On Monday night Jake had a slight fever again, and still this lingering cough, so I held him home Tuesday, transferred my lunch meeting to a phone meeting. In the middle of said meeting, Jacob climbed the stairs, whimpering a bit and rubbing his hip. I made sympathetic faces and continued to chair my 4-way phone call. About 20 minutes later I realized Jake was lying on his bed, crying softly, big tears streaking down his face. I wrapped my meeting quick.
Jake said, "I've got to pee, but I can't get to the bathroom. I can't walk." Not being able to walk is one of Jake's favorite means of avoiding unpleasant tasks, so I didn't take it too seriously. Thought he was mainly just bored and feeling ignored. So I scooped him up and carried him to the toilet, then I carried him down to the couch and turned on a movie for him. Usually the rule is kid's home sick don't watch tv, but he seemed pretty out of it, and I know he wasn't enjoying this as much as he enjoys school, so I thought I'd make an exception. We had 45 minutes till we had to go collect the other boys. I went back to my desk to attend to a few final things. About 15 minutes later, Jake began to wail. I went down to him. "I hate my position, but I can't move." This was a whole new dimension to the helpless act. I offered to help him move, but when I did, he screamed in pain. At which point we were both of us good and scared.
I called Jenny and asked if she would pick up Gus and Tucker for me, something I've never done before. I called each school to alert them to the fact. Jacob sobbed, "Get off the phone. I want you. I want you." "Sweetie sweetie sweetie, I've got to call the doctor now. Just let me call the doctor so we can figure out what to do, how to make you stop hurting, ok?" I left a message for the doctor to call me, then sat by Jake and stroked the tears from his face and told him how he used to get so mad at me when I'd touch the tears from his cheeks that I'd have to give them back. He liked that story. Almost smiled. Clutching me.
He identified the pain as in the groin at the top of his right leg. He said it wasn't belly pain. He didn't feel nauseous. He wasn't constipated didn't have diahrea. Just couldn't move his leg, had to keep it bent at the hip. We lay him on his back with a pillow under his knees to support the weight of them. The doctor called, listened to the story, suggested a remedy and to call back in 15 minutes. The remedy calmed Jake down, took the edge of panic off, if not the pain. In 15 minutes the doctor says, It doesn't sound like appendicitis, but keep him under observation for 24 hours and if he begins to vomit take him to the emergency room. Ok. So we wait and watch.
Gus and Tucker come home in a flurry of noise and need. I shush them, trying to woo Jake into sleep. Gus mopes upstairs. Tucker stays close, stamping his feet. Jake falls into a fitful sleep waking every 10 minutes, crying desperate for me. In the quiet bits, I tickle Tucker, try to think what to order for dinner. Watt comes home and asks if I've given Jake Tylenol. I hadn't even thought of it. The tylenol takes the edge off the fever and the pain. Watt's teasing helps too. The tv comes on, watt finds one dumb show after another. Jake is quiet, watching. I retreat to the other room, numb and uncertain. I don't want to turn my attention to anything else. I am afraid to become distracted. At the end of the evening, the doctor calls again. I say Jake has calmed down a lot, he's lying quietly, watching tv, even joking some. The doctor says, good I'll check in again in the morning.
At bed time, we find that Jacob cannot be moved. The pain remains, shifting to the other side now. I think if it weren't so traumatic to move, I'd take him to the emergency room, just in case. But I don't think it's a life-threatening thing and I keep weighing out the trauma of travel, the trauma of being in the emergency room and coming up with the feeling he's better off where he is. So he spends the night on the couch (which is at the foot of my bed at the moment.) I turn off my alarm, assuming it's going to be a rocky night. Jake wakes several times, thirsty. I give him water. Then he says, "Ok, you can go back to sleep now." Sweetie. I take this as a good sign, I'm thinking maybe Watt won't have to be late for work after all, maybe Jake will be fine in the morning. But he's not. When I suggest he try getting to the bathroom, he wants me to help him up so he can walk. But as soon as I lift him, he screams.
Watt calls in to work to say he'll be in late. He stays with Jake while I get the others off to school, then waits with me for the doctor's call. I'm a wreck by now. I can't just do nothing. I hate not knowing what to do. At 9:30 the doctor calls (after I've left 2 frantic messages in the last 30 minutes). He says it sounds like it might be an infection in the hip and the we should take him to the emergency room at Children's where they can do all the necessary tests. I'm so releived to be told what to do. I bundle up some books and crayons and my laptop. Some juice boxes and granola bars. Make a bed for Jake on the car seat. Watt carries him down, screaming and screaming, settles him in. Jake quiets down. We drive. We pull up the emergency ramp and ask the attendent for help moving him. The attendant brings a wheel chair. Watt settles Jake into it. I ask the attendant if there's someone who could park the car for us (imagine me, hah) and hand him the keys.
