The Last 48

 So....  4th day of kdgtn.  I'm in my room with about 10 minutes left before recess starts and E's teacher runs in to tell me Ethan is in the office and got hurt.  "He's crying hard Katie.  In my experience kids don't cry like that unless it's real."  He was in there with his caregiver who happened to still be around.  He was holding his elbow and screaming.  I later found out that he was screaming, "I don't want to die!"   I ran out of there and got my purse, told them to do whatever they needed to do with my class but I had to leave.  My colleagues stepped up and took care of everything.
I called the triage nurse at our pediatrician's office who told me to come right away.  At this point, this is what the elbow looked like.  He couldn't move his arm at all and refused to let go of it.  The screaming was still happening, though he was exhausting himself so it wasn't quite as ear-piercing.

They got us in after about a 1 minute wait just to tell us that he definitely needed to go to the ortho down the street.  There we waited about 2 minutes, got an x-ray and then a consult with the ortho PA.

"This is not good Katie.  Do you have someone that can drive you to Mary Bridge in Tacoma?"

"Can't they take care of it here?"

"No one near here is going to touch this break.  Who can drive you?"

"I'll call my mom.  So we just take him to the ER there?"

"Yep.  and DO NOT let him eat or drink."

"What?  Ok...  Wait, are you saying surgery is possible?"

"More than possible.  Definite.  Go home and pack a bag quickly while you wait for your ride."

"Wait, overnight?  Are you serious."

"Here's a copy of the x-rays.  Show them to everyone so they don't try to unwrap it or move him until absolutely necessary."

The hardest part was not being able to freak out at all.  Ethan was already so scared.  I excused myself to the bathroom.  Said a few choice words, let out a few giant tears, pulled myself together and we were on our way.  My mom's school was as great as mine and she was out waiting for us.  She got to be the strong one while Ethan slept and I went along for the ride.

We got to the ER and they got us inside in less than a minute.  They also had (free) valet parking - amazing place.  Right away they started setting up for putting him in a cast.  I was confused as the ortho had told me surgery was a necessity.  One of the ER nurses told the others to wait and showed them the x-ray.  Everyone sucked in a big breath and then left.  Ethan was thrilled to get to watch TV and was sucked in.  He was feeling okay between the meds they'd given him at the doc and the distraction of Nickelodeon.

 The ER doc came in and explained that he was waiting to talk to the orthopedic surgeon.  He made the following drawing on E's sheet.  The left diagram shows where Ethan broke his humerus (right above the joint, straight across).  The diagram on the right show how it was currently aligned in his arm.

 Basically, they would have to line it up before they could set it in a cast or a splint.  They still thought there was a possibility they could do it right there, though they would need Ethan to be pretty much out to do it.
Regardless, he'd need an IV, so they set upon doing it.  This was rough.  Even for me.  I don't do real well with needles and they chose to make me the test case to show Ethan how it's done.  They never actually put in a needle, just taped the tube on top, but it was enough to almost get me.  Ethan still had to have someone hold him down to get it in.  He was freaking out.  Once it was in, he refused to move that arm either (this continued until the next day.
There were a few plans made until finally the surgeon showed up to tell me they had an OR available at 3:00 and let's just do it then.  He way over-explained the process, making me weak in the knees, but confident in his ability to take care of my baby.  They would put him fully out and then move everything back into place (I'll spare you the step-by-step).  Then they would insert 3 pins into his arm to hold the bones in place while it heals.  The pins will come out after the cast comes off.  Because there was so much tissue damage, he'd have to have the pins.
They loaded him up on morphine and I ran to eat while my mom stayed with him.  I hadn't eaten since breakfast and didn't want to pass out (as there were oh so many reasons to pass out at this point).
I got lost trying to find them afterward and had a bit of a panic attack that I wouldn't make it back before they took him (though rationally I knew they wouldn't take him into surgery until I signed some more forms). I found them and saw that the arm had gotten a bit nastier over the last few hours.

 When the morphine kicked in, he was a pretty happy guy.  He was snuggled up with the penguin they'd given him down in the ER.  I didn't know how to explain what was happening, but I tried my best:  "E.  Stop watching TV and listen babe.  Hey you.  Look at me.  They are going to give you some medicine in another room.  The medicine is going to make you fall asleep.  While you are asleep they are going to fix your arm.  Remember Dr. Will?  He is going to put your arm back together."
I'm not sure why I fretted.  He was so drugged up at this point.....

