Managing expectations

Don't worry, I'm no longer on a rampage about our doctor setting our expectations poorly. I've accepted it and moved on. Actually, we're doing pretty well these days; I think we've found a little bit of a routine, a groove. It helps a lot that Zach has slept until at least 7 AM the last 3 days in a row, as opposed to the 5:30 wakings that had become his norm the first couple weeks he had the cast on. Actually, he's been sleeping a lot better in general, which helps all of us.

And while I have completely run out of enthusiasm for playing cars, Zach sure hasn't, so I'll just be happy he's found something to do that entertains him so much. Our days basically rotate between playing cars and play-doh, with a few other activities thrown in occasionally. And yes, with the movie Cars usually on in the background, or the occasional Diego. And we're getting a little braver with our outings - we'll keep going to Zach's "school" and ECFE for a few hours a week, and will keep trying things like the zoo and playdates with friends. While his immediate reaction is that he just wants to stay home, he usually does pretty well once we're out and about.

I titled this entry as I did because we are already thinking about having the cast removed, and what Zach's recovery will be like. We've been told it's possible he'll want to walk immediately, but that it may also take up to three weeks for him to do so. According to the doctor, and to what I've found on-line, the recovery varies dramatically kid by kid. Obviously his joints will be pretty sore and stiff, since he won't have been using his hips, left knee, or his left ankle for five weeks. But there is also the fear factor - the kids are understandably afraid it will hurt to walk. We learned that physical therapy is a possibility, but not necessarily standard for small kids, since the best therapy is just to encourage them to walk again. It's very odd to think about Zach having to learn to walk again - he's been walking since he was 10 months old! Yet another adventure we'll just have to watch unfold, trying to keep our expectations to a minimum!

Spica cast days completed: 17
Spica cast days remaining: 18

Oh... I have to mention a funny story. Zach occasionally makes references to not being able to walk/get up/stand, and he states the obvious so matter of factly we always laugh. Last night after Scott put Zach to bed, he was crying a little bit, so I went up to see if he needed something in particular. Turns out his leg was itching inside the cast; we had just begun using the hair dryer on the cool setting to relieve the itching that day, and Zach thought it was pretty fun. So when he asked for the hair dryer, I said it was downstairs and that I'd go get it. He responded with "thanks mama - I'll wait right here." :)

Customer Service 101

I thought everyone knew the basic rule of customer service: under-promise and then over-deliver. No matter what your business, this simple rule seems to guarantee happy, satisfied customers. Example? Pizza delivery guys tell you it’ll take 30 minutes to deliver your pizza when they know quite well they can get it to you in 22. But aren’t you delighted when the doorbell rings “early”??

Well, we’ve found the one person who doesn’t realize the importance of this: Zach’s ortho doctor. Fifteen days ago, as we sat in the hospital, exhausted and helpless, we felt pretty overwhelmed as it began to sink in exactly what type of cast Zach would have, and all the limitations and challenges that would cause. So when the doctor explained how quickly small kids heal, specifically that the rule of thumb for the length of time the cast remains on is one week for every year of life, plus one week, we were quite pleasantly surprised. 3 and a half to 4 weeks?? That’s not bad – we can do that!

I’m sure you can see where this is going… nowhere good. I’ll get to the punch line: the cast will be on for another 3 weeks. And no, not because it isn't healing well - the bone is healing just as it should be. When we went in to get Zach x-rayed again today, the doctor casually said – so the rule is a week for every year plus 2-3 weeks. I suspect we were staring at him blankly, trying to make the words coming out of his mouth match the words he had said over and over in the hospital. Then he said something I couldn’t have said better myself, and I quote: “Did I say a week for every year plus 1 week? I shouldn’t have said that. I’m an idiot.” Uh… yeah.

So, while we originally were targeting somewhere between 10/5 and 10/8 to have the cast removed, the removal is scheduled for 10/15. I have decided to give myself the rest of the day to be crabby and bitter about it, and then I’ll do what I have to do – get over it and focus on making the next three weeks as painless as possible for all of us. (I don’t mean to make this sound like I’m single-handedly taking care of Zach… Scott is more than an equal partner in this. But while I know he’s as irritated as I am, I don’t like to presume that I can speak for him. Well, at least not all the time.)

