Thursday, March 3, 2011

Stab me in the ear

So I got a call from the school nurse on Monday morning saying that Hunter's ear was bleeding and I needed to come get him.  Weird.  He has had no pain associated with it, it's not infected, and the ear drum is intact.  I couldn't get an appointment that day in the pediatric clinic, so I talked on the phone with the ENT, who thought maybe the tube was coming out.  I opted to try the watch-and-see approach. 

It bled all night, so I loaded them all up and went to the ER first thing Tuesday morning.  They were as hostile as unhelpful as always regarding the hemophilia, and refused to give him the factor I brought.  Instead, they decided it would be best to transport him in an ambulance to another hospital, so I followed in the van.  I never would have found it myself, I'm sure, but it still seems like a huge waste of resources, which the military loves. 

They were extremely nice at this hospital, but we had to wait some time because the pharmacy was busy mixing chemo meds, so they finally asked me to mix it myself.  I hadn't done it for about three years, and the instructions were in Korean.  It has to be done just right, and the clotting factor is extremely expensive.  I followed the pictures, but they left out one part, namely removing the caps on the bottles of the sterile water and the factor concentrate (which aren't obvious), but apparently that step was in the written instructions, and thankfully the nurse dude was able to salvage the factor after reading through the instructions.
Not sure what it means.  We've also seen a "Beer Hunter" sign, but have yet to get a good picture.
Hunter continued to bleed for a few more hours until it finally stopped, and since there was no active bleeding by morning I sent him to school Wednesday, with instructions to not go to recess or horse around at all.  I picked him up when school was out and we went to the bank to get big money, then went to Itaewon to exchange it for Won so we could pay for the factor at the hemophilia clinic.  I have been reimbursed by Tricare for Tristan's treatment from last year ($4500), but not yet for the preliminary testing/xrays/factor for Hunter.  I would have gone to the clinic in the first place on Tuesday, but it was closed for a Korean holiday.

People here often carry their small children on their backs.  This lady looked older, too, perhaps a grandmother.
 The clinic is the most efficient operation I have ever witnessed.  They have a tiny parking lot, holding maybe a dozen cars if they are double and triple parked.  So they have two full-time guys who rearrange cars all day so that people can come and go as needed.  We just wave at the receptionist - she knows us, and then sit down until it's our turn.  Our name will come up on the TV screen in the front of the room, only I don't read Hangul, so usually people will let me know that it's our turn - funny how much an American name (Tristan or Hunter) must stand out.  We then open the door to the doctor's office.  He sits at a desk in front of a computer with our electronic charts.

He looked in Hunter's ear and said the clot was very unstable (he speaks good English) so he would need more factor that day, and said to come back the next as well.  It was impossible to tell what was bleeding in there until we went back Thursday.  By then the blood had cleared out and the other hemophilia doctor who was working that day said that he appeared to have scratched the skin in the ear canal.  Apparently the skin is very thin in there.  At least he didn't hurt the ear drum.  There's a play room downstairs for the kiddos, near where the physical therapists work with patients, so they saw Kyler and one of them brought Hunter's coat to me (that I've been wondering what became of) that he must have left there months ago.  The nurses gave Hunter the factor intravenously and we were out of there within half an hour.  Amazing, especially compared the the 5 hours we spent going to the base hospital, then the next hospital...

Today, Thursday, they gave him another dose of factor and the doc said he should be seen by an ENT to "dress" the wound in there.  I am sure grateful for modern medicine.  Life wasn't so easy for my dad in the days before factor replacement.  He would be laid up in the hospital for weeks at a time when he had a serious bleed, whether external or internal (such as a swollen joint or a big bruise/hematoma).


Dawna Greer said...

My goodness! What an ordeal for you and Hunter. Isn't it amazing that as a mother you are learning more about your sons' disorder than some of the hospital medical personel who treat him. Of course you have the motivation. . . Its good that there is a good and helpful clinic that you can take him to.

The Merrills said...

So you all still have to stay 2 years in Korea, and not 3? And that's because of the hemophilia, right?

Living Lavallee said...

We chose to not apply to extend for a third year, and they probably wouldn't want us to anyway.