As I mentioned yesterday, I had a bit of an eventful weekend. I actually thought it was over, and then yesterday everything escalated.
It all started on Friday. I had plans to go out for martinis with Jessica, Renee, and Rachael for Jessica's birthday (I'm still not drinking for a little while, but I planned to get a mocktail or something). My kids were going to stay the night at my parents' house, since my parents hadn't seen them for so long while they were in South Carolina.
Just before I was supposed to go meet my friends, we got a call from my dad saying that we needed to come pick up Noah because he got a splinter in his foot. (He had been sliding around in his socks on my parents' hardwood floor.)
It was weird, because I just couldn't imagine why my dad would call me over a splinter (my dad thinks duct tape is an acceptable bandaid--and that's when he doesn't have superglue on hand to glue his skin shut, haha); but, Noah can be a little dramatic at times, so I thought maybe he was just hurting and wanted to come home.
When I went over there, I was hit with Noah screaming in agony and he wouldn't let any one of us near his foot. The bottom of his foot was a little bloody, so it was hard to see the sliver that he said was in there. He had pulled a tiny little piece of wood out, but he said there was something still in there.
When I got to my parents' house, I hadn't been planning on taking him anywhere but home, figuring I'd just clean up his foot and pull out the splinter; but after seeing the amount of pain he was in, I knew I wasn't going to be able to do anything. Jerry and I were debating Urgent Care or the emergency room. I would have felt like an idiot going to the ER for a splinter, so we chose Urgent Care.
I assumed it would be simple--they would numb his foot, remove the splinter, and all would be fine. Renee even picked me up from Urgent Care while Jerry stayed with Noah, and I met the girls for Jessica's birthday. About an hour later, Jerry called and said the Urgent Care doctor said we needed to go to the ER--I was NOT expecting that! I had Jerry pick me up so I could go with them, because I figured it had to be somewhat serious if the Urgent Care doctor sent us to the hospital.
Noah was calmer, because the Urgent Care doctor had numbed his foot to probe around for the splinter (later learned this was not a good idea). We went to Henry Ford Center for Health Services, the ER that I've always trusted and received good care from. I explained what happened to the nurse, who then explained to the physician's assistant.
When the P.A. came to Noah's bed, he didn't examine Noah's foot--didn't even glance at him!--he just said, "Uhh, we're not in the business of digging around in people's feet. If the Urgent Care x-ray showed nothing, then nothing's in there. And if there was, it would come out on its own."
That physician's assistant made me feel like I was a complete idiot for taking my kid to the ER, even though the Urgent Care doctor told us to go there. I told the P.A. that Noah could feel something stuck in his foot, and could they please do an ultrasound to see if there was something there (I assumed that wood wouldn't show up on an x-ray, and they had done an x-ray already at Urgent Care, which showed nothing).
The P.A. dismissed me with, "Oh, an ultrasound won't show anything, either." He said he would order antibiotics and that we could give Noah Tylenol for pain.
I was furious. Our co-pay is $100 for an ER visit, and we didn't even get an exam!! I didn't even wait for the script for antibiotics or discharge papers or anything. Jerry carried Noah to the car, and we drove to Henry Ford Wyandotte Hospital, another ER (that deals with trauma). Another $100 copay, but I wasn't going to accept what happened at HFCHS (ER #1). I knew that as soon as the numbing medication wore off, Noah was going to be in agony again.
At HFWH, the staff was much friendlier. However, they pretty much said the same thing--that if there was something in there, it would come out on its own--they weren't rude about it and they explained why they don't probe around (risk of infection is high).
I asked again about an ultrasound. They told me they'd rather do another x-ray, because if something was there, the x-ray would likely show it (and having a radiologist look at it instead of an Urgent Care doctor may help). So, they took an x-ray, and it showed nothing. They said there is nothing in his foot, but we could start antibiotics if we wanted.
I can't tell you how frustrating it was that nobody believed us. I know my son better than anyone, and if he felt there was something in his foot, I believe him. But everyone just thought I was a crazy mom.
The ER didn't even prescribe him pain meds--they just said to alternate Tylenol and Motrin, even though he was clearly in agony. They gave him a boot and crutches to use (mainly just to "shut me up") until the splinter that they said wasn't there worked its way out.
(If I look at it from their perspective, I can see why they weren't very concerned about a "simple splinter"--but I wish they would have at least humored me with an ultrasound. I did not feel like "waiting until it comes out on its own" felt right, when my child was clearly in so much pain. And really, what harm would it do to perform a simple ultrasound?!)
Noah was in excruciating pain all night; and the next morning, I called his primary care doctor to see if we could get something better for pain. She prescribed Tylenol 3, which helped him get through the weekend.
I couldn't stop thinking about how we were treated at the first ER, so I wrote a letter to the director of ER to explain what happened. (Even if that physician's assistant hadn't wanted to remove the splinter by "digging around in someone's foot", it was unacceptable for him to treat us the way he did.)
On Monday morning, I sent an email to Noah's primary care doctor with a photo of his foot to see if she wanted us to come in for a follow-up. And I wanted her opinion on whether we were treated correctly.
(The dark spot by his toes is the original puncture wound from the splinter. The cut underneath is where Urgent Care poked around.)
I was surprised by her response: "Take him to Mott Children's Hospital ER in Ann Arbor right away."
She was worried about osteomyelitis and didn't like how his foot was looking. There was a snowstorm yesterday, and the last thing I wanted to do was drive all the way to Ann Arbor with the roads being bad, but his doctor was insistent and said she showed the photo to her colleague, who agreed. So, Noah and I headed up to Mott Children's Hospital.
