Monday, October 5, 2009

My first ER call...

So..While on call this week, I get a call at 4:30am. The emergency, as explained to me via phone, is an 11 year old, bike accident, avulsed tooth and intruded tooth. I ALREADY know this means 'splinting teeth'. Fine right? WRONG! Why? BECAUSE I AIN'T DONE NO DARN SPLINTS! LOL so Imma have to wing it... Well when I get there, my co-resident is already there who knows how to splint teeth so..all is well...I go in the room to talk to the mom (my co-resident had already spoken to her and had already walked out). The convo goes something like this:
Me: Hey, I'm Dr. Trotter, what's going on here?
Mom: Yeah, man, shoot, I'm glad you in here now, maybe I can get some answers. Look, her tooth is over there (in a cup on the table). Can you put it back in? She's only 11! Would you wanna be 11 with a missing tooth?
Me: Okay, I'm going to see what it looks like. There is a possibility to put the tooth back in, but that depends on the time it's been out of the mouth.
Mom: good, cause shoot that other guy was acting like nothng could be done.
Me: so when did this happen?
Mom: oh, yesterday at 4:30 in the afternoon.
Me: Oh, about 12 hours ago, huh? Well that certainly changes the chances of us saving that tooth. Typically you wanna get those back ASAP, and by ASAP I mean IMMEDiATELY... an hour at the latest!
Mom: but she only 11, would you wanna go without a tooth at 11?
Me: No ma'am, I wouldn't but the chances of this tooth replanting is slim to non at 13 hours.

I go to the lil girl sleeping on the chair. I say 'hey 'Lil Missy', how are you? She wakes up and instantly starts to cry.

I talk to her a little bit. We had about 3 minutes of 'it's okay, imma try to help you blah blah blah' talk before she calmed down enough to let me look in her mouth. I look in and I see what appeared to be 2 missing teeth. One of em was on the table and I couldn't figure out where that other front tooth was. I try to look and she snatches away (anticipating pain). I say Lil Missy, did you lose 2 teeth or just one? She said 'just one, the other one feel like it's in my nose'. I get a mirror and look again and bam- there it was! Sooooo at this point my job is to pull that tooth back down and put a splint on the teeth to keep them stable. BUT I have to anesthetize her first. I prepare to do that and what happens? She goes bananas! LOL COMPLETLY CUH-RAZY! LOL I coaxed her enough to let me at least 'spray sleepy juice' on her gums with no stick. When she trusted me enough on that, she didn't realize I had actually injected her a few times. When she saw the needle though, she went crazy again. I stopped and asked 'Lil Missy, have you ever gotten in trouble in church and your Granny or Moma pinched you?' She shook her head 'yeah' through a flood of tears. I said 'well look, this is going to feel like a little pinch. Like that pinch, the sting is going to go away fast and it will make your whole mouth feel better, will you trust me to pinch your gums for a second?" She agreed, but wanted to hold her mom's hand. Mom came up and I told Lil Missy, 'if it doesn't feel good, squeeze yoru mom's hand as hard as possible!' Her mom asked her 'you wanna pray while she does the SHOT'? Lil Missy started to cry again and said "YEAH..We gotta pray hard moma", Her moma gave me the nod, and started to pray, during that injection, Lil Missy didn't move a bit, didn't whimper a bit, didn't feel a thing! (Don't tell me there isn't power in prayer!). After that one, she looked at me and said 'I can't feel nothing now, are we done'? I told her now and proceded to fish for that tooth. She got a little ansy and asked through her whimpers, 'Hey, miss..this hurt so bad, you just don't know... you ever had a shot in your mouth'? I said "if you let me finish, I'll tell you a story after we finish...deal?' She agreed and I finished up the procedure. Pulled #9 down into place and stuck #8 back in there (with no confidence of it replanting). I splinted them all together (with the help of my co-resident). Stitched her up and we wer done. When I finished, she said 'oooh, miss, you done?' I tell her yeah and she said 'I gotta pee, but don't leave you said you had a story to tell me.' I do paper work and chit chat with her mom about the prognosis of that tooth and future treatment options. Moments later Lil Missy walks back in and says 'Miss, can I eat when I leave?' I say 'yeah, but only soft foods, soups and mashed potatoes'. She said 'ohh miss, can I drink'? I said 'you can drink any thing you like except alcohol'! She died laughing and said 'Moma, she funny, I like her and she didn't even hurt'. I said 'umm hmm told you... you wasted all those tears for nothing didn't you?'. She laughed and said, "umm hmm I shole did!' Then she said 'wait, miss, what about the story you said you had'? I said 'okay, when I was about 10 or 11, I was playing baseball and I got hit in the mouth with a baseball. I was kinda like you. I was all fussy, I was crying and going crazy. I was so crazy that my dad had to sit on me so the doctors could fix me, so I knew how you felt, that's why I was tyring to talk to you and help you calm down'. She said 'ahh, so you got fake teeth?' I said 'no, i had braces kinda like what we put on you and my teeth are fine now because I did what the doctor told me.' She said 'oh okay, Imma do what you say to do, cause I want all my teeth when I grow up and Imma be a doctor like you cause you were nice. You a DENNIS now cause you had did this when you were little?'. I said 'as a matter of fact, yes, that had a lot to do with me wanting to become a dentist'. She hugged me and then said 'wait, Imma be a model AND a doctor too, can I do that?' I said 'yeah girl, do what ever you wanna do!!! But you gotta start my keeping good grades in school.' She said 'oh yeah, I do good in school, but umm look, do I GOTTA go to school tomorrow? you see my lip!?' Told her she could go tomorrow if she wanted to, but it was up to her and her mom. She gave me a high five and I left!I left feeling darn proud of myself! LOL I managed a fussy kid, who after injections said I was nice and funny and wanted to be like me! awwww!

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