Wednesday, March 21, 2007

The Scariest Moment in My Life So Far

Ravenna had an accident last night. The good news is that she is okay.

She fell, 3-4 feet, from a baby chair on the kitchen table to the floor. Andrew and Ahuvah were in the kitchen but didn't see the fall, just the aftermath, and I was downstairs in the basement - I just heard the thump and their reaction and her crying. I don't think I've ever been as scared before in my life as I was at that moment, and in the moments after.

I ran upstairs and grabbed my baby, and was holding her, consoling her, crying myself, trying to assess her condition, didn't really know what to do...I started dialing the pager for my pediatrician, but then changed my mind and called 911 instead. They sent some firemen medics who came, looked at her, were glad to see that she was crying (good sign), and that she hadn't lost consciousness (good sign). I don't remember much of that time, it was all a blur, with the exception of one fireman who was trying to calm me down, and who gently reminded me that Ravenna takes her cues from me. They advised us to go to the ER at Children's, which we did. Ahuvah drove Ravenna and I. Jaimes wasn't home when she fell, but he met us at the ER right away. Both Ahuvah and Jaimes were amazingly solid and calm and supportive the entire evening.

At the ER, they looked her over. By that time (and since), Ravenna was acting well and in good spirits...laughing, playing, a little cranky that we weren't allowed to feed her until they finished assessing her and ruled out the need for any immediate surgery, but otherwise very much herself. It's we, the adults, who were the basket cases, although I think we all held it together pretty well.

Right off, Ravenna's vitals were good, but they could tell from a dent in her head that she had a depressed skull fracture, so they did a CAT scan and then had a neurosurgeon come talk to us. It turns out she has what is called a ping pong fracture - the bone, in one section of the skull on the left side of her head, is dented in. Miraculously, there is no break in the bone, n no internal bleeding, no swelling, and no other trauma. In fact, the neurosurgeon had trouble believing that the injury had happened at 6:30 that evening...he asked us several times if it was possible it had been injured during delivery, via forceps or something, because the injury, to him, looked healed.

Because of her age, the nature of her accident, and her fracture, (and in retrospect, possibly to assure themselves that we are not abusing Ravenna), they also did a full set of X-rays on her to make sure there were no other fractures or injuries, and those all looked fine. After a grueling 6 hours, they let us go home. With a traumatic head injury, it is important to maintain close observation for the first 24 hours. Under their instruction we woke Ravenna up every 3 hours to make sure that she was responsive, and she was fine.

Over the next few days, we need to make a decision about surgery. As far as I understand so far, we can safely opt out. The reasons they would do surgery to fix the fracture are partially due to concerns about long-term implications of the pressure on her brain from the bone - it's possible that it could be a root cause of chronic headaches or who knows what else later in life - and/or cosmetic concerns. The surgery could be done at any time, and it could be done months or years later, but it's much easier if done in the first week, before the bone has time to harden and set as it is now. I think at the moment Jaimes is leaning away from the surgery, and I am possibly leaning towards it, but we both want very much to educate ourselves further, before we decide either way.

Today we followed up with our pediatrician, and she thought Ravenna was doing well. We talked over our options, and decided to see an Infant Cranial Sacral Practitioner in the short term, to make sure Ravenna is in alignment and to see whether Cranial Sacral work might help with the fracture. We'll also schedule an appointment with the neurosurgeons to discuss the possible surgery, but we won't commit to it until we've tried the Cranial Sacral, checked back in with the pediatrician, and really, just had a little time to think it over.

So that's where everything's at now. Again, at this point, Ravenna is doing great. She's in good spirits, happy, chatty, laughing, interacting with everyone, doesn't seem any the worse for wear. Our pediatrician says nobody would be worried at all, except for this fracture.

Keep us in your thoughts, please, and wish us wisdom as we figure out what comes next.