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Trauma: life in the kitchen
I’d like to use today’s post to publicly apologize to my brother-in-law. See, back when we were fellows (pediatricians getting extra training in emergency medicine), Jim did his trauma surgery rotation at the same time that the TV show, “Trauma: Life in the ER,” was filming. That was all very exciting and fun to see people I know on TV. But I gave him endless, endless grief for his biggest line: “We’re trying to figure out where the bleeding is coming from.” Seriously? You don’t have any idea? Your patient is bleeding and you have NO idea from where?
So flash forward to my life today and there I am, making roasted squash. The girls are playing with some plastic framed photos of their very vain mother that I have stuck to the fridge. Playing and eating Cheerios and having a grand time. I look down at my feet and there is blood. Not a lot but enough to make me look again. Smeared all over my photos and the floor. But no one is crying. What the heck?
Neither of them was particularly happy when I shrieked and fell to the floor, picking each one up, looking for the source of the bleeding. They didn’t really want to be disturbed. But seriously, kids, one of you is hemorrhaging. It literally took me about 3 minutes to figure out that Eva’s 2nd and 3rd fingers were to blame. What the heck did she cut them on? No clue? Bad enough to need stitches? Of course not. Little bitty cuts, full use of her fingers, no tenderness or foreign bodies. Bleeding heavily enough to require some attention? You bet.
What 10 month old understands direct pressure and bandages? Not mine. So we danced around the room for 5 minutes with me surreptitiously holding her hand in a kitchen towel. Then I stuck the world’s biggest bandage on her fingers. Which I just now fished out of her mouth. Gracious, it’s not so easy to deal with this stuff at home, without resources. Just as it’s not always so obvious where the blood is coming from. Ha. Sorry Jim.
Believe nothing, trust no one
So, my kids went missing this week. Well, they weren’t really missing so much as I didn’t know where they were. And while I knew who they were with, I had that sick moment of thinking, “Oh God. Someone is selling my children on the black market right this minute.” All because I had a new babysitter and just like all of you, I am always worried about my kids when they aren’t in my direct line of sight (and even then, watching them pummel each other, I’m worried.). And it made me think that maybe all of you would like to know how I decide how my children are cared for when I am not with them.
The first thing is references and recommendations. Our regular sitter was on holiday this week and I needed a few hours of help. Our back-up sitter was busy but she said that her mom could come. What better recommendation could you get than Emma’s Mom? I’ve known Emma for months and have even met her husband and daughter. The girls love her and I trust her. But when I met Emma, I didn’t leave the house the first day and just made myself busy upstairs. And I had seen her background check and references from the agency that sent her. In other words, do your homework before inviting someone to take care of your little ones.
Secondly, what kind of experience does this person have? Jackie (Emma’s Mom) is a mother of 3 and has immense nanny and babysitting experience. My regular sitter didn’t have much little baby knowledge before meeting my girls but is a former nursery school teacher. Regardless of their knowledge, I keep an infant CPR DVD and a practice doll in the cupboard and force people to watch it twice a year if they plan on feeding my kids. I’m uptight like that.
Thirdly, I have no problem “surprising” my babysitter with an unexpected appearance. I think you can get a good feel for what goes on if you pop in on someone when they don’t know you are coming. It’s not being sneaky, it’s being careful. Of course this was what happened when Jackie took the girls for a walk. I assumed they’d gone to the park when actually they’d gone the other direction for a walk around the block. When I didn’t find them, I called Jackie but her phone was in her purse and she didn’t hear it the first time. So I called Emma who called her mother who then called me. Conveniently I had left my wallet on the stroller and had an excuse for needing to find them (that didn’t make me look like a crazy over-protective Mommy). And, of course, 5 minutes later I had my wallet back (money and credit cards accounted for) and was reassured that my girls were clearly enjoying themselves. Eva even went to Jackie over me that afternoon.
And that is my final test. Pay attention to your kid. If she cries when the sitter comes in or doesn’t want to go to her, maybe that’s not the right sitter for you. Look for bruises or injuries that aren’t readily explainable. Make sure your kid has a clean face and clean butt. I think those are all good signs that someone is taking good care of your tot. My kids are pretty smart and they are rather particular about whom they will go to. I trust their judgement as much as my own on these things. That said, they might like a circus clown to babysit so my own gut feeling overrules theirs when in doubt.
Of course you are always taking a risk when you leave your child with someone else but it’s a risk most of us have to take. It’s just another one of those times as a parent that you have to hope that everything will be allright. And it usually is. So long as you trust your little Jiminy Cricket.
The First of Many
Came home last night to find two very happy girls playing with their new sitter (that’s another post). And Jackie’s shirt covered in blood. Actually, I probably wouldn’t have noticed the blood if she hadn’t pointed it out. Zoe is 7 ½ months old and is freakishly pulling up to a stand all the time, at least 4-6 weeks earlier than the book says she should. She’s not terribly stable, but she’s determined to keep up with Eva. And apparently yesterday she pulled herself up to the window while holding a tube of diaper ointment in her mouth. (Ok, I know. That’s yet another topic for another day.) Unsteady as she is, she fell forward, jamming the tube into her face and cutting her mouth.