Ahhh… on a happier note, I’ll include some pictures from our outing to the zoo yesterday with our friends Laura, Clark, and David. I have the laugh at the one of Zach in the stroller – what an odd look on his face! You’ve all seen what expression he makes when you ask him to smile; well, this is what you get when you ask him to laugh! I also had to include one of Koskie taking advantage of one of the many pillows we have laying around to make Zach comfortable; doesn’t he look cozy?

Ups and downs

Well, that last entry was a bit of a downer. We definitely have good days and bad days, and Friday wasn't such a great day, as you can probably tell! Saturday, on the other hand, was great. Scott and Zach went on their traditional outing to McDonalds for pancakes while I slept in, and then when Scott and his friends headed to Wisconsin for Rosie's 5th annual bachelor party, Zach and I had a very fun day. We went to out in the afternoon for a little treat, and I was surprised when Zach yelled "there's Dairy Queen" as we rounded the corner; he'd only been there once! I guess you remember the good stuff, even when you're two! Sunday I got to take some "me" time, when Scott got back. I took myself out for lunch and to a movie... a nice break. So we had a pretty good weekend, all things considered.

Oh, and I forgot to mention - Zach kept things interesting for us by spiking a relatively high fever on Saturday. After phone calls to the children's hospital and our normal doctor, and an even more thorough search for pressure sores (he has none), we were told to just give him some Tylenol and keep an eye on him. He didn't have any other symptoms, so that was it. And Sunday it was gone. Mysterious...

Let's see, what else have we been up to? I forgot to mention that last Thursday Zach and I went to our first ECFE class for this school year. I didn't know what to expect, I was concerned Zach would get frustrated that he couldn't play like all the other kids. But I wanted to give it a try anyway - a change of scenery, new toys, etc. I'm so glad we went - Zach was so excited when we walked in the door. It's the same room we were in last year, and he clearly remembered it. I got to flex my newly developing muscles as I heaved and hoisted Zach around, finding ways to sit him on my lap or on the floor so he could reach the toys and play-doh, and of course, his snack. Typically our class separates - the parents leave the kids with the teachers after a little while, to go talk parenting. But I stayed behind, since they aren't exactly staffed to provide the one-on-one attention Zach needs. It was fun, and we made it almost the entire two hours, which really surprised me!

We also had an exciting development in the area of transportation. We had been using various wagons to take Zach out and about, which was not ideal. We could never get him comfortable, and he'd end up laying back looking so very pathetic. And he really, really did not like it. Our friend Cindy to the rescue - she had a stroller that is both shallow and wide enough that Zach actually fits! So now he can sit upright when we go on our outings, and we can also use it to play outside - he can knock beach balls around, throw frisbees, etc. A much better solution for everybody.

The biggest challenge these days is sleep (we finally mastered the diapering challenges). Zach actually slept better the first few days than he is now; for some reason he seems to be plagued by nightmares a lot more now. He had nightmares before this happened, but either they're a lot more frequent now, or he just has a harder time settling himself down and going back to sleep - or both. I had assumed his nightmares were about the pain when he first broke his leg, or some of the scarier experiences in the hospital, or just random weird things we all dream about. So I did have to laugh at about 3 AM this morning when I heard Zach yell "I don't want to watch that movie! Get it out!!!" He sounded so upset about it! But I guess a nightmare is a nightmare, and besides the fact that they are hampering all of our sleep, they're frustrating because there isn't anything we can really do to help him. But that seems true of so many things these days, that's for sure.

I miss...

I miss...

