New crisis!!! HELP!!!

[gijanet]

Just a few minutes ago, Katie fell off her stool and hit her head on the edge of the bathroom counter. She hit the side of her head just above the ear. She already has a nice little goose egg (then she almost fell again trying to get up on the counter to see her egg in the mirror). We've got ice on it. It's just a lump, no blood visibly pooling under the skin or anything.........yet! Just a good quarter size lump. Ordinarily (read that as BC - before coumadin), I wouldn't panic over this, but with the coumadin, of course, I am! Sooooooo, do I continue panicking now? Panic later? I did a quick scan of Al's site and read the head hit section and sounds like it's another crap shoot.............so I'm looking for the experts' opinions out there. Do we just watch it and her? What do I look for? It's getting close to her bedtime...........do I let her sleep or do we stay up and party all night? ......................sigh! Thanks! Janet

 

[Mary]

Katie has been through so much that I'm casting a conservative vote, and suggest you call the doctor and see what he thinks. If you can't call the doctor, then go to the ER.
We have been through too much (listen to me, WE'VE been through so much) to take a chance with her. Look at it this way, call or take her in this time, then you will have a better idea of what to do the next time it happens.

 

[Ross]

I second that motion! Probably nothing but knocked herself silly, but don't take chances now.

 

[geebee]

Sorry, Janet, but I agree with Mary & Ross. Call the doctor or visit the ER. If nothing else, you will get a good idea of what is something to worry about (or not).

 

[gijanet]

Well, that is what I was kind of leaning toward, too.

Well, that is what I was kind of leaning toward, too.

but then that article on Al's site said that if they were checked too soon that a brain bleed might not pick up that quickly........but I did read this pretty hurriedly. She is not vomiting or nauseous. She does obviously have a headache. And she is getting really sleepy, but this is her normal driftoff time................

 

[Mary]

Sorry, Janet, but I agree with Mary & Ross. Call the doctor or visit the ER. If nothing else, you will get a good idea of what is something to worry about (or not).

Janet,
I'm assuming you are trying to call or else you're getting ready to go to the ER. Don't sit around waiting for more responses, JUST DO IT!

 

[gijanet]

Okay.............I'm gonna try calling..........

Okay.............I'm gonna try calling..........

Just don't know where to start. No one seems to be too well-versed in coumadin. Guess I will try her ped's on call service, but I strongly suspect that I know what they are going to say..............sigh!

 

[Ross]

I know, yes that's what they'll say, but do it anyhow. I'm fairly sure she'll be fine, but no sense in going through all that you have to have something really out of left field happen.

 

[tobagotwo]

Three things to remember: kids are amazingly resilient, they bounce well, and they have surprisingly hard heads.

I'd be most worried about concussion. Check if her eyes are tracking well and she's not unusually sleepy. If there's any doubt in your mind at all, take her in to be checked for concussion.

You probably already know by now if that goose egg is trying to become an ostrich egg.

I'm not certain the average emergency room has enough practical knowledge of how to handle a head injury complicated by warfarin, and frankly, I'd be concerned they could make things worse. Unfortunately, they are the only port in the storm.

Do you have a doctor or hospital that you trust to understand Coumadin, whom you can call for advice? If you know what should be happening, you could better gauge how they're handling the situation, if you do wind up at the ER.

Why don't kids ever do this stuff during the day, when people are available?

Very best wishes,

 

[cocoalab]

I haven't scanned through your responses here but my gut says take her in and have it checked. USUALLY goosebumps are good cause swelling is going outwards but having had a nephew have a head trama from an apparently benign fall has made me more cautious. A scan could be agood thing. (This from the mom who didn't believe Andrew when he broke his arm.) I will be watching to see how she is.

Just a few minutes ago, Katie fell off her stool and hit her head on the edge of the bathroom counter. She hit the side of her head just above the ear. She already has a nice little goose egg (then she almost fell again trying to get up on the counter to see her egg in the mirror). We've got ice on it. It's just a lump, no blood visibly pooling under the skin or anything.........yet! Just a good quarter size lump. Ordinarily (read that as BC - before coumadin), I wouldn't panic over this, but with the coumadin, of course, I am! Sooooooo, do I continue panicking now? Panic later? I did a quick scan of Al's site and read the head hit section and sounds like it's another crap shoot.............so I'm looking for the experts' opinions out there. Do we just watch it and her? What do I look for? It's getting close to her bedtime...........do I let her sleep or do we stay up and party all night? ......................sigh! Thanks! Janet

 

[Karlynn]

I'm sure things will be fine - but checking is a good thing and I think more likely less stressful for you than waiting to see.

 

[gijanet]

Thanks y'all for always being here............

Thanks y'all for always being here............

well not always being here........like at 2:30 the other morning. I just got off the phone with the Michigan cardiology on-call fellow. I figured if I called my ped's emergency on-call#, they'd just refer us to the OR, unless our ped actually was the one on-call, which is unlikely. She's semi-retired, but did some time in a ped card unit. Anyway, I feel better........somewhat. He asked all the questions about swelling, site, size, increase, decrease, eyes tracking, etc. Given the 1500 miles between us and sight unseen as a given, based on what I told him, he feels like we are okay with avoiding the ER tonight, but I am to check the goose egg every couple of hours, wake her up in about four (and despite her sleep-induced grogginess, assess her mental status) (Hey, whose gonna check mine? ). As far as the egg, I am to look for any increase in size, and once the swelling starts going down, determine whether the bruised area is spreading or getting bigger than the original egg. I am also to check for bogginess or sponginess of the egg and surrounding areas, cut her coumadin dose in half for tonight (we hadn't given it yet - he said that he would be hesitant to do that if her INR had been hanging out at the 2.5 range, but felt since her last one was up in the 3.3 range that we should be okay............course I didn't bother to go into the stomach flu bit and the vomiting the other night, so God only knows where we really are..........sigh!), and get her into the ped's in the morning. I guess I feel okay with this plan of action...........I suddenly feel like I have gasoline in my stomach. P.S. While I was waiting for the return call from Michigan, Katie woke up and drew a picture and watched a little TV with her daddy, so that made me feel a little better.

