"Yep, well,...."

Elias fell off the back of the couch tonight onto the wood floor. None of us saw how he landed but we all heard the thud. You know the sound, the type that makes your heart fall right along with it.

When he couldn't answer simple questions--

"Elias did you drive home from school or walk?"

"I don't know."

"Did you have indoor or outdoor recess today?"

"What did I have?"

--I decided to call his pediatrician to make sure we knew what to watch for in case he had a concussion.

I tell the evening nurse he doesn't seem to remember events from the past few hours, but its hard to tell for sure, because Elias will often evade questions, anyways, or ask questions with obvious answers.

"He may be on the Autism spectrum," I hear myself saying. He may be on the Autism spectrum. Just like that. He may be....

"Did he tell you what he hurt when he fell?" The nurse asks.

"No, but he put his hand to the side of his face, by his cheekbone and forehead, and we can tell that's where he landed. It's bruised."

"Does his equilibrium seem off? Is he off balance?"

"Well," I breathe. "Do you know Elias?"

"No, I'm sorry I don't." 

Must be a new nurse. "Elias was born four months premature. He has Cerebral Palsy, a type called ataxia, and his balance is always off. He looks drunk when he walks without his crutches so its kinda hard to tell."

We talk about assessing if his balance seems worse than normal, worse than his usual decline in stability the more tired he gets.

"Another thing to watch is his tracking. If he doesnt seem to be following you with his eyes."

"Yep, well,..."  

If you saw me, leaning against the windowsill, with a phone to my right ear and my fingers pressed against my left so I could hear the soft-spoken nurse, you'd see a wry smile on my tired face.

"... he's also visually impaired, he has Nystagmus, which means his brain has a hard time controlling his eye muscles, so he doesn't really track."

I was beginning to feel sorry for the new nurse who had never met Elias. I imagine her, scanning her notes, head in her hand, picturing my seven-year-old son. 

"Has he complained about his head hurting?"

"No, but Elias rarely vocalizes pain. He has a high pain threshold and never complains. So we wouldn't know."

I see Elias out the window, in the front yard with his grandparents, standing with one cane by the birch tree, he smiles and waves his free hand in the air after pushing Olive's swing.

"Has he vomited or held his stomach as if that hurt?" the nurse asks.

Ah, something we can work with. "No, but we are about to eat dinner, so I'll see if he eats."

I'm not gonna even get into the fact that some nights Elias doesn't touch his food, that he just sits at the table asking questions he know the answer to...asking questions he knows the answer to...asking questions he knows the answer to...

 

PS. Elias seemed like himself by the time I hung up the phone, just a regular old kid with constant concussion signs.

Comments

[fleming]

Angus falls over backwards while sitting in chairs almost daily since his ADHD means he is bouncing around all the time. He has never had a concussion. They are tough these little boys, especially Elias. I can barely hike without staring down at each stone and carefully placing my feet and Elias does it without tracking well with his eyes and with blue canes at his sides that need to find a place to land too. Amazing, truly. Glad he is ok. Sounded like a good nurse by the way since she didn't get flustered and continued down the checklist!

[niksmom]

Oh, I can so relate to all of this! Glad Elias is ok. If it helps any, some of the things our neurologist has told us to watch for in those cases include: significant or sudden behavioral change, extreme tiredness, and gratly impaired eye-hand coordination from his baseline. In other words, where Nik can see well enough to reach for a cup (or something else offered to him) and pick it up just fine, it's when his aim seems off (keeps reaching past or to the side of the obect being offered) that I need to worry. Also, any signs of unusual tremors or seizure-like activity.

[elizabeth]

Oh, Christy! It's hard not to cringe at that phone conversation, especially the soft spoken part. Elias' fall reminds me of my ice hockey days. I think these falls usually hurt the parents way more than the kids. Miss you!!! xo

[Kelly (aka, a nurse that's had that feeling before!)]

I think that office should have an orientation for the new staff to some of their more involved kids! I imagine that nurse didn't feel too good about the way that phone conversation went either!

[Lee]

That sounds like a conversation I could have too! lol! We recently discovered that my son doesn't convey just his emotions, but his physical symptoms as well. He vomited recently (due to meds)and couldn't tell us if he'd felt nauseas beforehand. He also bangs us gently with his head until we rub it if he has a headache...

As mom's of kids with Autism, it just makes us more atune to our kids needs. It sounds like you are doing a great job already!

[Christy]

So tonight Elias fell again from his chair at the table and split his lip and nose, blood everywhere, tears, his and mine, but again, he recovered faster than I did. I still feel weepy with the weight of his imbalance and his inability to communicate his feelings/needs. All your words help-- just knowing that when I write about it all people will not only respond but with wisdom and support and humor and stories and compassion is truly amazing. So thank you. Its the first week of school and his hard-working body and brain must just be exhausted. I know mine is...its off to an early bed for me, so we can start all over again in the morning.

[Lisa in Elijahland]

I don't know whether to laugh or cry - not at the fall, of course, but at how much I can relate. My little guy, Elijah, also has CP. He is nonverbal, is on the spectrum (PDD) and I cringe whenever he gets hurt. How would I know when it's serious? Like you said, Elijah is "just a regular old kid with constant concussion signs." His pain tolerance is exceptionally high and he can't tell me how he feels. It's just such a helpless feeling, I know. I think Niksmom's advice above is great.

I'm loving your blog by the way. I'm a newer reader. Glad Elias is all right.

[Jessica]

So that last line made me laugh! Glad he is okay. It reminds me of a time they office gave me the wring bus # for a Kinder student who was non verbal. I told them which bus I put him on as the frantic parent stood in front on me. The office kept radioing the bus and I could here the bus drive saying, "Is____________ on this bus" I finally (after much frustration) got it through their heads that NON VERBAL meant HE WASN'T GOING TO ANSWER!!! So they did what I said in the first place (LOOKED FOR THE KID PER MY DESCRIPTION)and brought him back to school!
Happy to say if it happened to him today after 3 year of schooling (in my class, not that I am bragging) he would say "Yes, I am here" and then get back to reading his book :)

[Christy]

Jessica, I can picture the scene so clearly and feel your frustration as the driver keeps expecting a response. Thanks for sharing this story and the knowledge that now he would respond.

Welcome Lisa, and I sooo hear you about not knowing whether an injury/illness is serious or not. I worry about that with Elias and am always amazed at how many bruises and scrapes he has when I give him a bath.