Tuesday Austin had a fun field trip to Midway Sports.
He loved the bumper cars, played mini-golf (which he said he got two hole in ones) and drove a go cart.
The go cart adventure didn’t turn out well since he crashed. With Austin it’s often difficult to determine if something is really wrong or because of anxiety he’s looking for an escape. The staff noticed no visible injuries, and just like I would have thought, assumed that anxiety kicked into high gear and comments made were just his fight or flight response, he was looking for an escape.
He complained about his side hurting and after inspecting his side (by the staff and later by myself) there was no injury evident. I would poke him in both sides and when I had no immediate response that something hurt or was sore I just let it go. In the shower I didn’t notice anything but Austin is responsible for washing his privates and other than giving the family jewels a casual glance I didn’t notice anything out of the ordinary.
On Wednesday morning I did ask him if we needed to see a doctor and he replied “no, I’m okay”. When I picked him up on Wednesday, mid-day, I asked the staff if he had complained at all about his side and one staff member said “Yes, on and off all day”. Keep in mind it’s still difficult to gage because Austin often follows his complaints with an “I’m okay” or “just kidding”. He never cried and we never had any real indication that he was in severe pain. Still, at that point I had decided I would make an appointment first thing in the morning.
We had a few complaints in the early evening but nothing that made me really concerned.
When I got him into the shower I decided to do a thorough inspection and found high up between his legs, hiding behind his testes there was massive bruising, and it looked bad, bad enough that I decided I couldn’t wait until the next morning for him to see a doctor. Keep in mind Austin’s history, he had a splenectomy in December and I’m still not sure how that will impact his future health and now I often try to err on the side of caution. I hoped to get him into urgent care but I got there at 8:15 p.m. and didn’t know urgent care closes at 8 p.m. so our only option was the ER. Before I left the house I let Austin pack his bag, he packed everything he had with him when he was in the hospital in December, Mickey, Minnie, a power ranger, the touchpad and his Nintendo – I just smiled and let him bring them all along.
I was baffled that he never pointed to his privates as being sore, never touched them but then I remembered a conversation we had just this weekend about socially appropriate behavior. A friend had a sad experience with negative social behavior in public recently and it was an important reminder for me to stay vigilant with Austin about what is socially appropriate, what we can do in public and what we can do in private. To put it bluntly I reminded him that grabbing himself or touching his penis at any time should only be done in private, this discussion took place on Sunday. Well come Tuesday mom’s words were still fresh and in a situation that any normal male might have been rolling on the ground holding and grabbing himself in public, I think Austin remembered my words “we never ever touch our self in public, this should only be done in private, in private places like your bedroom or the bathroom”. We also had the other discussion as to who could touch him in the privates, who he could show his penis to, i.e. a doctor. Now this clearly makes since to me, I probably should have asked him to show me what hurts in the bedroom or bathroom, maybe I would have seen the bruising sooner because the other attempts to figure out what was going on were done in the living room and kitchen, all considered public places.
On a side note, July is Fragile X Awareness month, so I created a little more awareness with medical staff who had never heard of fragile X, no surprise to me, I’ve been working on awareness since 1997. As always I had to demonstrate how Austin may just answer how he thinks you want him to answer and if he doesn’t really know what you’re asking he’ll just say anything and not tell you he doesn’t understand what you are asking. This was quite easy to demonstrate when the nurse asked “Are you in a lot of pain or are you in a little pain? He responded “a little”. Then I asked “Are you in a little pain or are you in a lot of pain?” He responded “a lot”. So I pointed out to the nurse that we can’t trust his answers, he’ll respond with what he thinks you want to hear or repeat the last of the choices.
I just about died when the nurse asked “Do you feel safe in your home?” and he responded “No”. Really with the extensive bruising in his privates I was clearly concerned with how the staff might respond, I could visualize a visit from Child Protection Services (or at his age maybe it’s Adult Protection Services) all because Austin didn’t really understand the question being asked. It comes down to defining what does “safe” mean to Austin. Safe might mean to Austin that Dad isn’t hiding under his bed or in his closet to scare him, or Genevieve, or Natalie, aren’t hiding around a corner just to make him jump and scream like a girl.
Triage went pretty quickly but then we had to wait in the waiting room for a bed to open. When an entire family came into the waiting room wife, husband, mother-in-law and two young children I was ready to wait in the parking lot. I still don’t understand what they were thinking bringing young children to wait in an ER waiting room. Strange family in appearance to put it politely - the mother-in-law was dressed in a Hijab yet the wife dressed like a hooker –what a strange combination. The youngest screamed on and off while the husband was being seen in triage – turns out he was stung by a bee, after triage they just told him to go to the drugstore and buy some Benadryl. Reminds me of Austin’s dilemma with “safe”, what one person considers an emergency another doesn’t.
Our adventures didn’t end there. I truly wonder about the purpose of HIPAA and how often it is violated in an ER, why does it even exist? We overheard numerous results of pregnancy tests, STD tests and the use of the Contraceptive “Plan B” along with some detailed family history. Through it all Austin was paying attention. Oh my goodness, I was between dying of embarrassment and bursting out in laughter when he did ask me what is a STD; what is Plan B, LOL. I whispered quietly that we’d talk about it later and please use a quiet voice, a library voice, because people here are sick and they are trying to sleep and get better.
They did some blood work, gave him an IV, added a little morphine (his blood pressure is always a solid indication if he could be in pain, if it’s elevated it means he typically is) and had a CAT scan with contrast.
The blood work showed that most counts were normal but his white blood count was elevated, the doctor said that might only be a result of his body trying to repair and recoup from the injury. Thankfully the CAT scan showed no internal bleeding, just swelling in the bruised area. We were discharged and will follow-up with his primary care physician next week.
He’s home today, I wanted to give him a little time to be quiet and be not so active, give his body time to heal. And of course, it’s all thumbs up according to Austin, he says he’s okay. And, if he’s okay, I’m okayJ.
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