Starship
You may have noticed that I haven’t been posting much. Life has thrown us a couple of curve balls lately and I’ve been taking care of kids. This post covers what happened and what kind of care to expect because “Starship” has nothing to do with space exploration, Space Force, or an up-and-coming sci-fi movie. Starship is the children’s hospital here in Auckland, and unfortunately, I know my way there by heart now. I thought I’d share what our experience was like receiving emergency and follow up care for not one, but two kids over the past week. We have been cursed with bad luck coming out of lockdown.
The first incident was my daughter. The two kids were playing on a tree swing we set up in the front yard. The story as the kids tell it is that they managed to get both kids on the swing at the same time. My young daughter, M, slipped off, tumbled down a slope, and smashed face first into a retaining wall. Jon and I had a total and complete freak out as we heard her screaming. Within minutes we were in the car, making the 13 minute drive to the children’s hospital as this was clearly going to need some serious medical intervention. She slipped into unconsciousness on our way there, and to say that we were beyond scared by the time we made it to the emergency room (known as “ED” or Emergency Department here) is an understatement.
My husband ran in with her while I parked the car and waited with my son. Because of coronavirus restrictions, only one parent was allowed in at a time. In the mad dash out of the house we gathered my son in the car with us as there was no time to find someone to watch him. About a half hour later, Jon gave me a call from the ED. They got an IV in quickly to give her some pain medication. Doctors had already come in to look her over and they came up with an assessment plan. The first thing she needed was a CT scan to determine exactly how much damage there was. Jon and I decided that we would switch places and he would wait with our son, R, while I went in with M. Just a few minutes after I arrived, I held her hand as the nurse and doctor pushed her bed to the CT scan. We talked about giving her a dose of ketamine so she would be still during the procedure. The doctor carefully explained why they wanted to do this, what the risks were, and what precautions they had in place in case she had any kind of reaction.
And then she suddenly sat up, threw up all over the place, and scared us to death as it was bright red. As the nurse, doctor, and I sat there is shock for a minute - all of us wondering what kind of internal injuries she had that would cause such bright red blood in her vomit. All of a sudden I remembered. “We had berry smoothies for morning tea!” I exclaimed. Everyone breathed a sigh of relief. We cleaned her up as best we could, wheeled her into the CT scan room, and I stepped out while the scan took place. A few minutes later, we all wheeled back to the ED to await results.
The initial results showed two small fractures in her eye socket, but the eye itself looked to be in good shape. She had two deep contusions that would need some serious work to stitch up and clearly had a concussion, but it looked like our worst fears wouldn’t come true. The doctors in the emergency room consulted with a number of specialist before it was decided that the best plan of action was to bring in a maxillofacial team from Middlemore - another hospital in Auckland. On Saturday evening we met with them to discuss her upcoming surgery. Initially they wanted to do the surgery that evening, but after there were additional vomit bouts, they decided it was best to wait until Sunday morning to give her head a little time to recover. General anaesthesia can be rough when there is a concussion involved.
The emergency room staff took us up to the surgery ward where she would stay for the night. We had a private room with an amazing view of the SkyTower, and there was a pull out bed for a parent. While not particularly comfortable, it was better than sleeping in a chair. The ward nurse showed me where a small kitchen was, the linen room, and the parent’s bathroom and shower. M was asleep for all of this, and I quickly got settled into bed, knowing we would be woken up constantly throughout the night, even if I could sleep with all of the adrenaline running through me.
The next morning several surgical teams came by to check on her. By 9:30, we were prepping for surgery. Both the anaesthesiologist and the surgeon came by to discuss what was going to happen and answer questions. I was struck by how unrushed everyone was. All of the doctors wanted to make sure that both M and her parents were ok. By 10, she was in the operating theater, and Jon and I were waiting in the small room across the hall. We spent the next hour and a half mindlessly staring at our phones, too shocked and tired to do anything else. (Yeah for decent, free Wi-fi in the hospital!) Around 11:30, the lead surgeon came by to talk to us, show us pictures of how she looked post-surgery, and reassure us that everything went well. The nurse would come and get us when she was coming to. Shortly thereafter another one of the surgeons came out to talk about expectations and aftercare. Basically, he expected her to heal nicely. We would stay in the hospital one more night to meet with the concussion occupational therapist and then go directly to an eye clinic for an ophthalmologist exam at 1:00 on Monday. We would come to his clinic on Thursday for a check up. It was a huge relief to know that she would be ok.
We took M back to her room shortly thereafter. She slept fitfully for the rest of the day, occasionally waking up and asking for food. Fortunately, the ward kitchen was well stocked with individual ice creams and ice blocks. She was living her best life alternating bites between the two. At that point, I was so relieved that if she wanted to take a bath in ice cream I would’ve said yes.
