Page 6 of Kaya's King

As Poseidon said to us long ago, “We didn’t spend years honorably serving our country and defending our nation’s freedoms, as well as those of the places we were deployed to, only to come home and take a shit on it.” No judgment to the clubs who opt to run that line whatsoever; at the end of the day, they’re living their lives free and easy just like we’re doing.

Medical records for Noah start downloading in reverse chronological order. I wait for everything to finish, then resort the files so I’m starting from the beginning. The hospital notes show a normal birth with no abnormalities and an APGAR score of 9. Because I don’t know what that means, I spend a few minutes researching it until I understand.

Moving on, I find the first visit to the pediatrician then quickly scan the prognosis notes.

Patient is a well-nourished, three-week old. Umbilical cord site healed completely. Circumcision healed. Mother notes child is sleeping almost six hours during night. Patient has regained the weight he lost while in the hospital, adding two pounds. Alert, clean. Presents with congestion and low-grade fever x one day. Ears clear. Eyes clear. Nose stuffed and patient is fussy. Swabbed for Flu A; negative. Advised mother to use over-the-counter fever reliever, humidifier, and infant nose drops. Possible allergy to formula; mother will observe and return if symptoms continue.

At his two-month visit, he starts receiving his childhood vaccines. Looks like there were no issues with those as the next visit doesn’t happen until he’s almost six-months old.

Mother states patient cries incessantly whenever he attempts to crawl as if in pain. Physical exam doesn’t detect any abnormalities. Advised mother to continue to observe and return if it continues.

In between well check-ups and vaccine appointments, there are several more visits where Kaya insists Noah acts as though he’s suffering with no known origin to constitute her concerns. No tests are run on him; she’s merely advised to keep watching him.

There’s a visit to the emergency room when he’s almost two. I click the section for the notes and read what happened.

Patient arrived in triage with a towel wrapped around his forehead. Mother indicates he fell into a coffee table while running and split head open. No indications of abuse; no bruising or old injuries present. Used local anesthetic, cleaned wound then stitched shut. Advised mother of aftercare procedures. Stitches should dissolve within 10-14 days.

My hand rubs my head while reading this because I’ve got one of those scars myself. Chuckling, I think about the fact that most little boys I know get their fair share of bumps and bruises, as well as stitches. “So far, so good.”

Everything continues with the occasional visit for strep throat or an ear infection until the middle of last year. That’s when the visits start talking about pain when he walks or runs around that goes from his hip down to his knee.

Patient presents with a slight limp. According to mother, he hasn’t fallen or been in an accident. Palpitation of the area shows some swelling. Somewhat limited range of motion. Scheduled patient for physical therapy. Possible growing pains.

So, this has been going on for a little over a year. Poor kid. I continue reading, clicking over to the physical therapy notes once she starts taking him to those appointments. There are continued visits to his pediatrician, as well as recommendations for massage therapy and more physical therapy after the initial sessions were completed.

Mixed in are trips to urgent care, the emergency room, and also another doctor who specializes in pediatric orthopedics. “She’snot actually doctor shopping,” I state out loud to shut the voices in my head up. “It looks like the urgent care visits were because he got sick or hurt himself outside of the normal hours so she wouldn’t have been able to see his doctor. The emergency room trips happened when he fell off a trampoline at a friend’s house and broke his arm, then the next one occurred after he spent all evening into the night vomiting. He got dehydrated. She’s a good mom to him, just like yours was, Specks.”

Kaya

“Well, the X-rays your pediatrician sent over were clear,” Dr. Young states. “I’m waiting on ours to be brought in so we can discuss a plan of action for Noah.”

I nod, already stressed because what if he has to have surgery? “I just want him to be able to be a little boy,” I reply, looking over to where Noah’s quietly sitting playing on his tablet. When we first arrived, they ran a battery of tests which I had anticipated. Noah, on the other hand, was less than impressed that they had to draw blood. The X-rays, while not typically painful, were for him because they had to position him in various poses that he had to hold still for until the shot was taken. I know he’s hurting right now based on the frown line drawn between his brows.

“Hopefully, we can achieve that for you,” he states. “I know he’s unhappy with us right now because he’s in pain. I’m going to have one of the nurses bring him a pain reliever if that’s okay with you.”

“I think that would be a good idea, otherwise he won’t be able to sleep tonight.” He nods his head and jots down in his chart that he’s prescribing this medication for my boy.

Dr. Young calls for Noah’s delegated nurse and tells her what he wants. When she arrives, she has the x–ray in one hand, and in her other palm are two tiny cups holding the pills and some water. Handing over the X-ray to Dr. Young, she walks over to Noah, and I hear her say, “Hey, little man, I understand you’re hurting. Here’s something for you to take that will hopefully help.” When he glances at me, I nod to let him know it’s okay for him to take it.

“Thank you,” he says to her before swallowing the medication, then drinking the water and handing the empty cups back before returning to his game.

“Let’s see what we’ve got,” Dr. Young announces, walking over to the lit up lightboard they use to look at scans. He hits the on switch then places Noah’s on the front to brighten up the area where Noah’s pain is originating.

“What am I looking at exactly?” I ask, moving closer to examine alongside the doctor. “I mean, I know that’s his hip and the top part of his leg, but outside of that, I’m utterly clueless.”

Dr. Young chuckles before telling me, “You’re correct with what you said. Now, you see right here?” He points to the top of the bone in the hip socket. When I nod, he continues explaining. “Okay, well, fortunately, we’re in the initial stages of Perthes.”

“What does that mean?”

“There’s some irregularity in the femoral head right here,” he implies, pointing at a spot on the X-ray. “The osteonecrosis, or bone death, has begun, but the fragmentation phase of the disease is just starting. Our goal is to make sure we do everything possible so that when it heals, it heals as structurally close to normal as possible.”

“It’s all Greek to me, Dr. Young,” I confess. My knowledge of medical jargon is zilch. “Just tell me in layman's terms what we have to do, and I’ll do it.”

“Well, we’re going to schedule an MRI so I can get a better look at what, if any, damage has already been done. Initially, we’re going to try him being non-weight bearing for four weeks.”

“How on earth do I do that?” I murmur.

“If you don’t think he’s old enough for crutches, we can get him a walker or put him in a wheelchair during that time. He won’t be allowed to walk around, he’ll need to be carried to and from the bathroom, and no showers since he won’t be able to stand up for extended periods of time.”

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