Journey of a Broken Arm of a 3 year old Toddler – Part 1

PART 1: Journey of a Broken Arm of a 3 year old Toddler

I wrote this to document my journey as a mom who went just went through her toddler having a broken arm. When this happened I scoured the internet to find others with this experience so I know what to expect and I found very little in terms of daily details and follow-up. This is to help you ease your mind if this ever happens to you and your little one. God forbid but accidents happen and if it does, stay strong – research and trust your instincts when it comes to your baby!

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Wed May 25th, Pre-Day 1 – THE FRACTURE/BROKEN ARM ACCIDENTAL FALL OF MY 3 YEAR OLD DAUGHTER

Noteably one of the worse and most traumatic days of my life. I can still feel her limp arm in my hands as I hear her scream through the tears on her face as I ran to pick her up off the ground where she fell off a 1.5 foot high cement separator which separates the park and the walking path at our Hotel home park area. She was playing with another 3 year old and they were running with each other and she was tired at this point and lost her balance. I saw her run by and I should have stopped her… I was with my son, and I wanted her to have fun and the though in my head to just not worry and let her be a 3 year old actually went through my head. She was also watched by the other little girl’s nanny and I had a false sense of security…when i really should have known better. She was literally less than 10 feet away from me when it happened and when she fell I just knew something was wrong. I immediately put her in the stroller, got ice for it, called for help and tried to take her straight to the hospital ER. Though it took hours and hours that night to go thought the process at multiple hospitals, after X-rays and getting a splint, we were home at 11pm. We were advised to spend the night at the American hospital in Dubai to have surgery first thing in the morning, but knowing my daughter, I demanded we go home and come back in the morning again. That proved to be the best idea as she was able to get a good night’s sleep in the comfort of her own surroundings and she was mentally prepared for what was to come in the morning. Not me however, I was in a state of disbelief and much to stress to sleep. I had to pack, research, find strength and get everything ready for a journey I didn’t want to go on. I think I slept an hour, but not sure. I fed her some congee and cheese before midnight and she went to sleep immediately after. She was tired but didn’t seem in too much pain as she was still on morphine (They gave her a morphine shot at the hospital before applying her splint – she was also given 10ml of orange flavored Brufen for pain relief). Ari on morphine = very sweet and funny!

Thurs May 26th, Day 1 Surgery Day. So after a night of worrying and in utter shock and sadness, anger and confusion, my husband and I woke up extremely early ~ 4:30AM and tried to do our own research and to source out a 2nd opinion of an industry professional. Since we are in Dubai, all our web research directed us to a man named Dr. Marc Sinclair who has been working as a Pediatric Orthopedic Surgeon since 2006 and specializes in helping children and has a very impressive list of credentials. He is also found of the Little Wings Foundation, a registered charity that provides help to children with limb deformities, which really spoke out to us. We were very antsy this morning as you can imagine, and 8pm/9pm couldn’t come fast enough for the clinics to open so my husband can do the rounds before we take our daughter back to American Hospital to get on the surgery wait list. Around 6:30AM, I just took a leap of faith, and emailed Mark Sinclair, which to my surprise he emailed me back. Our email conversation went something like this:

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Thu, 26 May 06:31:53: FROM ME

Hi Marc,

I know it’s very early; my daughter has a bone fracture and a dislocated arm. I took her to a few places yesterday but no specialists were available anywhere in Dubai. Finally we arrived at American Hospital and she is scheduled for surgery this morning but I would like a second opinion if she even needs the surgery. She was given morphine and Brufen Paediatric Syrup for pain last night and she has on a temporary cast.

We keep seeing your name pop up on our web searches and I am very worried as she is so young that going to anyone to have her surgery done might affect her future growth and functionality of her arm.

Please advise when time you will get in, if it’s possible to see you asap.

Thank you in advanced. I am a very worried and concerned mother.

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Thu, 26 May 06:48 : REPLIED FROM MARC:

Sure. You can show me the xrays this morning. I will be in the clinic at 8. Alternatively send me the xrays to my account and I can see them on my BB.

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From there we went on to have a few conversations via email and with my husband on the phone and in person! Wow…the care and just the outreach from Dr. Mark Sinclair was really something else. Long story short, after a visit with him and realizing that our insurance didn’t cover the practice he was at, it would be $12,000 for the surgery… he recommended some other surgeons to us that are experienced and would do a great job. Once we told him our decision to just go with our insurance coverage surgeons at American Hospital, we realized that we lucked out with one of the best Orthopaedic Surgeons in the world (we were told – Dr. Samih Tarabichi is US Board Certified in Orthopedics, Arthroscopic & Joint Replacement Surgery. He holds two US patents for surgical instruments — not sure how he is with kids however, my baby will only be his second pediatric case, but we are in good faith). After we advised Dr. Mark Sinclair that we would not be doing the surgery with him, he was still extremely pleasant and even offered to do our follow-ups just to make sure they were doing their job correctly. This made me cry, as it’s so rare that someone you don’t even know would even care that much about your little girl. Thank you Marc for your prompt response, your bedside manner and overall general care is truly something special and to be commended.