Once she was clearly doing better, I left Jon to enjoy dinner at the hospital (they feed the parents, too!) and headed home to shower and take care of my son who was with our neighbour all day. The next morning, M was still groggy and not feeling very well. She was on alternating doses of paracetamol (the Kiwi version of acetaminophen) and Ibuprofen. She met briefly with the OT who officially diagnosed her with a concussion and sent in a referral for a concussion clinic. Then a social worker came in to try to talk to her about what was going to happen at the eye doctor’s. M was too out of it to get any of it, but she got to keep a hospital doll the woman brought by which she uses to draw on to explain what’s going on to children. The doll, now named Starry after Starship, is a prized lovey.
We left the children’s hospital and drove ten minutes to the eye clinic, which was a bit of a chaotic mess at first as we didn’t understand how the setup worked. Soon, however, we found ourselves waiting in a comfy lounge chair waiting for our turn. Little did we know exactly how long we would wait - not for care, but trying to dilate her eye that was swollen shut turned out to be a very arduous process. (We took advantage of this time to get M’s prescriptions fills at the pharmacy down the hall. I love how any pharmacy can easily fill prescriptions without the hassle of going through insurance checks ahead of time!) However, one nurse was so patient and amazing with M that we eventually got the drops in. I cannot stress how much time and effort this woman put in to making her accept the stinging drops. This nurse took her on sticker treasure hunts around the office, held her hand, and basically dealt with all of the tantrums a cranky, in-pain 5 year old had for two hours. She had a never-ending well of patience. Eventually, M’s eyes were ready for a proper exam, and the ophthalmologist was able to give us reassurances that the eye itself looked ok. We were relieved and ready to go home!
The follow up care continued - we met with the surgeon again that Thursday and once more the next week. On Tuesday, the day after we were discharged from the hospital, our family doctor called to check in on us and see if there were any questions she could answer. ACC called to talk to us about all of the health benefits available - free of charge - to help care for M. The OT called twice to check on M’s concussion and we made a visit to a concussion clinic to meet with a team of specialists as she still has lingering symptoms.
The second incident happened the Friday after my daughter’s fall. My son, R, and Jon were looking over a balcony at one of our orange trees following a discussion of whether or not there were any oranges ripe enough to eat yet. Somehow R flipped over the railing, falling to the second floor deck. He popped up immediately, saying “I’m ok, I’m ok!” Jon and I ran downstairs, freaking out again. We looked him over and immediately noticed his left wrist was not ok. Jon and I took him to the car, and he raced off to a local A&E (accidents and emergencies. Think like a stand alone ER.) I stayed home with M, trying to keep myself from showing how freaked out I was so she wouldn’t be scared.
About 45 minutes later, Jon called to say that he and R were going in an ambulance to Starship. No one could believe that the only damage he sustained from a 15-ish foot fall was a broken wrist. They wanted to get him thoroughly checked. I packed a bag with iPads, snacks, and a lovey and said I would meet them there. M and I hopped in the car and made the drive back to Starship. We met up in the ambulance bay where I got to climb in the back of the ambulance (the first time I’ve ever been in one!) to hold his hand while the paramedics and nurses decided where to take him. They had given him a dose of fentanyl up the nose, so he wasn’t feeling any pain.
In the ED he got a full check up. He had a nasty bruise on his leg and a big bump on his forehead. They decided to add a leg x-ray in when he went in for the arm x-ray as well as a CT scan. When the results came back, it was just the arm, which had a broken radius and ulna. Fortunately, the orthopedist could set the bones and surgery wasn’t necessary. Later that evening R was given a dose of ketamine and the doctor was able to set the bones and plaster him up with a huge cast up to his shoulder.
In the ED the nurses were very informative and attentive. So much so that a few of them made comments like, “You’re back?!?!?” and we had to explain that this time it was for the OTHER kid. It was a terrible feeling and I felt like an awful parent. To be on the safe side (because still no one could believe he didn’t sustain any other injuries) he spent the evening in the hospital. Jon, who I think felt responsible because he was the one looking over the balcony with R, wanted to stay the night. The next morning he met with the concussion OT (who didn’t think R had much of a concussion) and eventually got R discharged in the early afternoon. Our follow up appointment with the orthopedist was already scheduled, and we knew we would get the barrage of follow up calls in the days ahead.
The quality of care we had at Starship for both incidents was incredible. There were no waits and no delays for anything. I was shocked at how well coordinated the whole process was. Appointments were made for us. Everyone had the kids’ medical records and notes so we didn’t have to repeat information or carry documents from one appointment to the next. Our family GP is aware of everything and proactively reached out to me to make sure all of my questions were answered and concerns addressed. Best of all, the only thing we have paid for is the parking at the hospital. Both incidents were clearly accidents and therefore covered under ACC. I was acutely aware that worrying about doctor’s bills, fighting with insurance companies, and the uncertainty of future financial obligations did not play a part in the quality of care we received or the decision process on how best to treat the kids. It was intensely freeing, and I felt guilty for enjoying this type of healthcare. It was one of those moments when I internalised exactly how screwed up the US system is. I’m thankful we’re in New Zealand.
