This story might be gross. Just warning you.
My son broke his big toe. Yes, it was that son, the four-year-old who's always hurting himself, the one who's always getting into things, the one who got attacked by poison sumac with a vengeance. He flipped off a bench he was crouching on top of, and the bench slammed down on his toe on our tile floor. Ouch. What's worse is that we had just come home, it was 9 o'clock at night, and we were busy putting things away and sorting children and trying to get ready to get ready for bed (an arduous process around here), and I didn't really pay attention when he hurt himself--he's always doing it, right? So he actually had to hobble over to me before I noticed that he was crying a little more than usual and there was blood all over the floor. That's probably when I earned my dad of the year award.
I carried him to the bathroom and realized we probably had to go the emergency room. The nail was loose and already reddish-black, he had a big laceration down the front of the toe, and he was crying so hard he was almost dry-heaving. I felt so bad for him. I tried to gently wrap it and put ice on it. We arranged for a "babysitter" (my wife's brother...in other words, just an adult body to remain in the house, and most likely the kids would be up eating candy and watching movies all night) and I carried him to the van. He stopped crying so much and became more concerned why we were going to see a doctor about it. Poor guy. Then we drive to the hospital with a crying baby and a crying kid with a bleeding toe.
Luckily the hospital is so close. I carry him into the emergency room and he stops crying. The registration person at the desk asked me his name and birthdate. I can never remember his birth year. This happened a while back with my insurance company, too. She tried to calculate it with me -- let's see, he's four, this is 2011, his birthday is X, so... Then my wife walks in after parking the car. It turns out, ironically, that our registration lady is the same person who registered us at a different hospital's emergency department a few years ago (with the same kid, I believe) and once or twice over the years has seen us at church. So she recognized my wife! Which is nice, though it doesn't seem like a generally good thing for ER registration people to start recognizing you. At any rate, she and my wife are discussing on our new family events (new births, etc) while I'm wheeling him down the hall to triage.
The triage nurse unwraps his foot and his toe is still bleeding pretty hard and looks awful. She asks him how it feels and he, trying to look unconcerned, says "It's fine."
She gave him some ibuprofen and sent us for an x-ray of the toe, which I figured was just a formality. I assumed he just needed some sutures.
Eventually we get to a room in the pediatric ED, and we wait. And wait. Eventually we're seen and the doctor informs us that the distal phalanx was fractured. He doesn't know if this will require pinning or not so he'll send us for a consult first thing in the morning for a plastic surgeon or a podiatrist (it's now 11pm or midnight). He shoots the toe with some lidocaine and sends the ED tech in to irrigate and clean the toe.
The tech was very nice but very busy with lots of kids, being the only tech in the pediatric wing of the ED. At that point I felt like telling them I'm a nurse and volunteering to do whatever they need done--I had the impression the doc could work on the toe now, but had to wait for the irrigation to be done, so he had moved on to other kids.
During the clean-up the hard-working tech told me all about how he was a single dad of a few kids, since his kids had flatly insisted on staying with him after the divorce. He pulled a lot of hours as a paramedic and ER tech to put them through school and now college, spent the rest of his free time with them being a dad, and said he was going to vomit if another woman told him what a nice guy he was (since he's developed the theory that women say they like nice guys but really they like total scumbags.) I hope he didn't mind me as a fellow hard-working dad telling him what a nice guy he was. Readers--high-five that guy.
Anyway, back to the toe. After another long wait the doctor wants to suture the toe and see what he can do about the nail. The nurse has the foresight to have me hold a towel up so my boy doesn't have to watch it (why don't physicians ever think of these things?). But it's still not numb. Apparently big toes (and thumbs) are hard to anesthetize. He has to inject and re-inject the toe probably a dozen times to try to get to the nerve root. And this is what really hurt him the most, after the initial injury. He was crying but he tried so hard to hold still, and when the towel I held up slipped a bit he grabbed it and threw it over his own head. Still, as much as he squirmed, he held that leg totally still.
The doctor left to wait for the toe to numb up. My son tells me "I wish I was made out of metal."
