked him up, trying to comfort him. He usually only cries for a minute, and he would definitely stop when offered a bit of comfort nursing, but he kept crying, and he wasn’t moving his arm. I waited a bit to see if he calmed down, but I knew there was something wrong. Courtney and I suspected that his shoulder perhaps was dislocated, so I grabbed my ID card and (what I thought was) my credit card, put my rain boots on, wrapped Abraham up in a fuzzy blanket, and literally ran over to the ER, a good solid 200 meters, through the drizzling rain and cold. My heart was pounding and I had a big lump in my throat. Abraham cried and the suddenly he looked up and said cheerfully, “Is naining, mama!”

I had no idea what to expect when I walked through the sliding doors, but as a mother with a mission and one mission only, I addressed the first person I saw wearing an AUB badge, “I need a doctor.” I must have looked very serious, because almost immediately we were brought into a room where a nurse filled out a paper, took Abraham’s blood pressure, and then brought us to see a doctor. In fact, we saw lots of doctors. I’m going to guess because it’s a teaching hospital, all the residents wanted to have a look at Abraham. They were all very sweet, in their early 30’s, and spoke nearly perfect English with an American accent. Only one doctor examined him though, and every time he touched Abraham’s arm, he screamed a painful cry, “No way!! No way, no doctor fix it!! No way! Mama, fix it!!” It was quickly concluded that we would need x-rays, and paper work ensued. Our insurance file was not in order. Could I pay and then claim the money back? Of course. When I reached into my pocket to give the secretary my credit card however, I noticed that in the hurry I had grabbed my cash card (they look exactly the same, only the Mastercard has a small Mastercard symbol on it). After quite a bit of going back and forth, where I tried to convince them to go ahead and take care of Abraham first assuring them that I would send my husband to pay afterwards, Abraham and I were sent home to get means of payment. “No payment, no treatment.”

So I picked up Abraham, who cried as soon as I moved, in the blanket and ran the 200 meters back to our house in the rain, grabbed my Mastercard and gave Courtney a quick update, and then ran back again. I didn’t have to wait at all, and the process took only a few minutes. After having settled our payment we were brought into the x-ray room, where a very skilled technician took tons and tons of pictures of Abraham’s arm, shoulder and hand, all the while he was screaming himself hoarse on the stretcher. As horrible as the whole thing was, at this moment it was a good thing that Abraham couldn’t move his arm, because it made this part of the whole experience go quickly and effectively. After the pictures we got to sit back down in the ER area – Abraham calmed down as soon as he was back in my arms, and the doctors analyzed the x-rays and called the orthodontist down for a consultation. In the meantime Abraham was talking to me about all that he saw; “The doctor go THAT way, mama!” There was a baby crying in a separate booth next to us, “Baby cwying, mama. Baby want watch Beggie tales, mama? Make baby happy, mama?” Good thinking. Veggie Tales might have worked. He was trying really hard to be good, while bursting out into little sobs now and then, obviously from pain. Still very interested in everything and everyone around him. After a few minutes, the orthodontist examined Abraham’s arm once more to rule out nursemaid elbow (which is very common in young children apparently), but it was very clear that the problem was a hairline fracture on the elbow. The orthodontist proceeded to put a fiberglass cast on Abraham’s arm – he was being really good through the whole thing – stabilize it with a sling around his neck, and let me give him pain relief. The doctors told me to come back with Abraham in about two weeks, that the fracture should be healed within two-three weeks, and then sent me off home. On my way out I had to pay for the cast in the cashier’s office, and while the clerk was processing my file, Abraham fell asleep in my arms, exhausted, shirtless, wrapped in William’s blue, fuzzy blanket. It was almost one in the morning when I stepped into the wet and dark street for the short walk home.

Courtney was waiting for us, having spent the evening helping the boys, who were in tears, get to sleep, reassuring them that Abraham was going to be fine and that he knew they had not meant to hurt him, yet trying to get the message through that they will have to be more careful than they had been that night. What a difficult thing to manage.

I didn’t sleep much that night, waking up every so often to check on him – I slept the kind of sleep you sleep when you have a newborn, or when you’re watching over your child; alternating and light. Considering everything, it was a good night, and when everyone woke up we all had a long talk about everything that had happened in bed, all cuddled up. “Aimeeh bwoke aaahm, mama!” Abraham said with a cheerful voice. So pitiful, so brave.

Midnight ER admission, $40
Infinite amount of x-rays, $40
Cast, $40
My baby getting good and speedy health care, which helps him heal without any permanent injury, priceless.


  1. Hmm.. In Egypt when we had a nursemaid elbow once, the clinic here summoned their "bones specialist", an elderly doctor, who immediately fixed the elbow by touch simply. It took perhaps 5-10 minutes from the moment we entered the (very ordinary) clinic, and no casts required. Payment after treatment, of course. I would never return to someone who leaves my baby crying, waiting for money.

    For some reason I do not believe into a fracture in this case - what could have caused it? Fractures happen from strong impact, by falling or hitting. But from someone grabbing his brother? Maybe they expect foreigners are not satisfied unless they see something very material done, so they try find more than there really is?
    Poor boy, of course. Don't know, the whole Lebanon sounds so cold and and full of trouble, and completely inefficient while horrendously expensive.

    Nursemaid elbows seem common, indeed, I have girls and the older one had it twice under the age of 2 - once another mama by the pool took her by arms and swirled her around the same way she does with her boy (boys usually sturdier), and once she herself stretched it out when refused to follow papa, who innocently pulled too hard.
    With the younger one we had already learned :).

  2. I saw the x-ray: it's a hairline fracture for sure, and the speed, weight and angle of the fall and impact make it possible, indeed. A freak accident, of sorts.