 Brian was on his way and my mom needed to leave so she could get Lucas and keep him overnight.  We had no idea how long all this would take.  Brian got there about 30 seconds before we left for the OR.  He got to kiss E and tell him he loved him and then they took him to the OR and sent us to the surgery waiting room.  There were screens with color coded numbers telling us where our patient was in the process.  I tried to scratch out some sub plans while we waited, though I couldn't really think of anything.  I didn't want to leave, but was starving.  We had no cash for vending machines, so ended up eating some stale cookies that were sitting out and a mini-butterfinger bar.
When we finally got to go to recovery, he was moaning and crying.  They told us it would be tough coming off the anesthesia, as kids are so disoriented, but it still was disturbing.  The doctor showed us the "after" xrays and told us about the procedure.  The break was not lateral (as those normally are), so he had to do the pins differently than is standard.  I didn't care.  I just wanted to be with Ethan.  It took him a long while to seem himself.  He was so thirsty and we were only allowed to give him minimal sips of water, as they were afraid he'd throw it all back up.  He just cried and begged.  One great distraction was the nurse took the oxygen mask from his surgery and turned it into a jetpack for the penguin.  After we finally got out of there, we settled in our room upstairs.  It was a really nice place with a playroom, kitchen, computer room, all sorts of comforts for the families there.  I went to go send off some (dismal) sub plans and was surprised by my principal.  She showed up with a teddy bear for Ethan and a big hug for me.  Her husband was also there, whom Ethan had met when his babysitter (their daughter) took the boys to VBS at their church.  A great surprise and so thoughtful!

 The night was rough.  He slept really well from about 9:45 until about 1:00 am.  From then on he really didn't sleep.  He zoned on the TV or fussed when it was time for more meds.  We finally gave up at about 6.  At this point we were all concerned that he wasn't feeling much better.  He still had no feeling in his pinky and was in a lot of pain when the morphine wasn't going.  He also spiked a little fever and then was soaking with sweat.

At that point I was pretty discouraged (and exhausted).  The doc came in and checked him out and decided to try a different med.  We also suspected at that point that he might have a bruised nerve, causing the numbness.  The doc would come back and check later that day, but we needed to see a lot of progress before he could come home.
Once the new drug kicked in, he was feeling a lot better.  He even regained feeling in his pinky.  He was still terrified to move at all though.  We finally (after much screaming and trying) decided to bribe him with the use of the video games.  You have to sit up to play video games, right?!  That did the trick.  He still screamed a bit, but was willing to let his nurse, Stephanie, get his arm in the sling and sit him up.
Once he was there and got to play games - he was thrilled!  Our boy was back and feeling good.

 The rest of the day was tough on me.  I had to make him get up, get dressed, walk, etc.  He did not want to do any of this and didn't really want to go home, so wasn't interested in trying.  Finally Stephanie and I decided we were just going to have to make it non-optional.  We finally got him up and over to their really cool car/wheelchair so I could drive him around a bit.

He liked that - such a great place - but then did not want to get out.  We let him sit in the car in his room while we started the process of discharging him.

In the meantime, Bob and Stacey- friends from church - showed up to visit!  My dad was there to drive us home and chatted for a bit while I grabbed our take-home meds.
The process of checking out was a bit rough.  Ethan really made it tough on the nursing student (her first day in clinicals) taking off the IV tape.  He screamed like a banshee and fought it all the way.  Poor girl.  He also fussed quite a bit getting into the car and having the seatbelt on.  Luckily, he feel asleep pretty quickly.  Not sure we would have made it home otherwise.
Getting him into bed was tough, but we did it and then I knew the decision to come home was right.  He slept from about 9:45 last night 'til 7:30 this morning, only half-awakening for meds.  We had him sleep with Brian in our bed and I slept in his bed upstairs.  He can't do those steep stairs until the cast comes on.  And maybe not even then, we'll see.  Plus, I got some great sleep.  Needed.
Now he's curled up on the couch, just watching TV and relaxing.  The drugs make him pretty sleepy and out of it, but he definitely seems better today.
Let the healing begin.