• Waking to a loud but cheerful “Mama! Dada! Mama! Dada!” (at the decent hour of 7 AM)
• Walking into Zach’s room in the morning or after his nap to find him standing in the far front corner of his crib, with his blankie draped over the edge – ready to go!
• Holding his little hand as we cross the street or walk thru a parking lot
• Zach saying daily “what are we going to do today mama?” – ready for whatever adventures the day will bring.
• Listening to Zach chatter as he stands on the stool at the end of the island, while he eats breakfast, colors, plays play-doh, etc.
• Watching Scott take off with Zach in the jogging stroller, off on one of their almost-daily adventures around the lake and to the playground.
• Laughing at the goofy things Zach says while he’s playing his various sports:
  - I’m kicking it old school – soccer
  - Go deep mama! – football
  - I cranked a homer! – baseball
• Smiling at the sight of small kids running and jumping, instead of feeling a pang of envy.
• Zach not even paying attention when I tell him I’m leaving.
• Watching the pure and absolute joy on Zach’s face as he jumps on the trampoline.

Spica cast days completed: 9

Spica cast days remaining: 16 - 20 (hopefully)

Quick update

We had our first return visit with the doctor yesterday, to make sure Zach's leg is healing appropriately. They took an x-ray, a process that absolutely terrifies Zach (sigh). The entire time we were there, which was a while, since once again we had to wait, he just kept repeating "I want to go home." The doctor remembered that was Zach's constant refrain at the hospital too, and commented that our house must be a great place to be. :)

Anyway, the good news is everything is healing well. Even I, with my uneducated eye, could see on the x-ray that the bones looked more "fused" - less space in between the two broken segments. Hooray!

Unfortunately, we didn't get a target end date; we need to go back again next week for one more x-ray, and then they'll give us a date to have this cumbersome beast removed.

I'm including a picture of some of the gifts Zach has received and is enjoying - a Cars laptop from Scott's parents, a big hit, and a blue bear he got from "Sylvia's grandma and Jim," as he calls them (our friend Adam's parents). He's funny about new things, especially stuffed animals, so we're amazed at how much he's taken to that blue bear - he loves it!

Cars squared

Week 1: Done.

I shudder to think about where we were 7 days ago at this time. Compared to that night - we're doing spectacularly now.

I don't have a lot of news to report. My parents were a wonderful help; Scott and I even got to go out to dinner on our own, something that won't be happening again for quite a while! G&G left on Tuesday, and left behind many of their creative contributions, fortunately. We've also had a lot of people stop by with gifts and food - we honestly can't thank all of you enough.

We're continuing to learn how to make the best of this situation. We've gotten a lot better at the diapering situation, which makes life easier. I think it helps that some of the swelling has gone down - the areas all around his cast were a little swollen, which made him uncomfortable at times, particularly during certain types of diaper changes. His constipation is also gone - a big relief for all of us. He has definitely accepted the situation - he sometimes talks about what he'll do when the cast comes off. We've also managed a few outings; it seems to help him as much as me when we leave the house.

But we still spend a lot of time with Cars - either the movie or his actual play cars - or both. This video captures his current favorite activity, using the ramp that Grandpa K created. We play this game probably 6 or 7 times a day, since his attention span is rarely longer than 20 minutes. And this particular time, we were watching Cars while playing cars!

Adjusting

We made it through day 4. Whew.

We have learned a lot, about so many things. But what we already knew is that we have great family and friends, and boy, has that been obvious the last few days. I’m amazed at how quickly people have jumped into action; Zach broke his leg Wednesday night, and we didn’t tell anyone other than our immediate family until Thursday. Yet two days later, in the mail I found three cards and/or gifts for Zach! He loves getting mail, so he was thrilled. We also know many other things are currently finding their way through the air and across the ground to help us keep this boy entertained; friends and neighbors have dropped by with more gifts or loaned toys, or are planning to do so soon. I have never been good at accepting help, but in this situation, it’s very easy, and I can’t express my gratitude enough!

In general, I’d summarize the last few days by saying we’re all adjusting. Zach seems much closer to accepting this situation. The first couple days he kept insisting he wanted to go outside and play, and he did not like the options we offered – sitting in the wagon or the carseat outside. He wanted, of course, to run and jump and play baseball. He would also say things like “Mama, I want to sit on the couch, but without this” – and he’d point at the cast. Or he’d say funny things like “Daddy – I can’t walk, can you carry me into McDonalds?” Those types of comments are slowing down, and now instead he’s demanding (and yes, I do mean demanding) to sit on the couch, in the carseat, on the beanbag chair, etc – he now knows what his options are.

