The Saturday before Nola's birthday (Chuck E Cheese party day) Nola woke up with a lip. She didn't complain of it hurting, she just wasn't walking normally. We asked her about it but figured she had just bumped it at school and she would be fine. When I picked her up from school on Monday they told me that it had gotten worse throughout the day, so I decided to make a doctor's appointment for Tuesday. I was trying to avoid that because I didn't want her to have to go to the doctor on her birthday, but I really thought they would just tell me she bruised it and it would heal itself. I made the appointment for after school so she wouldn't miss any of her birthday festivities!
We drove straight from school to the doctor in David City. Dr. Summers examined her knee and decided to get an X-ray because it was a bit swollen. So, we went back to get her first X-ray. She did a great job and thought it was pretty cool. When the X-rays came back normal, the doctor decided to get some blood work done. Nola had a slight fever and her knee was warm to the touch, so he was worried that there might be an infection. A nurse came in and took blood through a finger poke. Nola was not happy about that. It was heart breaking, at one point she asked me why we had to do this on her birthday, I felt terrible but still thought we would be home to celebrate soon.
The blood work came back with high counts of white blood cells which aligned with the doctors' fear that the joint was infected. He called down to Children's Hospital in Omaha to get a second opinion then came in to tell us that we should go down there immediately. Ummm, excuse me? He explained that if it was an infected joint then the infection could start breaking down the cartilage and cartilage can't be repaired so she would have chronic pain in her knee. Children's hospital had more resources to diagnose it and figure out treatment. I don't remember the specifics of that conversation but I'm pretty sure I said "but it's her birthday" about a hundred times. We went home to pack a bag and wait for Robert and Turk. Luckily, our neighbor was more than happy to take Turk for the night, so we loaded up and drove an hour to Omaha and checked into the emergency room.
Nola got "a few" stickers from Dr. Summers, so when they asked her to put on a gown she wanted to take the stickers off of her shirt and put them on the gown. Daddy told her she could move one, luckily Mommy was able to get them all off together- that still counts as one, right?
Showing off her stickers, still in good spirits.
While we were waiting we told everyone it was her birthday. Nurses, and even the helicopter pilot, brought her stickers to add to her collection. One of the nurses even brought her a brand new Candy Land game!
When the ER doctor came in she did an examination and right away said that she didn't think it was an infection. Nola was moving around on it too well, she said most kids wouldn't be able to walk. So they did another X-ray and then said they needed more blood. They knew she might need an IV so they tried to do that first but it didn't work, so they just took blood- if you're keeping count, that's 3 pokes. She got poked so much more the next couple of days :( Blood work showed that, again, white blood cells were high. Doctors were confused because the physical exam wasn't matching the lab work (according to the lab work, she shouldn't be able to walk around) so they called in the bone doctor. The bone doctor extracted fluid from her knee (another poke) and said immediately that it was infected. He told us that she would need to go to the OR immediately to get her knee flushed out, so 20 minutes later we were holding her down to get an IV in, it took two tries :( and just before midnight on her 5th birthday she was in her first surgery.
The surgery didn't last too long but by the time we were able to see her it was almost 1 am. Fun birthday, huh? We were shown to a short stay room that really wasn't too bad. There was a couch that laid out into a queen sized bed and a recliner.
The doctors said that it was infected and that she just must be a tough kid, which is why she could move around so well. The next two days would basically be a waiting game. We were waiting to see if bacteria would grow on a culture and what kind of bacteria to see how to treat it. In the mean time she was getting her antibiotics through IV. She was still pretty drugged up the day after the surgery and wasn't really awake until the afternoon. Robert had bought a cake on the way home to celebrate her birthday and it was still in the car so I went to a near by toy store and bought her some activities she could do in the hospital. I dropped the cake off at the nurses station and asked if they would come in and sing to her. A few minutes later about 6 of them came in singing with the cake, a balloon, and a couple of presents. It was very sweet but I think she was overwhelmed by it all.
This is when they came in, she was still a little groggy.
The next day she was more herself. She was walking around a bunch and was soooooo excited when Robert's mom and sister brought Turk up to visit. She was missing him quite a bit.
They stayed until her evening IV treatment. When the nurses started it they realized the IV had gone bad which meant taking it out and putting another one in. By this time she was over all of it and so tired. She fought us hard the whole time and at one point screamed, "it feels like scissors" which broke my heart. After that ordeal she passed out.
The next morning at 6 they drew blood again (it took 2 tries) to see if the white blood cell count had gone down. The doctor came in and said that everything looked great and we should be able to go home after she takes one dose of her antibiotics orally. We were able to try at 2 and she threw a fit. She spit out the first half and we ended up having to hold her down to get her to take the second half. Because she spit out half of it the doctor said that we had to stay and try again at 8. Then she said that if Nola couldn't take all of it at 8 she would have to get a tube placed in her nose to her stomach so she could take it that way. Because she would have to have that done in the OR they wouldn't be able to do it until Monday, which would mean spending the weekend in the hospital.
We spent the next 6 hours talking to Nola about how important it was that she take all of her medicine at 8. She wanted to go home, we wanted to go home, and everyone was missing Turk. Luckily, the thought of not seeing Turk for two more days was enough for her to be brave and swallow all of it. We were out the door a few minutes later. Nola got to ride to the car in the wagon and thought that was pretty cool!
Bacteria didn't grow on the culture, which is pretty common- according to the doctor. He said that it was an infection, but with no bacteria we don't know exactly what kind caused it. If we knew what kind we might be able to determine where it came from. His guess is that it came in from a cut somewhere on the body and made it's way to her knee. He said that a child's knee joint is so small that it probably got caught there and started to grow. Apparently it's not uncommon in children (although more common in the hip) and they see about 1 case per week.
We are so thankful for everyone that called, texted, and commented. And especially thankful for our neighbors and families. Our neighbors watched Turk the first night and following day until Robert's mom and sister came up and took over. Then my mom drove up on Friday to watch him and stayed through the weekend so I could take a nap :)
When we got home the house was decorated for Nola's birthday (curtesy of Mary and Jennie) and Nola's teacher sent cards from her class and the daycare kids. My brother and sister-in-law sent a "box of sunshine" which Nola loved (she loves anything from Hannah), and my sister sent us some Nothing Bunt Cakes which I loved (I love anything with the word "cake" in it).
I know that we are very lucky that it wasn't anything serious and that our hospital stay wasn't longer. I also know that while it was hard to be there on her birthday it's probably not something she's going to remember and like much of the last week, it was much harder on me than it was one her. I'm just glad we have that "first" out of the way!
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