We arrived at 10am to American Hospital and though we didn’t get the same detail to attention or bedside mannerisms we got from Dr.Marc Sinclair, we managed to finally get our baby into surgery at 2:30pm, after what seems like a REALLY long wait of trying to figure out insurance paperwork. Our daughter was also extremely hungry as she hasn’t eaten a thing since midnight the day before because we thought her surgery would be first thing in the morning. Poor sweetie, she was so strong and so brave and I am just so proud of her through the whole process. Elmo was there too and proved to be a big help as he also had a broken arm and they were going to fix their arms together.

By 4:30pm, Our daughter is out of surgery and is crying hysterically. She had been given laughing gas as the anesthetic instead of via I.V, which I preferred as well. They told us that all children come out of surgery crying for about 2 hours and then they will sleep. This is exactly how it happened..and it was the longest 2 hours of my life. Seeing my baby cry like that was truly heartbreaking and not something I ever want to do again. She hated the IV in her arm and said she was in a lot of pain. We were told it was just because she is not use to the cast yet and it’s just uncomfortable for her, which I understood. At around 7pm she had some apple juice and was ready to eat. She ate 2 pieces of toast with butter and marmalade and was told that once she had a pee, her IV could be removed and she could go home. By 9:30pm, we were in the car and heading home. Ari got a 7-up treat downstairs at the hospital for being so amazing…she shared it with her little brother who was also such a little soldier. I am so blessed with such great children. Can’t wait to go home. I was starving and desperately need food… we ordered Nandos, but Nandos Dubai = bad expensive food. Oh well… I slept that night, as did everyone else!

Friday Day 2 – May 27, Home and I’m at Ari’s beck and call. I love her just so much and her little brother is such a sweet patient baby allowing me time to help his sister. Husband is off work today and will make up for work this weekend as we have to save all vacation days as we will be heading back to Canada later this month. Still haven’t told anyone about Ari’s arm and don’t know how to tell anyone as it will just stress me out more to have to answer questions and actually talk about it. I dont think I have ever been this traumatized in my life… good thing nothing worse happened, although this is pretty bad. Ari is taking her medicine and is relatively in good spirits and likes being home with her shows and pillow. I really want to bathe her but know it’s not a good idea so I will wait. I keep thinking hospital germs and how she smells like puke but it’s Ari and I love her so it’s ok. We managed and I am still a walking zombie and extremely concerned.

Saturday May 28 – Day 3 – I am alone with the kids today and it was business as usual. We watched a lot of TV, lounged around and play lots of games and they both napped a long time. Ari is noticeably better but still very whiny and likes me being at her every beck and call. This is still ok with me…i know it will soon drive me nuts, but for now, she’s got my full attention. Im still a bit angry at the whole situation and wish I could turn back time. I can’t stop replaying the fall in my head and her running by… and it’s like I just knew it was going to happen and I can’t stop it every single time. Argh… I need to think something else and stop blaming myself for even taking her to the park. I know kids fall and accidents happen, but I can’t seem to shake it yet. I really feel I let her down.   Hurting my little Ari is the worse feeling in the world.

Sunday Day 4: I changed Ari’s clothes today and wiped her body down completely and washed her. I want to wash her hair too but will wait as I don’t want to get her arm wet and still thinking about how to tackle that one. She’s getting bolder too and is demanding more of me. She is back to playing games on the computer – thank goodness her dominant hand wasn’t hurt or else we’d be even more stressed out. Keeping her occupied all day long is challenging…I’m going to need to come up with more creative ideas soon. Good thing both of my kids are quite the homebodies…they don’t need to go out constantly and they are used to staying in. Ari keeps saying how hot she is and she doesn’t even use a blanket under the AC. I begin suspecting maybe she has an infection…but no other signs and after eating a popsicle and rubbing a cold water bottle over her body (a game we made up that made her laugh hysterically) and me fanning her with the Nando’s menu…she was cool as cucumber again.

