Monday, August 13, 2007

"Pop!" Goes the Nursemaid's Elbow

Yesterday, around 11:30, I started our nap-time routine by herding together our two youngest boys.

Being three, Jacob is old enough to dread his nap, and he began to protest, while Henry, 18-months, held my hand and climbed the stairs next to me. In playful retaliation, the J-Man, decided to grab hold of Henry's leg during our climb. Trying to prevent a serious fall, I was forced to maintain a firm grip on our toddler's hand while the full weight of our 3 (almost 4) year-old son threatened to pull everyone down the stairs. The end result of this tug-of-war was the sound and vibration of a firm "pop" from little Henry's arm, followed by crying.

He cried for a good 15 minutes, but was very tired and fell asleep for a short bit. About half and hour later, Henry was awake again and crying. He held on to his left arm and would not move it. For a while I was able to distract him as I called and consulted our pediatrician's office. The nurse advised me to bring him to an Urgent Care clinic or the ER so that he could be X-rayed.

While waiting for my husband to drive home, I carefully observed our injured toddler, so that I would be able to answer any questions the doctor might ask. I noticed that he was holding his arm slightly bent and perfectly still, almost as if it were in a sling. He was in good spirits and even smiled and tried to play. If he forgot about his injury and tried to move his arm he would flinch or cry.

It is amazing to me how resilient children are, because for all little Henry knew his injury could have been permanent but despite this grim idea, he continued to play. When he encountered a situation where he wanted to grab something but could not because his right hand was full, he would stop and carefully calculate what to do.
"Ok, I've got my Thomas train in this hand, but I want to grab that tricycle. Hmmm, what can I do....well, that other hand is no good anymore, so let me think.....I can try to grab both in the same, no, that doesn't work....this is the only arm that moves, so I need to find somewhere safe where I can put my train down and then I can grab on...."
All of this seemed to play-out in his head as he held his useless left arm firmly paralyzed at his side. It was a very, very sad thing to watch, but I was amazed at his ability to adapt to the situation!

After Corby arrived home to stay with the big kids, I was finally able to leave for the ER. Worst case scenarios accompanied by visions of little Henry toddling around in a cast played out in my head as I drove into Huntsville.

When we arrived at the Pediatric ER, the administrative nurse look doubtingly at Henry, who was all smiles in his stroller. While I described what had happened to him she calmly stated,
"It sounds like Nursemaid's Elbow."

We were admitted without a wait, but there was no urgency. Next the triage nurse assessed Henry,
"Probably Nursemaid's Elbow."

No one seemed surprised or worried. The doctor came in and I began to explain what happened. Before I could even finish, while holding Henry's arm and twisting inward, he said,
"There, it's fixed. It was Nursemaid's Elbow."

Wow, it really was fixed!

No x-ray or cast needed. He was diagnosed and cured in an instant of something I had never heard of before.

It turns out that Nursemaid's Elbow is a common injury to children whose arm has been pulled too hard. The doctor said that once it occurs it is more likely to happen again, up until the age of 6 or 7. Needless to say, I had the doctor show me how to "pop" the elbow back into place.

Henry began to use his arm almost immediately after the "fix" and never showed any sign of residual pain.

I guess having the experience of parenting three toddlers doesn't show you everything there is to know. Does anyone ever get to the point of being a hardened parenting veteran with encyclopedia like knowledge?

Maybe these parents.


Anonymous said...

You're my source of parenting knowledge, so if you weren't aware of it, we surely didn't know about Nursemaid's Elbow. Needless to say, we won't be pulling Johnny up by his arm anymore. Glad Henry is fine.
~ Miranda

Grandma Bettyanne said...

Your Father-in-Law had something similar happen to him when his dad swung him around for fun.

Poor Hen-man!

It made me smile to see you refer to Jacob as "the J-Man."