Update on dd's arm. Not too good. Update post #5

[AmazingGrace]

So she fell, broke her arm, had pins the first week of April. She fractured her humerous. She has a soft splint for two weeks, then a hard cast for two weeks. Last Monday, cast comes off. Pins come out. She has almost full motion of her arm. No pain or swelling.
Today, she comes home unable to straighten her arm at the elbow. No pain, just can't move her arm. I take her to the base hospital. They do xrays. Even though the XRay didn't show anything, it's obvious that something is wrong. They think the bone might have slipped into the elbow joint. She goes back tomorrow morning. I've never heard of this happening.

 

[HelenePA]

I broke my upper humerous when I was about 12 or so (no pins althought I did have them later when my broke my pinky..) I remember not being able to straighten my arm for YEARS afterwards. Not in a noticable way just not as straight as my other arm lol I guess it was from being casted and not moving for 8 weeks? I never made a big deal out of it, I dont know if I ever told my dr's or even my parents I figured I'd regain full straighting over time and I did. I hope its the same for your dd. I like her never had pain. Hope its nothing!

 

[AmazingGrace]

I expected some stiffness and not being able to straighten, but up until today, she was able to straighten it almost all the way. Now it's to an almost 45° angle and no further. It's weird. Do you still ever have pain in your arm? How about popping?

 

[HelenePA]

Let me just start out by saying I've broken lots of things lots of time lol... now my humerous doesn't hurt,it might have when I first got the cast removed but that was going on 20 years ago. My right wrist (broke twice) DOES hurt, no popping, though it swells during seasonal changes BADLY. my left wrist (broke once) doesn't hurt at all, either does my pinky (the one with pins which were removed but I was casted the whole 6 weeks with them in)

 

[AmazingGrace]

Here's the background and update...
DD broke her arm on 6 April. So, she had the surgery, had pins put in, was in a soft splint for a week, then a hard cast for two weeks. On 2 May, she had the cast taken off and the pins removed. And that was supposed to be it. Her ortho said that Grace'd be a little siff at first but would slowly get movment back.

She started getting movement back over the next week, to the point that she could totally straighten the arm. Then on the 8th of may, she came to me and told me she could not straighten her arm. She could only straigthen it to about a 70% angle. I called orthopedics, as i was instructed to do. I left a message and said it was urgent, again, as instructed to do, and they never called back.
I then called their after hours number, only to have a machine tell me that messages would be checked three times daily during the duty day.
So I called the nurse hotline and given the symptoms, I was told to take her to the ER.
So we go to the ER and the ortho resident, bless his heart, keeps getting called out to traumas, so finally he comes in, looks at the XRays and says there's nothing wrong there, but she definitely has something going on. He tells us to come back the next morning. The attending dealing with Grace is out of towns, so he wasn't sure what was going to happen.
The next morning, the other resident calls and tells me that the XRAYs look perfect and that Grace just doesn't want to move her arm, and that it's normal for it to be stiff. I kept telling her that it was locked and up to 24 hours before, Grace had no problem moving her arm, but the resident didn't seem to be liestening. She tells me to bring grace in a week later.
They ended up calling and making an appointment for Grace the following Tuesday. We get more xrays done and the attending comes in. She thinks at this point, the bone is forming a callous and may remodel the way it's supposed to. That they could CT her arm, but she didn't think it was necessary. I told her I thought it was necessary and she actually listened and ordered the scan.
The scan showed callouses and cracks near the original fracture. She's now in a removable splint and goes back on June 10 to discuss options. Perhaps pt or hopefully not, surgery.
I'm just floored by a couple of things. I know this is an Army med center, catering to soldiers, but my daughter isn't one. I cannot believe that they took her cast off so soon and then wouldn't listen to our concerns. They took her cast of and basically let us go without any kind of followup. They took pliers and pulled those pins out without any kind of warning or even "mom, give her motrin or something beforehand. This is going to hurt."
I'm also just at the options for after care. Seriously? the after hours number is only checked during duty hours??
I'm trying hard not to be a snowflake mom here. My dd has been a little trooper through this whole thing and i don't expect special treatment for her. I do expect that she's going to be able to move her arm at the end of this ordeal. I don't think that's an unreasonable expectation in this day and age.

 

[FredinFL]

I'd be mad as hell and going to the head of the hospital and who else was in charge of the place. That is ridiculous, callous and dangerous.

