So we survived the beach with a 10.5 month-old in a cast, including the necessary plane ride to and from to reach the beach. We were celebrating my grandparents' 90th birthdays (within about 3 weeks of each other), and everyone had a blast. Unfortunately, as is not uncommon with visits to extended family that involve multiple (8 total) munchkins, E came home with a fever that, while controllable with ibuprofen, did not want to go away. That was Monday, and Monday night he woke up at around 3 am crying - I re-dosed him with the ibuprofen because he felt really warm, and he fell back to sleep, but I didn't really.
Tuesday we made our second trip up to UNC. We'd been reading up on the diagnosis of oblique talus, and there really wasn't a whole lot to see - most of the research we could find was on the more involved vertical talus. Any mention of oblique talus was accompanied by a statement that resembled - it's not that bad and doesn't always even require treatment. That should have been our first clue, I suppose. We traipsed up to UNC, and due to feeling crummy and not sleeping well the night before, E actually napped during the drive up. He held up remarkably well to the cast removal, and didn't start really crying until Dr. H came in to re-apply the second cast. During all of the crying and holding him down for the casting (that SO sucks, by the way), we did manage to turn our brains on enough to ask Dr. H about the surgery issue. It hadn't sounded like, from our reading, that it was always a necessity. Dr. H was very firm though, that surgery would definitely be necessary to fully correct E's problem. Maybe just a tendon lengthening, but probably also a pinning of the joint. We blinked, and missed our chance to ask more questions. We were (again) a bit shell-shocked. The doctor had just confirmed our worst fears, in that we would have to deliver our precious baby over to the medical team for him to have surgery. We were confused, as we had thought his diagnosis was the more benign oblique talus, but in all of the swirling, we packed up our sniffling little boy and headed home.
That was a very long day. E was fussy all day, difficult to console, and very un-like our normally happy child. We attributed it to the new cast, and doled out the acetaminophen at regular intervals. Which explains why he wasn't still running a fever, I guess. Tuesday night was probably the worst night of his entire childhood. He slept in 40 minute intervals all night, with 10-20 minute spurts of crying in between. Which means I slept in 35 minute intervals, assuming it took me longer to fall asleep after I was sure he wasn't going to start crying again. We decided that we'd just gotten lucky during the previous casting, and I made sure I kept up with his acetaminophen that day, which made him more comfortable. Wednesday night was only marginally better, so by the time we got up on Thursday, I'd decided we were going to the pedi. I was going insane from lack of sleep, and while he was taking very nice, solid 2 hour naps, the little guy was obviously exhausted. Sure enough, on top of a new cast, the poor dude was coping with a double ear infection. Antibiotics, followed by the normal diarrhea that seems to go with antibiotics in kids, but at least it was something we could fix, unlike the cast just being uncomfortable.
Amidst my lack of sleep, my husband had started to get upset. I wasn't operating on all 8 cylinders (heck, probably not even on 2 after all of the nights in a row with bad sleep), so it took me a little longer to get ramped up. Every thing we found on the internet suggested that with a diagnosis of oblique talus he shouldn't need surgery. We didn't understand why, if he had the milder version, he was definitely going to need surgery. Also, we didn't really know what the full plan of care was. We knew what the internet said, and Dr. H had answered "yes" when I had asked if he would be casted after the suregery, but we were feeling like we had been bundled so quickly from one thing to another that if anyone had explained what was going to happen, we'd missed that part. I called up to UNC, although given my sleep deprivation I was probably not the right person to be making that type of call, and was able to pretty easily get a nurse to look at E's medical records. I'm sure anyone actually reading this has already figured out that we had mis-understood Dr. H that first day and E was actually diagnosed with vertical talus. This made the matter-of-fact way he'd referred to E's need for surgery make much more sense. Dr. H passed the message along via the nurse that he would explain it (he actually said "again," but I'm pretending I didn't hear that part) at our next appointment.
So, we're closing the end of our first week in our second cast. No new cast this week because the doctor is on vacation, so I'm not sure if that means we'll need fewer casts because he's in these first two longer, or that we're prolonging the whole casting process between our various vacations, but at least my little boy will have some extra time to get well. On top of everything else, he's also cut 1 (and probably in the middle of cutting the other) of his top two teeth. The fact that he was sleeping at all, between the cast, the tooth, the ears, and the diarrhea, is nothing short of a miracle. Here's to more miracles and both of us getting sleep in the next week.
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