Sleeping has sure been an adjustment. We were originally told that we had to re-position him during the night, which did not work well for him at all. He’d sleep pretty well on his stomach, and as soon as we turned him over on his back – he’d yell every 10 minutes or so. Not good for any of us! Fortunately when we called the hospital, we got the answer we wanted – that as long as he’s not on his belly much during the day, he can sleep that way all night. Whew. So while he’s not sleeping the night through, the wakings are fewer, and very brief – he generally just hollers “mamaaaaa!” and then goes back to sleep on his own. I suspect he wakes up and is still startled to find himself “stuck,” so I’m hoping as time goes by he’ll continue to adjust.

I should back up – we’ve gotten lots of questions on exactly what the cast is like, whether he can sit up, etc. Hopefully the pictures I’ve included here will help, but basically since the cast comes up to his waist, and he’s casted in a fairly prone position, he can’t really sit up. We can prop him close to sitting, but not completely upright. And he can lay on his belly, although I think it looks awfully uncomfortable! When he lays on his back his left leg sticks up in the air, slightly bent. And his legs are spread apart, which is the primary barrier to putting him in any type of normal carseat or stroller – they simply aren’t wide enough. Hence the wagon…

The most interesting has been our adjustment to how he plays. We had already discovered that the carseat we borrowed from the hospital was the best way to sit him upright, and that we could put his little kiddy table over his lap so he could eat, do a puzzle, etc. We’d heard beanbags were the best way to provide lots of seating options, so G&G Klicka picked one up and brought it along. My dad invented something that I don’t really know how to describe… maybe the pictures will help. But he got two actual large pieces of Styrofoam-type insulation, and holds them up with paper towel rolls. So far we've used that as a big lap table, but we discovered it also makes a great ramp for Zach's cars. :)

One adjustment for me has been letting go of the "rules" drilled into my head - no more than two hours of tv per day is no longer a reality at our house. And what is he watching, primarily? Cars. Cars. And more Cars. Over and over again. Sometimes it's just in the background, but still. Can we try something else??

On Thursday we go back to the doctor so they can check out his progress, and we are assuming, give us the target date to have the cast removed. And then we're going to make a great big calendar and cross off the days until this thing comes off!!!

Stuck

I’ve never really understood the true definition of irony, so I may be wrong when I say it seems awfully ironic that the day after I blogged about how happy Zach was jumping on the neighbors trampoline, he broke his leg while doing so. The story…

On Wednesday Zach was jumping on the trampoline with a few of the neighbor girls after school/before dinner, which seemed like it was becoming a tradition. And while I didn’t see it happen (ahh... the guilt. I keep reminding myself even if I’d been standing on the trampoline with him, I doubt I could have prevented this, but the guilt remains), the girls told me he landed on a ball that was on the trampoline and fell funny. Zach told me his knee hurt. I couldn’t see any visible problems, but I could tell from the way he was crying that it wasn’t your typical give it a kiss and send him on his way injury, so I called his doctor and asked if we should head to the emergency room right away.

There are so many things I would have done differently had I been able to predict the future, and following the doctor’s office advice to come to the clinic for an x-ray is one of them. But that’s what we did, and after waiting way too long with a boy that would scream in pain if you moved his leg at all, we got our x-ray and saw the obvious break right in the middle of his femur.

After some delays with the nurses calling around to find out which hospital had a pediatric orthopedic doctor in, we were told there that neither Children’s Hospital (St. Paul nor Minneapolis) had one, so we’d have to go to Regions Hospital in St. Paul. After more debate, they called an ambulance for us, and Zach and I got to experience our first ambulance ride. At this point, Zach was pretty calm – we had figured out how to hold him so he wasn’t in any pain, and he was talking with us and the nurses, even laughing at times.

The emergency room experience was not great. By far the biggest thing I’ve learned is to push and push for a children’s hospital - they specialize for a reason! We were especially frustrated when we learned later than Regions could and should have checked him out in the ER, and then immediately referred him to Gillette’s Childrens, which was on the 4th floor of that very hospital!!!