 

[PrincessSuzanne]

Doesn't sound like Army hospitals have been updated much since I was a teenager and that was over 20 years ago. I think she should have gotten better care than you describe, it just seems that the Army hospitals don't take the time to provide that care.

Most Military families I know go off-base and are even willing to pay more for services than deal with our local Army Hospital.

It doesn't sound right to have her casted for that short of time. I had a hairline fracture when I was about 13 and I think I was in a cast/splint for 6-8 weeks. I had some additional problems with that arm when I was 16 or 17 and I was in a hard cast for about 8 weeks.

You have every right to be upset, even angry at the lack of treatment she has received and I think if it continues, I would be contacting someone who is in charge.

Suzanne

 

[minniebeth]

I'm so sorry this has happened to your DD~ my DD had a very serious break when she was little that required surgery and a lengthy recovery and physical therapy. I remember her getting the pins out and can't imagine what your DD had to endure having it done that way.
I have no advice how to deal with military medical care, but I'm praying that you can get the course of action that will be best for your DD's healing and that the injury heals well.
Hang in there! Sending lots of healing thoughts~

 

[AmazingGrace]

Thank you all!! I'm just starting to get a really bad feeling about this with dd's arm. We are going to her next appointment and either we get some answers or I move up the chain of command. I'm having all these thoughts about how her arm is not healing the way it should and I'm going to scary places, like bone cancer or her arm being permanently damaged and i just don't feel like anyone's listening to me. The resident on the phone that day, made me feel like the stupid overprtective mom of a snowflake, and really I'm not. I'm more of a free range parent under normal circumstances. But at the same time, when my mother self is telling me something's wrong, it usually is. These doctors need to listen to moms more. We know our kids.

 

[BernardandMissBianca]

IS there any way you can champus her out to a pediatric ortho?

When DD broke her arm (green branch break of the forearm) last summer the hospital wouldn't even look at her, let alone cast her. This was a Saturday morning and they said the local ortho would see her Tuesday afternoon. She was 4 years old for crying out loud.
DH forced the issue and made them transfer her to Hartford Children's Hospital where they had to sedate her, set her arm, and hard cast it. She was in the cast for 5 weeks and a brace for 6 months, due to potential rebreak.

I would push to be outsourced to a peds Dr.

 

[loopymommy]

IS there any way you can champus her out to a pediatric ortho?

When DD broke her arm (green branch break of the forearm) last summer the hospital wouldn't even look at her, let alone cast her. This was a Saturday morning and they said the local ortho would see her Tuesday afternoon. She was 4 years old for crying out loud.
DH forced the issue and made them transfer her to Hartford Children's Hospital where they had to sedate her, set her arm, and hard cast it. She was in the cast for 5 weeks and a brace for 6 months, due to potential rebreak.

I would push to be outsourced to a peds Dr.

I agree. Also, start keeping track of when you are speaking with them (date and time) and with whom you are speaking. Make sure you get everyone's name and position. Let them know you're writing it down.

 

[clori]

My dd then 9 broke her arm on August 30th. The local hospital we went to put her arm in a splint, gave her pain medication and send us an hour away by ambulance to Boston Childen's Hospital which fortunately was local for us. The hospital sedated her, set her arm and put her in a full cast a few hours after the initial break.

The pediatric orthopedic dr knew it wasn't necessarily a stable break but wanted to wait to see if it could be stable. We went back a week later for xray and it had moved a tiny bit but within normal range. She also got a new cast because the cast was a bit loose since the swelling had gone down. Interesting all of dd's casts were held together by tape so they could be slightly adjusted until the last cast. A week later it had moved too much and dd was scheduled for surgery a few days later. She had two rods put in (one per broken bone -humerous and ulna). She had a full cast put on. A week or so later at a follow up they changed the cast to a shorter cast.

DD then complained that something was sticking out. I took her pack and it turned out that one of the rods was actually coming out. DD was switched back to a full cast and had a second surgery a few days later to remove the rod that was about to break the skin. They said that though the bone was stable enough without the rod her arm still had to stay in a cast. A week or so later she was switched to a shorter cast. I think it was the day or so before Halloween that her cast was off. I think it was at least 8 weeks of wearing 5 different casts. I think xrays were taken at least once a week until the cast came off then bimonthly.

