Tuesday, February 16, 2010

A Change of Plans

The follow-up x-ray showed that the bones were no longer aligned.  How do you keep a 7 year old from playing for 2 months?  Our middle child underwent surgery last night to internally fixate the radius and ulna.  He sailed through the surgery and anesthesia like a champ. (Thank God and the wonderful staff at TAMC)
He woke up and said, "I have stridor."  Only a doctor's son would wake up and make his own diagnosis.
Since the ward was packed to the gills they allowed only one of us to stay with him through the night. So, we asked him who he wants to stay with him.  He chose Grandma (my mom, Hi Mom! thanks).  I was sure he would choose his mother and my wife was sure he would choose me.  We asked why grandma and he replied, "Because I haven't seen her in a long time." Bless him.
We performed a change of the guard this morning.  Grandma is none the worse for wear.  Wife just called.  They played cards, there is a classroom on the ward and he's been playing games and the organ.  She's worried that he's not complaining of any discomfort. Such a worry wort. 
Silly me, I thought no pain was a good thing.

Friday, February 12, 2010


Yesterday, I anesthetized a patient who sports the last name of one of the more prominent organized crime families.

In the holding area I interviewed him and put him at ease with my usual banter and I believe I  achieved a good rapport with him.

Having forgotten that discretion is the better part of valor, I asked the question that should not have been asked.

"I'm sure you've been asked a million times, but are you a member of that famous family?"

He smiled and said, "I'll answer your question with a question."

"Shoot." I said. (Another unfortunate utterance.)

He asked, "Do you know why the Sphinx has been around for about 4000 years?"


As his smile disappeared he said, "Because he asks no questions."

Point well taken. 

Broken Arm

Child number 2 broke his arm...again. Again he tripped on another kid's feet while playing soccer.  Midshaft radius and ulna fracture, same arm.  No more soccer for you young man!
The orthopedists in our local hospital didn't like how the fracture was set and determined that he needs an operation. I decided to get a second opinion mainly because I have lost confidence in the doctors in the hospital where I used to work.  Here in Tel Aviv, not only is there an entire department of pediatric orthopedics, there is even a specialist in pediatric fractures.  I made a beeline to him for his opinion and he concurred that internal fixation was necessary.

Then began the debate.  Should we operate in Be'er Sheva or in Tel Aviv.  My wife wasn't keen on the idea of the logistics of traveling far from home (1 hour 15 minutes is far in Israel).  I told her that our boy deserves the best treatment possible even if it is inconvenient.  We'll get the grandmothers to look after the other kids and we will make the effort.

In the mean time the consultant asked that we take another x-ray the day before the operation because sometimes the alignment improves.  The new pictures showed better alignment, but not perfect.  The orthopedist said that he can do even better.  He removed the cast, reduced the fracture (this caused no pain, just mild discomfort BTW) and applied a new cast.  The re-x-ray was perfect. 

Long story short, no need for the operation. Yoohoo!

Come on honey, say it, say it out loud, you know what I want to hear: "You were right."
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