Turns out she must have also hit her head pretty hard on the concrete.
She cried longer than she normally does with an injury. She was also really sweaty - almost clammy and cold. At first, she laid pretty calmly on the couch with a bag of peas on her head. After about 30 minutes, she was getting pretty restless and would cry out in pain every few minutes. About an hour later, she really started crying, and vomiting (a lot). She then fell sound asleep and was pretty disoriented. Shit! This was more than just a little bump on the head.
We called the doc's office that is open on Saturdays, described the symptoms, and they sent us to the ER given the vomiting and sleepy delirium. We were all certain that it was a concussion, but cautious and wanted to monitor her to make sure it wasn't anything more serious. The docs encouraged her to sleep, but asked that I wake her occasionally to see if she was sleeping or unconscious.
Hmm - I guess we are not going to the pumpkin patch, as we had been planning to do! I arranged for another family to pick up Carolyn so she could still go. I prepared to go to ER with Lizzie, and Steve stayed home waiting for Carolyn to be picked up and next updates once I got to ER.
As I moved Lizzie to go outside and into the car, she cried at how bright the sunshine was. She threw up some more, though nothing was left in her body. As we arrived at the ER, she could not (or did not) want to walk. She was sick to her stomach. The triage nurse quickly registered her and sent us back to an observation room. The doc checked her over. He noted the large knot on her head, and found no evidence of a skull fracture. Then, she had to walk, talk, follow general instructions. He checked all of her reflexes, looked at the size of her pupils, and asked her to visually track his finger. She was pretty loopy and acted like a zombie, but generally she attempted to do everything he asked her to do. She was perking up a bit, was not as nauseous as before, and was trying to interact and talk. Those were all good signs.
Doc explained that she had a concussion, and that she has some higher risk signs (like the vomiting and overall delirium), but he did not want to expose her to the radiation from a CT scan until closer to 6 hours after injury. We were about 4 hours post injury at that point. So, as we waited, she napped and the doc asked her to drink some fluids to see if she could keep them down . An orange slushy was quickly delivered. She complied with the instruction to drink it. In fact, she drank the whole thing and asked for a second one.
Shortly thereafter, she sat up on her own, opened her eyes, and started talking. She still had no memory of how she fell or where she was, but she was Lizzie, just a bit groggy.
This is when she had a funny observation that I did not understand at first. To put it into context, you have to see the poster that was above my head where I was sitting -- a normal pain scale that you see in every hospital room. Notice that only the even numbers are represented on the number line.
And, here she is retelling what happened and her confused thoughts about how smart doctors were. This is during that golden moment when the sugary slushy had taken full effect and before she crashed again back to a slow, sleepy, cautious state. This was also the point that the doc said -- "good - the slushy test is telling me that she has just a regular old concussion, and not a more serious brain trauma. If she does not vomit over the next 30 minutes, I can send you home." She was discharged shortly thereafter. The videos were taken as she was being discharged, both in her room and just outside of the hospital.
I had to capture the videos because they were so funny (and a relief), but I also think they are a bit of a misrepresentation. She really was a zombie and down for the count, definitely before the videos were taken, and then again shortly after these videos were taken.
When dealing with a sick kid, the slushy tests is very effective! I have witnessed this with both kids. If the kid perks up after they drink the sugary cold goodness, they are probably trending in the right direction. If they do not perk up after the slushy, it is probably best to go to the ER at that point, and it is likely the child will be admitted. I think today (and those videos) confirmed this -- my new strategy is to run out to the gas station and buy a cheap slushy before spending the $100 copay for the ER. That said, I am glad we took Lizzie, just to make sure it was not something more serious. However, I am pretty sure I would have been just as convinced about her prognosis if I had seen the slushy transformation at home. Oh well, I am sure that bunny retails for at least $80! I would have paid top dollar for a couple of slushies at 7-11, and the "propeller" bracelet with her name on it is priceless, easily worth another $50 or so. So, put that way, the ER copay was a real bargain! Ha!
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Since coming home, she has been sleepy and has stayed mostly in bed. She says her head hurts, especially if she moves around. She has not asked for TV even once. She has not eaten much, but is drinking. She does not want me to leave her side, and went to bed before 8pm and is still sleeping 12 hours later. I did notice that she is sleeping on her belly, which is very unusual for her. The docs just said to keep her kind of calm (and avoid another head injury in the next week or two), and that she will be the best judge of how well she feels with normal activities. He said to provide her with a calm, low-light environment if she has headaches, just as you would with someone who has a migraine. She is supposed to rest her body and her brain.
PS -she named her bunny Connie, the Concussion Bunny,