If something in this plan doesn't sound right, please give me a shout back. I'm afraid I will be up - at least in spurts, anyway. Don't we just love life's little adventures?

Thank you all so much. Any prayers you want to throw our way would be appreciated greatly........especially for my sanity. Much love. Janet

 

[ALCapshaw2]

WHO manages her Coumadin?
(i.e. sets her target INR, writes the Rx's)
PCP, Cardiologist, Coumadin Clinic?

THAT's who I would recommend calling.

It's probably a waste of time to call the Hospital
and speak with one of their nurses. Whenever I
do that, the answer is ALWAYS the same -
"Go to the ER".

When I hit my head, not nearly as hard,
and not too long ago, I went to bed but did
report it to my cardiologist and was told to
get an MRI a couple of days later when I was
having 'visual symptoms'. I was also told that
if I had a SERIOUS Brain Bleed it would give me
the WORST HEADACHE I'd ever had.

TOUGH CALL, and they never seem to get any easier!

Hope all turns out OK.

'AL Capshaw'

 

[gijanet]

We probably cross-posted.....

We probably cross-posted.....

WHO manages her Coumadin?
(i.e. sets her target INR, writes the Rx's)
PCP, Cardiologist, Coumadin Clinic?

THAT's who I would recommend calling.

It's probably a waste of time to call the Hospital
and speak with one of their nurses. Whenever I
do that, the answer is ALWAYS the same -
"Go to the ER".

Yea, see that was my concern. Last time we went to the ER here locally, we wasted two hours just trying to explain Katie's anatomy. Everyone is afraid to touch her. We have a new PC (lost our dearly beloved PC who has followed Katie since birth.........and our new one we just haven't really bonded with yet.) We for the most part have been monitoring our own INR and coumadin dosages. Oh, we report them to her PC and she writes the RXs, but we have been basically making any adjustments on our own, thanks to Al's site and y'all. She said somethng really ditzy to Don last time he took Katie in that convinced us that she wasn't really on top of the coumadin issue............sigh! So, that is why I ended up calling Michigan.

When I hit my head, not nearly as hard,
and not too long ago, I went to bed but did
report it to my cardiologist and was told to
get an MRI a couple of days later when I was
having 'visual symptoms'. I was also told that
if I had a SERIOUS Brain Bleed it would give me
the WORST HEADACHE I'd ever had.

TOUGH CALL, and they never seem to get any easier!
Hope all turns out OK.
'AL Capshaw'

Now square me away here. You DID have visual symptoms? Or you were to go in if you had visual symptoms? And did you? Thanks much for the info and the good wishes. Hugs. J.

 

[Emma]

Oh Janet, I know how worrying this is. Chloes done it a couple of times now - excellent isnt it!
I do always go to the A&E (your emergency room) when she does a good old bang involving a large lump and they tend to overeact completely, try to convince me to stop her warfarin altogether and do her obs every half an hour for 24 hours!! Nothing like a bit of overreactive doctors to wind you up!
I would wake her just to test her responses every hour or so if you arent going to the hospital - just see if see moans at you and turns away again.
Bleeds may not show up for several days if its just a trickly one, so sometimes going to the hospital is a waste of time anyway. They never scan over here unless they have very good reason to suspect a bleed but they may be different where you are.
My best friend is a pead nurse and she herself told me that where they don't full understand warfarin and Chloes condition anyway, they will always keep her in and always over-react, so I now think twice about going in and think you may be right just to watch her at home. If she says anything about a worse headache, funny vision, throws up etc etc whip her to hospital. Also, might be a good idea to avoid tv for a while - we've always been told to avoid it for 24 hours after Clo does a good size head bang,
But kids to have hard heads and can take a lot more than we give credit for, so my betting is she'll be fine. I'll hop back later to check
Love to you both and a kiss for the goose egg!
Emma
xxx

 

[Phyllis]

Janet,
Just read this post at the light of dawn. I so hope that all is well with Katie this morning. Will be watching and waiting for your next post.
Best wishes,
Phyllis

 

[tobagotwo]

I am also eager to know that "our" Katie is all right this morning. (Much easier to say our, when you're the one who's up with her all night.)

We're not grandparents (although we worry, but don't actually have to sit up with her), and we're not godparents, so we must be webparents or parents-dot-com or something...

Anyway, please let us know how Ms. Mischief is this morning.

Very best wishes,

 

[ALCapshaw2]

Janet wrote: "So, that is why I ended up calling Michigan."

Were you able to speak with her surgeon?
or his 'on call' physician (or PA / RN / whatever)?

What did they advise?

Does Katie have a local cardiologist?
That would be my second choice (after her surgeon).
He should (hopefully) have a better understanding of Coumadin than her PC based on your experiences.

It is such a PITA to train a new doctor(s) when we have complex histories!

How are you and Katie doing this morning?

'AL Capshaw'

 

[Mary]

Good job Janet! I'm glad you called Michigan; probably much, much better than dealing with your local oncall doc or ER.

I'm guessing that by now you've left for work, but please take a minute and post an update on Katie when you get home.

 

[Ross]

I want Janet to be my mother.