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View Full Version : Would you go back to the Dr?



BabbyO
04-08-2013, 10:13 AM
Peanut is 19 mo. Yesterday while playing he backed up and tripped over one of his ride on toys. He fell over the seat backward. This was a small fall...I've seen him tackle his brother with much more force and fall further and harder. But when he fell his right arm seemed to get twisted under him and the toy in a weird way.

My generally take-it-as-it-goes guy started WAILING. Now, he was also short a nap...so we thought maybe that has something to do with it. He seemed a bit sensitive to touch on that arm and we tried to ice it. When he wouldn't let us, we gave him some ibuprofen to help with any pain/swelling.

He finally went down for a nap late in the afternoon and woke about 45 min later (usually takes 1-1.5 hr nap). He was fussy after nap and through most of dinner, but settled a little near the end of dinner.

When I was washing him at bath time he was all smiles and happy until I tried to wash his right arm. He SCREAMED again when I touched his wrist/hand/forearm. At this point DH and I decided he should go to the ER to find out if he'd broken anything.

When we first got to the ER he was a bit clingy, but quickly warmed up to the doc (doc was GREAT with kids). They did an X-ray, but the doc didn't seen anything. He said it could be a sprain or something similar and to just keep up with Ibuprofen or tylenol.

Peanut had very interrupted sleep last night and was really upset this morning. He was clearly avoiding using his right arm. He wouldn't pick up his blankie with his right hand, he only lifted his left arm when he asked me to pick him up, etc. Granted, I think his left hand/arm is his dominant one, but he was clearly avoiding his right.

The Doc flexed and straightened his elbow...and that didn't seem to bother him. He flexed his wrist and wiggled his fingers and he was happy at the time. But this morning I'm inclined to think either his shoulder or his wrist is bothering him. He cried if we picked his arm up (to shoulder level - straight out like one side of a T). But DH said he was fine with getting into his car seat even when DH maneuvered his arm. DH seemed to think it is his wrist still.

WWYD? The ibuprofen doesn't seem to be helping a much at all, but aside from that, I don't see any swelling, bruising, or feel any heat anywhere on his arm/wrist/hand/shoulder. But clearly something is bothering him.

I did ask the doc to check his ears. He was pulling on one...but most likely because he's cutting a molar on that side. The doc confirmed his ears are clear. This is FAR more upset than he normally is for a tooth...even a molar. And he's clearly avoiding his right hand/arm.

Should I go back to the doc? I sorta feel like it might be a wasted trip, but my baby is clearly in pain.

Philly Mom
04-08-2013, 10:20 AM
Personally, I would start with a call to the ped's office and ask if you should try to make an appointment with an ortho ped or just come in and see your normal ped. I would definitely try seeing one of them.

BabbyO
04-08-2013, 10:27 AM
Personally, I would start with a call to the ped's office and ask if you should try to make an appointment with an ortho ped or just come in and see your normal ped. I would definitely try seeing one of them.

Hmm...it never even occurred to me...ortho ped. I don't even know if they have one in our group.

I'll have to consider that.

ETA: Well, I just checked and there aren't any ortho peds in our network within 100 miles of us....

MamaInMarch
04-08-2013, 10:42 AM
I would have it checked again. My DS had a minor fall - same idea, normally plays more roughly than the accident appeared - and it happened on a Saturday. On Wed he was still protecting his arm/wrist and crying if we touched it in a certain way. But not always every way it was handled. Took him to urgent care for X-rays and he had a buckle fracture. We didn't go sooner (he only complained once a day if that and very mildly) so I don't know if it would have been missed immediately after the incident or not.

crl
04-08-2013, 10:44 AM
I would call my ped.

Catherine

MommyAllison
04-08-2013, 10:45 AM
It seems like I've read here that sometimes broken bones in small children don't show up on x-ray for a couple days - not sure if I am remembering correctly. At any rate, I'd call the ped and see what they think.

georgiegirl
04-08-2013, 11:00 AM
I'd take him in again.

DS broke his arm last may. I thought it was his wrist, and the X-rays at urgent care didn't show anything, but the doctor thought something was broken because of the way he was acting. (Dr got DS happy and playing and told him to give him 5, and DS did and freaked out.). We had an appointment scheduled with the ped ortho the next afternoon. DS had a bad night, but that morning he was playing pretty normally, but favored his left hand and wouldn't bear weight on his right arm. I even sent him to preschool (after I told them the situation) and they said he acted totally normal. I almost cancelled the appointment because DS seemed pretty good, but I'm glad he didn't. At the ped ortho, they X-rayed his elbow, and it turns it there was a small crack in the tip of his humerus. He ended up with a long arm cast for a month. Which was so much fun in June...no swimming, no sand, no dirt, etc.

o_mom
04-08-2013, 11:05 AM
I would call and talk to the nurse at your ped. Find out if they have the radiologist report on the x-ray yet - many times that can take a day to get read if the ER doc just looked at it himself. However, if he is not in continuous/uncontrollable pain, I would lean toward giving it a day or two before going back in because it can take some time for fractures to show on x-rays.

crl
04-08-2013, 12:07 PM
It seems like I've read here that sometimes broken bones in small children don't show up on x-ray for a couple days - not sure if I am remembering correctly. At any rate, I'd call the ped and see what they think.

That's what our ped told me when I contacted him after dd hurt her foot. He said not to come in that day and if she was still limping or avoiding putting weight in it in two days to call him back and we would decide whether to go see him or what at that point. he said there was no point to coming in right away because small breaks wouldn't show up on x-ray until later.

Catherine

Still-in-Shock
04-08-2013, 12:27 PM
I would have it rechecked, just for peace of mind. Since you have a regular ped, getting a second opinion from someone with more experience with your little one makes sense.

I don't know about breaks, but I do know that bruises sometimes don't show up for a couple of days. Even if it isn't a broken bone, a sprain can hurt for a while.

Reader
04-08-2013, 02:08 PM
I also would go back. DS (7) fractured his arm a few months ago. The first X-ray (done at a children's hospital) showed nothing. The follow up 2 weeks later (we were told to treat it as if broken because of the swelling) showed a fracture, and we were told arm fractures are easy to miss on X-ray. At your DS's age, my oldest got nursemaid's elbow from a fall. He was miserable until the ER doc popped it back into place, then it was like there was nothing wrong with him before.

maiaann
04-08-2013, 02:47 PM
Definitely call and talk to an advice nurse.