Health knowledge made personal
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Yikes, my blog is now THREE WEEKS out of date. I think that's some sort of a new record.
But these have been one of the busiest three weeks of our lives. Before I start on the updates, which I'll break into smaller posts, I want to thank everyone who commented on my previous post about changing the kids' names on the blog. There was some great advice given, and I will definitely be looking into what to do about my blog address in the future, once things calm down a bit and I have more time. And now, on to the updates: Our first mini drama kicked off on the children's first day back at school after their hospice stay for our 10th wedding anniversary. They both went back into school fine, and I spent the morning getting sorted out around the house, and then went out for lunch with some Alpha friends. I had a phone call from Laurel's teacher at around 2.15 pm, saying that there had been an incident at school at lunchtime, and that she was complaining of pain in her ribs. I asked what had happened, and he explained that Laurel had been standing up for her friend in the playground at lunchtime, and had got shoved in the chest. He said that when it had happened, she had been unable to breathe initially, and had been in pain ever since. He said that her pain had started at a 7 or an 8 out of 10 at first, then went down to a 5 or 6. He wanted to let me know, in case it would cause any CF-related problems. I asked what her pain levels were right now, and so he said he'd find out and call me back. When he called back, he said that her pain levels had gone back up to a 7 or an 8, and so I said I'd give the hospital a call and see whether they thought Laurel needed seeing on the ward. I called the hospital and they suggested getting Laurel checked out at A&E, so J and B gave me a lift to the school and I picked up both children and they took us all to A&E and waited with us. We had at least an hour's wait in A&E, but J helped to keep the kids occupied. When I'd picked Laurel up from school, she had been walking hunched over, and was very pale, and said that her pain was still a 7 or an 8. While we were waiting at A&E, Laurel elaborated a little more on her pain levels, saying that if she stayed still, her pain went down to a 5 or a 6, but if she moved at all, her pain levels shot up to a 7 or an 8 again. When we were called through to the cubicle, Laurel had her obs done, and they were fine, and then after a short wait, she was seen by a doctor. We explained what had happened, and Laurel told him that she and her friend had been playing out in the playground at lunchtime, and that her friend E had been showing her a paper stable that she had made for her (they are both horse mad, and have formed the Bridle Club together). A boy from the year above them came over and swore at them, telling E that her paper stable was rubbish. E asked him to go away, and the boy hit her on the head. At this point, Laurel jumped up and said "Don't you hit my friend!" The boy turned to her, said "Oh yeah? What're you going to do about it!" and shoved her really hard in the chest. So hard that she fell back down onto the bench with a jolt. She then couldn't breathe for a while, and was in a lot of pain, so she was taken to the first aid room. She spent the rest of lunchtime in the first aid room, then was sent to her next class, which was a violin lesson. She complained again of pain throughout the lesson, and eventually, the teacher contacted her form tutor, who became concerned and contacted me. The doctor listened to the story, and then examined her, diagnosing bruised ribs. He was confident that they weren't fractured, but said that things would heal in their own time, and that we should give her regular ibuprofen. I asked him for advice about her chest physiotherapy, and I was particularly concerned because when he had examined her, he had heard some crackles in the base of her right lung. He said that we would just have to 'play it by ear' and make do with PEP physio and Nebusal at first, and then move onto percussion physio again once her ribs had started to heal. However, the doctor was very concerned that the incident had been able to happen at all, and stressed that we should make the school very aware that an incident such as this, resulting in injury to Laurel's ribs cannot be allowed to happen again, as obviously a rib injury results in us not being able to do her physio, and in the long term, this will impact on her health and life expectancy. We finally got home just before 6 pm, so poor old Tomos had to miss his Disability Football Club session, but he was an absolute star at A&E, he played really well with J (he is getting to know her quite well now, as she is his one-to-one carer at church too) and coped quite well with all the sudden changes to his routine. Laurel wasn't too impressed about having to have her Nebusal nebuliser that evening, as she hates it and insists it makes her feel sick, but she did it in the end, and it got her shifting some of the gunk, so I was very proud of her. And the ibuprofen did its job and reduced her pain levels to a manageable level (as long as no-one touched her ribs or hugged her) for her to get some sleep. She went back to school the following day, and I had a quick talk with the headmaster, but I wasn't too pleased with how they seemed to be dealing with the issue, so I had another talk with her form tutor after school, to learn more about how they were handling things. Laurel coped well with her day at school. Her class had swimming that morning, and she had wanted to attempt it, so we dosed her up on the ibuprofen and let her have a go. She coped fine with the swimming, but her pain levels did increase through the day, partly as she was active and moving around, and partly because the ibuprofen started to wear off, so we decided that she should give her dance class a miss that night after school. Over the following week, Laurel's ribs gradually improved, and her pain levels gradually dropped, and so on the Friday evening, after a dose of ibuprofen, we tried a mini version of her percussion physio, focusing on the less painful areas of her chest more, and doing some huffs and coughs. She coped pretty well, and so on Sunday evening, we did a full percussion physio session, and it went fine. She was still a little tender around her ribs, but nothing serious. I submitted a complaint in writing to the headmaster on the Thursday morning, about my unhappiness over the way the incident was handled (without saying too much about it, I felt that due to certain circumstances, the incident could have been prevented, and that they should have notified me of the events sooner so that Laurel could have had pain medication sooner), and I wanted more information on the consequences of the boy's behaviour and any safeguards they would be putting in place for the future. I had a phone call from the headmaster that afternoon, asking me to go into school to discuss the matter further. I was pretty nervous beforehand, because I don't like to make a fuss about things, or come across as a pushy mum, but because of the seriousness of the incident, and the consequences it had for her chest physio for a whole week, I wanted the school to take the incident seriously and not just brush it under the carpet. Thankfully, the meeting went really well and the headmaster updated me on the way they had dealt with the boy in question, and that they had notified his parents, and spoken to him, making him aware of the consequences of his actions. The headmaster also informed me that he was going to brief every member of staff so that they are all aware that Laurel has CF, and that if she ever complains of chest pain after an injury, that I should be notified immediately. I modified this to suggest that I should be notified of any chest pain at all, whether following an injury or not, because chest pain can also be a sign of a chest infection, and certainly in Laurel's case, it has been in the past. I also reminded him that Tomos also has CF, and that if he should ever complain of chest pain, whether following an injury or out of the blue, I would need to be notified about that as well. I felt much better after the meeting, and now just over two weeks later, Laurel's ribs are fine, and her chest seems pretty clear. So hopefully she's come through the incident with no lasting ill effects! |
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