Monday Day 5: Ari has been more of herself today and really wants to run around, jump on the bed and play. She’s back to driving mommy nuts as I am so paranoid she is going to hurt her arm that I keep yelling at her to sit down and to stop moving so much. I swear, every time I see her standing on the bed, I feel a hot flash and age another year! But you know what… she’s on the road to recovery and this is all that really matters. She’s been eating good, drinking lots of milk and fluids, smiling and sweet. She gets irritated a lot and says she’s tired quite a bit still and her arm is extremely itchy under her splint which is probably the worst thing. She has been crying all night about it, waking up every 20 minutes…which as I am writing this post, I have been to scratch around her arm 3 times already this hour. We found that the hair dryer, though loud, works well for itch…alternating between hot and cold air. I also tried scratching by sticking a straw down the cast, but she didn’t like that… so i got a dry cloth and rub her skin above her cast until she fell back asleep. Seemed to work this time but I can hear her stirring a bit… sometimes I pitch/scratch the splint wrapped areas too as it’s soft on top and that seems to give her some peace. I can’t imagine her discomfort if she had on a full cast.

I am extremely worried about growth plate damage that I have been researching it like crazy. I can’t wait for her follow up on Thursday to ask a million questions now that i know more about what is going on with bone fractures, types, problems etc. Some questions on my mind which are probably on yours too if you are going through this same situation ( I was a bit tired and traumatized the day of her surgery to ask all the right questions or hear what I was being told for that matter, but now that I am more calm I need some answers so as I think of them I want to write them down so I don’t forget):

a) How do I know there is growth plate damage? b) Worst case scenario, if there was damage to the growth plate, what can we do? Is there anything we can do to fix it? c) How long do we have to keep the split/cast on? They said 3-5 weeks… but maybe after 1 week they will know more. d) What kind of fracture does she have? Does this type of a good healing success rate? How often will she have to get checkups? What are the complications? Does it seem like she will have any complications? e) Will removal of the pins/splint be painful? How long before she is fully healed and back to being her old self again? f) Can she bend her arm after the splint is removed? Will it look bruised? Will it leave a scar?

I found this site to be helpful when comparing my X-rays and figuring out exactly how her arm is fractured. From what I can deduce from all the web research my daughters fall is very common amongst children and the way she feel is exactly that of the hyperextension due to fall on the outstretched hand.

http://www.radiologyassistant.nl/en/4214416a75d87

Supracondylar fractures (2 – displaced distal fragment: In Gartland type II fractures there is displacement but the posterior cortex is intact. There may be some rotation. These fractures require closed reduction and some need percutaneous fixation if a long-arm cast does not adequately hold the reduction.)

- These fractures account for more than 60% of all elbow fractures in children.
- More than 95% of supracondylar fractures are hyperextension type due to a fall on the outstretched hand.
- The elbow becomes locked in hyperextension.
- The olecranon is pushed into the olecranon fossa causing the anterior humeral cortex to bend and eventually break.
- If the force continues both the anterior and posterior cortex will fracture.

My husband says I need to stop dwelling about this and driving myself insane. When it comes to my kids I like to take some control and learn everything I can about their problems and issues… i know i am overbearing but my kids are only 1 and 3… I have to be!! I just don’t trust anyone when it comes to my kids…and with good reason. Every time I do, it just seems something seriously goes wrong. I love them so much; I question even having them because love truly is painful!!

My son is very attention starved today… he is almost 1 year and a half and is such a smart and intuitive little guy. I guess he’s been noticing the extra attention his sister is getting so he’s been running to hug and hold me all day today. I’ve been giving him extra attention today too… I haven’t even been able to do a thing but they are so cute, it’s ok. I love that they love me so much and need me. I feel very blessed to have them both and picture them coming home from high school hungry and wanting to eat dinner. Every day I am still excited I get to mommy. I just wish I can keep them in a bubble and protect them forever…but i know this is not possible and this is just the start of the heartaches I must bear in this life time.  I haven’t old my parents about what happened to Ari as I know they will drive me insane and worry extremely… Im thinking of not telling them til I get back to Canada as we are so far away for them to do anything but add more stress anyhow.

Tuesday Day 6, Wednesday Day 7: Wow almost 1 week, these days seem to have gone by slow but fast at the same time. Can’t wait to see how much she’s healed tomorrow and what the Doctors have to say at her follow-up. The theme of these last 2 days seems to be itchy! I’ve been blowing her cast with the cold setting on hairdryer and it seems to help her, but she wakes up crying of itch sometimes and it’s definitely not good on the sleep! We found an item called CastCooler and it looks pretty cool…cept we didn’t order it because we only have an APO mailing address and 12-16days for express delivery seems too long. My husband went and got some anti-histamine for kids called Zyrtec – she takes about 5ml every 24hours and seems to work pretty good. She’s itchy about 3 times before bed instead of the 8.