She had to get a brace made to wear until her last follow up appointment at the end of February. She was supposed to wear the brace all the time unless showering or sleeping until the end of December then when doing physical activitiy until February. She was in a brace since the arm broke closer to her elbow so her hand didn't benefit from a splint. In addition the orthopedic surgeon didn't want dd participating in gym at all or even going out to recess until the final check up (though we didn't necessarily follow that).

 

[Binnie]

Another military mom here. I'm not at all surprised to hear that your daughter's getting crummy care at a military facility. It's been my experience that crummy care is what you'll get from a military facility more often than than not.

First off, I would request a referral to pediatric orthopedist. If you've already seen that person, ask for a second opinion. They'll likely send you into the community for it, which likely what you need.

Second, and once your daughter is back on the road to recovery, you need to contact the complaints department at the medical center. They will try to keep you from complaining, but you *must* fight through that and complain. No way should your daughter's pins have been removed without pain meds, nor should they not be listening to you and your concerns.

If they WON'T listen, write to the Military Times. Literally, that's what it took for me to have my complaint about my daughter's birth heard in 2007. Our MTF called me (on the commander's orders) to discuss my letter to the editor.

As military families within the Tricare system we ought to be able to trust the care we get, but for some reason we can't, and it stinks. Personally, I finally in 2007 went Standard and haven't looked back. If nothing else, I now have the flexibility to choose another doctor!

 

[kellyg403]

OP, I agree 10000% with others, try to get a referral out. I am not a fan of the care my children or myself have received in military hospitals. When my ex and I divorced,we went Standard and have never looked back.

My son, a server asthmatic, had been averaging 10 hospital stays a year. We never could seem to get meds straight, never got any answers that really helped. The first year of seeing a pediatrician out in town who was a allergy/astma specialty care, my son was no longer having frequent hospital stays, he no longer needed oral steroids for months on end. Within two years he was was having slight attacks but way more controlled. Today at 17 he still has asthma, still has allergies but they are controlled. I don't think we would have seen that day without seeing a reg ped on a regular basis. Every single time he went to the hospital or to an appt it was a different dr. A different dr who thought he knew all the answers and changed his meds. It never worked. Seeing the same Ped who knew my son and took care of him on a twice monthly basis, he was a whole different kid. It would have helped if they listened. I would try to tell them we just started this med or that maybe allergy testing etc.

While I was appreciative of even having medical care due to the kids dad being in the service, it really never felt like quality care for them. I am happy paying my co pay and deductible for the kind of care they deserve.

Kelly

 

[tasha99]

DS21 was born exactly 21 years ago cake: ) in an army hospital. It felt as if it might as well have been 121 years ago. Sounds like nothing's changed.

 

[PrincessSuzanne]

DS21 was born exactly 21 years ago cake: ) in an army hospital. It felt as if it might as well have been 121 years ago. Sounds like nothing's changed.

You are so right about that. Now, the peditricians I saw on post back a thousand years ago were wonderful, but they also had civilian practices, I can't say that for the rest of the military doctors, seems they get their medical training the from Pre-WWII era.

OP, I would definitely look to have her taken off post. I work in a civilian hospital and we see alot of Active Duty families, because they don't want to deal with the on post hospital, especially when having a baby. They are currently building a new Army Hospital, but that won't do anything for the under trained staff.

Suzanne

 

[AmazingGrace]

So we are going in tomorrow for an ultrasound, arthrogram, MRI and X rays. Her doc thinks she has a contracted capsule of the elbow with possible blood in the joint. She says grace will probably need surgery. She still can't move her arm.

 

[Pig Pen]

I really have nothing to add other than I broke my wrist falling off my bike a few years ago and ended up having two surgeries and 6 months of PT.

My arm is still crooked, stiff, and misshapen. Oh well.

 

[PrincessSuzanne]

So we are going in tomorrow for an ultrasound, arthrogram, MRI and X rays. Her doc thinks she has a contracted capsule of the elbow with possible blood in the joint. She says grace will probably need surgery. She still can't move her arm.

Bless her heart, she is in for a long day.

Suzanne

 

[sunnyday123]

I'd be mad as hell and going to the head of the hospital and who else was in charge of the place. That is ridiculous, callous and dangerous.

This. My DD broke her elbow three years ago, and when they took the cast off, they checked her out before we left, and her range of motion was fine. I'd be letting everyone important know what happened.