Anyway, after lots and lots of delays and painful experiences like more x-rays and a nurse’s frustrating struggle to get an IV in Zach’s arm, it was determined that they’d splint Zach’s leg temporarily and schedule him for surgery at 7:30 AM to cast his leg using x-rays to line up the bone. This seemed odd to us, since by then it was about 1 AM… but ok.

After more delays, we were transferred up to Gillette’s for our “night” stay – from 3 to 6, when they woke us to prep Zach for surgery. I think they called it surgery since Zach had to be completely knocked out to re-set the bone. So we traveled back downstairs to Regions, and by 11 AM the surgery was done and Zach was awake. His first words when he awoke? “I’m stuck!”

Yes, he is stuck. The cast they put on him is called a spica cast; it runs from his hips to his toes on the broken (left) leg, and to just above his knee on the right leg, with a cut-out so that certain biological functions can still take place. So yes, the poor boy is immobilized. I’ll put some pictures up eventually so you can see exactly what I’m talking about, but I haven’t had the heart to take any yet, so instead I’m including some pictures I took the other day when he was in an absolutely fantastic mood, having a snack before he went outside to play and jump on the trampoline.

We got home from the hospital yesterday about 4:00; we had spent the day making sure Zach didn’t have any complications from the anesthesia (he didn’t), and learning how to care for him in the cast. The biggest challenge, by far, has been figuring out the diapering situation. I won’t go into details, I’ll just say there’s a very complicated diapering process that Zach doesn’t enjoy, and we have to be vigilant about changing him to make sure the cast doesn’t get wet.

Since we’ve gotten home, I feel like I’ve been thrust back into time – back to the days when we brought Zach home from the hospital the first time! We are both feeling scared and unsure of what we’re doing, if we’re going to hurt Zach, how to keep him comfortable and happy, etc. And not to mention entertained! Last night went ok, he slept remarkably well all things considered, including our need to change his position during the night so he doesn’t get pressure sores. And he’s starting to adapt – at 6 this morning he called out “Mama! Dada! Can you roll me over on my belly?”

So, basically, Zach is doing his best to roll (no pun intended) with the punches. He is obviously struggling to understand what’s going on, and I think it’s sinking in a bit now. Yesterday he kept telling us he wanted to go outside to play… not exactly possible the way he meant. But this morning when he told me he wanted to go downstairs, he said – mama, I can’t walk! I told him I’d carry him, and his response was – but I’m a big boy, too big to carry!

The bottom line: this cast will be on for 3.5 to 4 weeks. Which is amazingly short; if this happened to one of us, we’d have the cast on for probably a minimum of two months! These kids heal fast. So we’re taking it day by day, figuring out logistics of how to carry him, how to prop him up comfortably, the darn diapering process, and ways he can play. Grandma and Grandpa Klicka are coming to visit tomorrow, and I know that’ll do wonders for him.

We’ll keep you posted…

Jump around

This is what Zach did over the long weekend:

No, we don't own a trampoline. We have what I consider even better: neighbors who let Zach use their trampoline any time! That's all he wants to do lately; first we hear "let's go play outside," and after we've been out for about 30 seconds - "let's go jump on the trampoline!" He loves it, and I love it because it wears him out. He was actually out of breath today as he was jumping!

Otherwise, the rest of our weekend was good too. One of the best parts was Zach waking up at 7:45 every morning!! Trust me, that's luxurious sleeping in at our house! Dinner with the Brodds Friday night, Bergums Saturday night - both are always a good time. And the rest of the time we filled with long walks and runs, outings to the park, running errands, more eating and relaxing. Oh, and we also found time to buy Zach a big boy bed! We aren't planning to move him quite yet, but we couldn't pass up the sales! We keep trying to picture him sleeping in a regular bed, and we just can't do it. A new adventure to look forward to...

Green Eggs and Ham

When someone asks Zach his name, he answers with his full name instead of just saying "Zach." So it seems only appropriate for me to introduce this video as follows...

A reading of Green Eggs and Ham, by Zachary Scott Willard:
(with a special appearance by Kasey)