So there we are. The emergency room. I'd never been to children's emergency room before. I will never again take a child anywhere else. A child needs a place set up for children. And there are so few gunshot wounds, etc. Watt settles us in and goes. Jake and I wait. Jake doesn't want to be here. He wants to be home. We wait a long time, first in the waiting room, then in one of the little emergency room rooms. The first person to examine him moves his leg carelessly and it takes a couple of hours for Jake to regain his composure. He refuses to allow me to remove his shoe and the pants that are down around the ankle of his right leg. He doesn't want his pants off. He insists I put his pants back on. I won't. I get tense about it. Wanting to do what I'm told, be good, follow instructions. The Doctor wants the pants off, the pants come off. Caught between that and a deep empathy for Jake and his position of helplessness and his fierce struggle to retain his dignity. I can neither remove his pants, nor put them back on. So we leave it at that, Jake with one shoe on and his pants hanging off his foot.
They need to draw blood to test for the presence of infection. Jake, all on edge, says absolutely not. No way. I won't let you. I ache at how certain he sounds of his ability to refuse, knowing this one is beyond him now. We have offered ourselves up to the authorities and are on for the ride now. We no longer have choices like: I will not take my pants off, or I will not get a needle in my arm. It takes three of us to hold him down. He thrashes and hits and even tries to bite me, going from: "No you can't. I won't let you." to, "Don't let them do it, Mom. Don't let them. Mom. Mom. Mom." I hide my face from him, from the nurses. My face is all twisted up and I can't make it clean and calm and reassuring. I hold his chest and hide my face against the top of his head. I try to hold him still, driven by fear of the damage the needle and his thrashing might do. And then it's done. They leave a tube his arm, taped to the inside of his elbow, just in case an IV is required. A green styrophoam sort of plate and cotton gauze are taped to the back of his elbow and half a plastic cup taped over the tube to protect it. After the nurses leave, Jacob waves his taped up arm disgustedly. "What do they think I am, a man who doesn't need to bend his arm?"
The nurse brings Ibuprofen to ease the pain. This seems to work pretty well. Jacob calms down. They say he shouldn't eat anything until they can figure what's going on. So we don't eat the snacks I brought. We wait. At about 12:30, they take us to get xrays. I move Jake onto the wheel chair, tucking his pants around his foot. I ask the nurse if she has any idea how long we'll be, beginning to worry about picking up Gus and Tucker. She says it'll be a while, the xrays need to be developed and then read, and to complicate things, there's a "city emergency drill" scheduled for 1:30. So I'm going to have to think of someway to get the boys home. The xray technician is sweet and gentle. It seems to be getting easier to move Jake from table to chair and back.
Back in our little room, Jake opts to stay in the chair rather than get on to the table, just to be moved off again. I get out my laptop and set it on his lap and get a game going. I notice a bump on Jake's neck that looks like a hive. And his breathing's gotten labored. I call in the nurse. She says, "What could he possibly be reacting to?" I suggest the ibuprofen. She says no way, must just be a mosquito bite. But listen to his breathing, I persist. She brings some elburteral and hooks him up with the oxygen mask steaming the medicine over his mouth and nose. I sit with Jake till the mask comes off, then I go to call Jenny and ask if she could get the boys again. Call Watt to let him know what's up.
The nurse checks Jake's breathing, doesn't like the sound of it, gives him another dose of albuteral. I sit behind Jake watching over his shoulder. The oxygen makes me cold and gives me a headache. When I come around to remove the mask when the time's up, I see Jake's eyelids are pink and puffy, lined with hives. I call the nurse back. We discover hives on his thighs and belly too. "Huh," she says, "That's really odd."
Jacob uses up 3 hours of batteries playing games on the laptop. We go for an ultrasound. They discover fluid in both hip joints. The doctor from orthopaedics comes down. By this time its about 6. The doctor examines Jacob who actually stands up on his left leg and moves his right leg from side to side. The doctor says, if this were an infection in the hip he couldn't do that. He'd be lying with his knee bent and screaming at the very suggestion of moving it. Feeling slightly silly, as if I had no business being where I was with a boy so painfree, I assert that that's how he'd been in the morning. The doctor assures me he doesn't think I overreacted, that it's good we came in. He says it's a hard call to make. If it is an infection, they want to drain it to avoid damage to the joint. But sticking a long needle into the hip of a seven year old is not something one undertakes lightly and given the improvement and the fact that the fluid appeared in both joints, he was willing to advise that we could go home, keep Jake under close observation for 2 days and return immediately if his temperature topped 101 or should the pain return to the extent that he could not straighten his leg.
So we go home.