Wednesday, September 14, 2011

The MRI and the ER, a Spinal Tap Update

Emma's MRI this morning went off without a hitch other than the sedatives turned her into a drunken sailor for several hours afterward. Drunken, but happy and very funny to watch, which is much preferable to the angry ball of slobberous fury that Toby was for five hours after his MRI last fall.

Naomi initially woke feeling slightly improved this morning. She was able to walk down the stairs and use the bathroom by herself, but within an hour the severe pain had returned. Matt had already left for work so our family friend dosed Naomi her Tylenol with Codeine and a cup of juice as my written instructions had asked her to do. Unfortunately, with no real food in her stomach, the medicine simply came up again within a half-hour. Thankfully, Naomi had a barf bowl beside her bed left from a night she was feeling queasy awhile back, and she grabbed that just in time.

By the time I made it home Naomi was in excruciating pain. She was literally writhing, trying to find any comfortable position. Her eyes were dark and puffy, her face tear-streaked, and she said she was having trouble using the bathroom. At that point I decided that a doctor needed to see her in pain in order to get her effective treatment. Thankfully, my friend volunteered to put her other plans on hold this afternoon. She stayed and tended to Toby, Hannah, and drunken Emma while I took Naomi to the ER.

Naomi winced and cried as she made her way to the van, bent over at a 90 degree angle. She stayed bent as far forward as possible in her car seat and in the wheelchair, but her honest pain helped us get effective treatment more quickly. After the doctor observed her try to walk and listened to her describe and rate her pain she ordered initial IV fluids and some benedryl while she consulted with the neurosurgeon from the children's hospital. When the benedryl made Naomi extremely drowsy, but she could find no comfortable position to sleep in Naomi finally lost her composure. She melted in sobs and screams that probably scared the entire ER ward. I sat beside her and wrapped my arms gently around her and told her it was OK to cry. So cry she did, with no inhibition, like I've never heard her cry before. Her nurse tried to offer suggestions, but Naomi wasn't taking anyone's advice. Finally the nurse brought three extra pillows and we were able to prop Naomi, sitting with her legs crossed, leaning forward on three pillows on her lap. I sang her a few songs and she dropped sound to sleep for about fifteen minutes, with her face in the pillow in front of her.

I snuck in a much needed snack break and a few phone calls before Naomi woke and cried that she just wanted to go home. I assured her that the doctor would give her some real pain medicine as soon as the two doctors had decided what to do. It took three hours total in the ER before it was decided by all tests and exams and consultations that Naomi was not suffering from neurological damage, but muscle pain, and that the appropriate treatment was heavy duty pain meds. Fortunately, those three hours gave the doctor plenty of time to see and hear that Naomi was indeed in serious pain that needed serious treatment.

Naomi was given a dose of morphine through her IV, which brought her pain down from an 8/10 to a 5/10 in one hour. She was still unwilling to move at all, so she was given a second dose of morphine which finally brought her pain to a 3/10 and Naomi was able to straighten her back a little bit and began to smile and talk to those around her. We were discharged with some strong prescriptions for Vicadin and Valium and instructed to try one and if it didn't work, to wait until the dose wore off and then try the other. Hopefully one of the meds will continue to control her pain well until her back can heal from whatever is ailing it.

We are now at home. Naomi can get up and walk cautiously with her back bent only part-way over. She happily ate a snack and is on the couch coloring pictures. She is clearly still in some pain, but is chatty again--chatty enough to boss her siblings around again too, which is always a sign of health. I just hope we don't have too many days of narcotics and sedatives ahead of us before she recovers.

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