The drive that normally would have taken about 55 minutes ended up taking 90 minutes! The roads were so bad that we were driving 35 mph on the expressway. When we got there, the visit began much like the one at Wyandotte.
The staff was all very friendly and patient, but they told us the same story--it's not a good idea to dig around for a splinter because the risk of infection is high and they don't even know if there is a splinter in there. They said it will most likely come out on its own.
I wanted to tear my hair out, because I really just wanted someone to DO something for Noah--I felt so bad for him! Again, I asked about an ultrasound. They said they could do that (basically just to humor me, because I was so insistent), so we waited for an ultrasound.
I went with Noah for the ultrasound, and I watched the screen like a hawk when she put the probe on his foot. Every once in a while, I thought I caught a glimpse of a line that didn't look "normal". I'm obviously not trained to read ultrasounds, but I'm pretty good at seeing things on them. (When I was pregnant, I even knew my babies were boys before the ultrasound tech told me, because I could see for myself).
I said to the tech, "I swear I am seeing a splinter--that diagonal line right there. Is that normal?" She kind of half-smiled and said, "We'll have to wait for the radiologist to read the results."
I took a quick photo of the part that I saw and thought was suspicious. I said, "I just want to feel like I'm NOT crazy. That looks like a splinter to me." The tech smiled again and said, "I don't think you're crazy," with a little wink. So I could tell she saw it, too (but she wasn't allowed to say anything about it).
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See that diagonal line across the screen? That's the splinter I was told "wouldn't show up" on an ultrasound.
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The splinter looked large enough on the ultrasound that they called for a consult with an orthopedic surgeon. We waited a long time for the surgeon, because he was finishing up a surgery, but I was so thankful to finally get some answers and have someone that believed us!
The surgeon came in and examined Noah's foot. He said he couldn't feel anything, so if he tried to remove it, he wasn't even sure he'd be successful; but the alternative would be to wait a week or so and see if it surfaced or encapsulated, and then have it removed. I didn't want to have to go another week with Noah in so much pain, so we decided to have him try to remove it right then.
The next 30 minutes were beyond terrible. The injection to numb Noah's foot hurt him so much, but I just kept thinking about how relieved he would feel when the splinter was out. Noah closed his eyes and held my hands.
For most of it, he couldn't feel anything, thankfully. The surgeon eventually said that he doesn't think he would be able to get it, and that it was like "finding a needle in a haystack". I was super bummed that after all that, the splinter would still be in there. Noah agreed to one more numbing injection. The injections were terrible, because they hurt Noah so badly.
When the doctor got to a certain spot on Noah's foot, Noah flinched and yelled in pain. He said that was the spot where he has been feeling like the splinter was stuck. The next five seconds felt like an eternity, but the doctor must have grabbed the splinter because Noah screamed in a way I had never heard before. It brought tears to my eyes in an instant. I had marks on my hands from Noah's nails digging in to me.
I turned to look at the doctor. I saw him holding up the splinter he'd just pulled out, and my jaw dropped.
It was ENORMOUS.
Based on the ultrasound photo, he had guessed it was about four centimeters; but it ended up being longer than my middle finger! It was about four inches long, and it had been stuck in Noah's foot all weekend. All the other doctors had told us there was nothing there! I just couldn't believe my eyes when I saw it.
The surgeon gave him a couple of stitches and bandaged him up. He said it was the largest "splinter" he'd ever removed. (I don't even feel right calling it a splinter.)
We're continuing with the antibiotics, but now we know that he'll heal and not be stuck with an enormous piece of wood in his foot! I am so grateful to his primary care doctor for insisting we go to Mott, and for the staff at Mott who took me seriously (or at least humored me by getting the ultrasound I wanted). I think they were very surprised that it wasn't "just a little splinter" as well. Noah is so happy that he's finally on the mend.
While I was at the ER yesterday, I got a call from the Director of the ER's at Henry Ford Brownstown and Henry Ford Wyandotte to follow up on the letter I'd sent. I just got off the phone with her this morning, and she was very kind. She agreed that the way we were treated at ER #1 never should have happened, and said that actions have already been taken with that physician's assistant (I'm assuming they probably talked with him about his bedside manner). Or maybe they didn't take action, and just said they did. I'll never know.
I was happy with the kindness of the staff at ER #2, but I wanted her to know that the ultrasound I'd asked for would have shown the splinter--so I hope that the doctors won't dismiss it for other people in the future.
I sent her the photos of Noah's ER visit yesterday, and she was shocked at the size of the splinter--she said she's going to show the pics to the staff that treated Noah. I REALLY hope that she does. I want that physician's assistant to feel like a complete ass. She also said she will make sure we aren't billed for those copays from Friday's visits.
So, I'm very happy with the follow-up I got from the director. I understand that doctors probably don't choose to work in the ER to remove splinters, but where else were we supposed to go? It wasn't a tiny little splinter that could be removed with tweezers. And I can't even imagine the amount of pain Noah was in from that thing! The ultrasound that I requested wasn't invasive, and could have saved him a tremendous amount of pain. I won't be going to be to Henry Ford, however--I'm switching health care systems, mainly because of the way that physician's assistant treated us.
I'm so glad that Noah is finally able to get some relief. He's home from school today, because his foot is obviously sore, but he'll be fine to go tomorrow. Today, I've got to take Eli to Children's Hospital in Detroit to get fitted for his orthotics!