The toe was sutured up but the nail was a loss. Removing the nail took forever. My son fell asleep during it (thank God for lidocaine). My wife had to leave the room to avoid passing out. I was a little grossed out myself. That's the irony of blood and guts, by the way. If I was in charge of the toe, I would've been fine. As it was I still had a job to do, so I was okay watching it but a little queasy. If I just had to stand around watching it, or if I had to hear about it, I'd want to barf. (Yeah, I know. I'm making you hear about it. Sorry!)
The doc asked me if I want to save the toenail. I was surprised but he said they could possibly clean it up and try to suture it back on. That sounded like more of a hassle (trying to keep it from getting caught on things, trying to keep it clean). It got forgotten about and tossed with the trash, however, so it's a moot point.
The tech redresses the toe. The physician assumed I'd see a doctor first thing, so he thought one dressing was enough, but the tech had the foresight to stuff a bag full of dressing changing supplies. Which was great, because we couldn't see somebody first thing.
We go home around 1AM, go to sleep, and call the consultant in the morning. It's Monday morning at 8:30 and I'm calling the office as soon as it opens. It turns out he's a hand plastic surgeon, and doesn't do feet. His secretary also said this was the second injured toe call they had since they opened, and somebody in the ER needs to stop referring toes to him. I call back to the pediatric emergency department and talk to a nurse who gives me the number of their pediatric orthopedic surgeons' group. With this unofficial (yet obviously accurate) referral, I went there the following day.
We waited in the waiting room forever. We watched Phineas & Ferb for the first time, which is a grand show. Finally we see the physicians--the orthopedist, his resident, and a pediatric resident--and they say there's no surgery to be done, keep it clean, he can walk on it all he wants, but--get this--try not to let him run or jump on it too much. Ha. Ha. Ha.
For the next week we keep him from jumping on the trampoline and riding his bike. Which was sort of like trying to tell him not to eat and breathe.
We're supposed to follow up with an appointment with the orthopods, not for an x-ray or anything about the bone, but so they can look at the nailbed. The nailbed is healing great and, for a gross-looking ex-toenail, is looking fine. So of course, me being a nurse, and a nurse with a high deductible health plan, I haven't bothered to set that appointment yet. I probably still should. Especially since he's gotten in fights with his siblings, kicked things, and had his toe stepped on I don't know how many times.Image may be NSFW.
Clik here to view.![]()
My son broke his big toe. Yes, it was that son, the four-year-old who's always hurting himself, the one who's always getting into things, the one who got attacked by poison sumac with a vengeance. He flipped off a bench he was crouching on top of, and the bench slammed down on his toe on our tile floor. Ouch. What's worse is that we had just come home, it was 9 o'clock at night, and we were busy putting things away and sorting children and trying to get ready to get ready for bed (an arduous process around here), and I didn't really pay attention when he hurt himself--he's always doing it, right? So he actually had to hobble over to me before I noticed that he was crying a little more than usual and there was blood all over the floor. That's probably when I earned my dad of the year award.
I carried him to the bathroom and realized we probably had to go the emergency room. The nail was loose and already reddish-black, he had a big laceration down the front of the toe, and he was crying so hard he was almost dry-heaving. I felt so bad for him. I tried to gently wrap it and put ice on it. We arranged for a "babysitter" (my wife's brother...in other words, just an adult body to remain in the house, and most likely the kids would be up eating candy and watching movies all night) and I carried him to the van. He stopped crying so much and became more concerned why we were going to see a doctor about it. Poor guy. Then we drive to the hospital with a crying baby and a crying kid with a bleeding toe.
Luckily the hospital is so close. I carry him into the emergency room and he stops crying. The registration person at the desk asked me his name and birthdate. I can never remember his birth year. This happened a while back with my insurance company, too. She tried to calculate it with me -- let's see, he's four, this is 2011, his birthday is X, so... Then my wife walks in after parking the car. It turns out, ironically, that our registration lady is the same person who registered us at a different hospital's emergency department a few years ago (with the same kid, I believe) and once or twice over the years has seen us at church. So she recognized my wife! Which is nice, though it doesn't seem like a generally good thing for ER registration people to start recognizing you. At any rate, she and my wife are discussing on our new family events (new births, etc) while I'm wheeling him down the hall to triage.