There is something to be said for having a sitter who has raised several children already. Jackie didn’t panic. She got Zoe calmed down and checked her over. The bleeding stopped once the crying did. Because the baby seemed fine and went immediately back to playing and since I was due home in about 20 minutes, Jackie waited until I returned to tell me what had happened. I appreciated both her honesty and obvious calm. (And I seriously don’t blame her one bit. I let them play in the diaper bucket all the time. It’s their favorite toy. In fact, I consider it a toy.)
Upon inspection, all Zoe had was a tiny, tiny scrape along the roof of her mouth. There’s nothing to do and it’s probably already healed up by today. The thing about mouth injuries is that even the tiniest of wounds bleeds like a stuck pig. Our heads have fantastic blood supplies and that’s why a tiny cut can bleed heavily. No need to call the doctor unless it is bleeding heavily and won’t stop in 10-15 minutes, especially after you’ve calmed her down. A popsicle or ice cube might help slow the flow for an older kid with a mouth injury. For cuts in the mouth, only really significant injuries require any kind of treatment. Even big cuts of the tongue will usually heal without any stitches. Of course, stabbing yourself in the back of the throat could rarely cause complications so that deserves a call to the doc. But what I always tell parents is that most mouth wounds will heal in just a few days. As long as there are no signs of infection (increasing redness, pain or fever are a few), the only thing to do is avoid giving your kid a lemon to suck (or anything salty or acidic) until it’s better. Because that will sting. And of course, don’t worry if it starts bleeding again, especially if she’s crying, so long as it stops when she calms down.
Fortunately we’ve had no further trouble and Zoe is completely unfazed. I’m sure this won’t be the last time I come home to someone covered in blood. Can’t wrap them in bubble wrap, can I? In an odd coincidence, she has a new tooth today. Talk about trauma.
When Worlds Collide part # 1738
I’ll make it quick. I’m in Wales teaching trauma. Only this time I have a little Eva strapped to my back. It’s a classic example of how parenting can sometimes interfere with one’s professional self. But also an example of how really wonderful colleagues can make all the difference. Or maybe just an example of how you should only associate with people who have children.
You all know I like to come up here and spend a few days being “Dr. Zibners,” not “Mommy.” But this time I realized that not only had I just left them, but our regular babysitter is on vacation. I’ve got a few other great girls that know the girls but none had spent full days with them both awake. So I made a few phone calls and the decision was made that it was better for me to be here with one kid than miss the opportunity. And Divide and Conquer seemed the best option. So we packed our bags and drove up last night.
And it’s been great. Eva played with a skeleton for an hour. She’s been strapped to a chair in her Wiggle Wrapper for cervical spine lectures. And she actually let the course director take her for a walk while I helped a demonstration. On the other hand, she fussed and cried through chest x-rays, screamed when I tried to leave her in the office with the secretaries and crumbled a raisin cake into the carpet of the conference room. In other words, if it weren’t for the understanding and kindness of both my fellow teachers and the students, I couldn’t make this work. And of course, like all working Mommies, I feel guilty. But this time not for leaving her but for needing my colleagues to understand that I may not be 100% the professional this time. Thank God she’s cute. 4 teeth and an serious interest in C-spine immobilization go a long, long way when your Mom is straddling two worlds. If only all working mothers could be so lucky.
My other girls
I made it home! And the girls are fine. They weren’t traumatized by my return, as I feared. They seemed to know exactly who I was and weren’t angry at all. Probably because they just spent 10 days without a routine or a bedtime. It was a party. Given Eva’s reactions the last two times I went away for a couple nights to teach trauma (first tears, then ignoring me), I had a little bottle of Dulce de Leche in my bag, ready to bribe her onto my lap with a finger dipped in caramel. But it wasn’t necessary. What a relief! And now that I know my baby girls are okay, I spent this morning making sure my other “girls” were also okay. So now that I’ve done it, what’s your excuse?
Of course I’m talking mammograms. You might remember that a dear friend of mine is currently fighting the Big C and that prompted me to finally schedule the appointment I’d been putting off for 4 years. There is a lot of controversy about when a woman should have her first mammogram. The old guidelines said 35 was time. However, because there are so many “false positives,” (meaning a spot shows up that looks funny and requires further testing but turns out to be nothing) some are now advocating that it is better to wait until after age 40 or even 45 for women without a family history of breast cancer and without any suspicious lumps on exam. That’s all fine, but I’m paranoid and I wanted my scan. So I demanded and today I got.
And I’ve gotta tell you, all those horror stories about how painful and miserable it is are nonsense. Unless I have remarkably tough breasts. It didn’t tickle but it certainly wasn’t torture. Almost like an extra tight hug for a boob. 2 minutes later it was all over. No big deal.
I know I’m a pediatrician and not a Boobologist but I still think that Mommies need to make sure they are taken care of too. So if you are over 35, or you have a family history of ovarian or breast cancer, it’s worth thinking about. At least mention to your doctor at your next visit. By the way, you need to have finished breast feeding at least 6 months before your scan and can’t be pregnant. (Fertility treatments and induced lactation were my 4 year excuse. What’s yours?) And I dedicate today’s post to Jen, who is one brave lady.
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"WHAT I LIKED: This book is written in a funny, down to earth way that doesn't make you feel like an idiot. I really would have appreciated something like this when my kids were really little and I freaked out over everything they put in their mouths. It has a scenario/question and answer format, with clear answers on when not to panic and when to call 911."
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