The triage nurse unwraps his foot and his toe is still bleeding pretty hard and looks awful. She asks him how it feels and he, trying to look unconcerned, says "It's fine."
She gave him some ibuprofen and sent us for an x-ray of the toe, which I figured was just a formality. I assumed he just needed some sutures.
Eventually we get to a room in the pediatric ED, and we wait. And wait. Eventually we're seen and the doctor informs us that the distal phalanx was fractured. He doesn't know if this will require pinning or not so he'll send us for a consult first thing in the morning for a plastic surgeon or a podiatrist (it's now 11pm or midnight). He shoots the toe with some lidocaine and sends the ED tech in to irrigate and clean the toe.
| Image may be NSFW. Clik here to view.  |
| Do you see it? |
During the clean-up the hard-working tech told me all about how he was a single dad of a few kids, since his kids had flatly insisted on staying with him after the divorce. He pulled a lot of hours as a paramedic and ER tech to put them through school and now college, spent the rest of his free time with them being a dad, and said he was going to vomit if another woman told him what a nice guy he was (since he's developed the theory that women say they like nice guys but really they like total scumbags.) I hope he didn't mind me as a fellow hard-working dad telling him what a nice guy he was. Readers--high-five that guy.
Anyway, back to the toe. After another long wait the doctor wants to suture the toe and see what he can do about the nail. The nurse has the foresight to have me hold a towel up so my boy doesn't have to watch it (why don't physicians ever think of these things?). But it's still not numb. Apparently big toes (and thumbs) are hard to anesthetize. He has to inject and re-inject the toe probably a dozen times to try to get to the nerve root. And this is what really hurt him the most, after the initial injury. He was crying but he tried so hard to hold still, and when the towel I held up slipped a bit he grabbed it and threw it over his own head. Still, as much as he squirmed, he held that leg totally still.
The doctor left to wait for the toe to numb up. My son tells me "I wish I was made out of metal."
The toe was sutured up but the nail was a loss. Removing the nail took forever. My son fell asleep during it (thank God for lidocaine). My wife had to leave the room to avoid passing out. I was a little grossed out myself. That's the irony of blood and guts, by the way. If I was in charge of the toe, I would've been fine. As it was I still had a job to do, so I was okay watching it but a little queasy. If I just had to stand around watching it, or if I had to hear about it, I'd want to barf. (Yeah, I know. I'm making you hear about it. Sorry!)
The doc asked me if I want to save the toenail. I was surprised but he said they could possibly clean it up and try to suture it back on. That sounded like more of a hassle (trying to keep it from getting caught on things, trying to keep it clean). It got forgotten about and tossed with the trash, however, so it's a moot point.
The tech redresses the toe. The physician assumed I'd see a doctor first thing, so he thought one dressing was enough, but the tech had the foresight to stuff a bag full of dressing changing supplies. Which was great, because we couldn't see somebody first thing.
We go home around 1AM, go to sleep, and call the consultant in the morning. It's Monday morning at 8:30 and I'm calling the office as soon as it opens. It turns out he's a hand plastic surgeon, and doesn't do feet. His secretary also said this was the second injured toe call they had since they opened, and somebody in the ER needs to stop referring toes to him. I call back to the pediatric emergency department and talk to a nurse who gives me the number of their pediatric orthopedic surgeons' group. With this unofficial (yet obviously accurate) referral, I went there the following day.
We waited in the waiting room forever. We watched Phineas & Ferb for the first time, which is a grand show. Finally we see the physicians--the orthopedist, his resident, and a pediatric resident--and they say there's no surgery to be done, keep it clean, he can walk on it all he wants, but--get this--try not to let him run or jump on it too much. Ha. Ha. Ha.
For the next week we keep him from jumping on the trampoline and riding his bike. Which was sort of like trying to tell him not to eat and breathe.
We're supposed to follow up with an appointment with the orthopods, not for an x-ray or anything about the bone, but so they can look at the nailbed. The nailbed is healing great and, for a gross-looking ex-toenail, is looking fine. So of course, me being a nurse, and a nurse with a high deductible health plan, I haven't bothered to set that appointment yet. I probably still should. Especially since he's gotten in fights with his siblings, kicked things, and had his toe stepped on I don't know how many times.Image may be NSFW.
Clik here to view.