Last Wednesday, the kids were finally better.  They’d taken turns over the past week being sick with “Hand, foot and mouth disease” — high fevers, low energy, general malaise.  Liam woke up at 1:00 a.m. on Friday with a fever of 102 which went up and stayed up for almost 24 hours.  He gradually got better and was finally fever free on Sunday.  B woke up at 11:00 Sunday night with his own high fever (though his didn’t last as long).  Liam went back to school on Tuesday, and B joined him Wednesday.  It was my first morning on my own in a few days, and Dan offered to take the boys in to school so I could have a little extra time to run and then start to reclaim order in the household after several days of prioritizing other things.

I made it through breakfast.  I had just finished eating and had gone to change my clothes for a run when my phone rang.  It was the school.  I immediately sighed, assuming one of the kids (probably B) had gotten his fever back and needed to be picked up.  So much for reclaiming order in the house.

Instead, it was Liam’s teacher.  Liam had had an “accident” and was going to the hospital.  She spoke in English, but it took me a moment to process what she’d said . I could hear Liam screaming in the background.  I started to panic and shake a little as she explained that he’d been pushed by another child and had hit his face on the bathroom sink, splitting his lip.  She said it wasn’t “serious”, but I figured it was serious ENOUGH if they were headed to the hospital.  I tried to parse her heavily accented English well enough to write down the hospital’s name and her cell number so we could stay in touch.

Up until that day, I’d only been familiar with two hospitals in Vienna, and this wasn’t either of those.  I called Dan (who, at work, was much closer to where we were headed) and tried to figure out where we were going.  I threw on some clothes and left to get a cab.  Never have I so wished we had our own car.

After a brief debate with the cabbie (in German) over where I was going (the teacher had given me mildly conflicting information), I was off.  In morning rush hour traffic, it took me an agonizingly long time to get there.  Dan arrived first … but couldn’t find them.  (He was initially sent to the children’s department.  We eventually ended up at the accident department … which is not the same as the emergency department.  We’re still struggling to sort out which kinds of things belong in which.)

045We found Liam and his teacher.  He had split his lip inside and out pretty badly and was wearing a fair bit of his own blood.  His teacher, who later admitted she couldn’t stand the sight of blood, had taken good care of him.

Liam’s teacher had given him a teddy bear to hold before they left the school for the ER. It was for him to cuddle on the way.  He wanted nothing to do with it.  (He has since softened his position.)  When I asked him about it, he said, “I asked for my mom and dad, and she gave me the bear.  I didn’t want the bear.  I wanted you.”  My poor guy.

We went back to be seen very shortly.  But unlike our other hospital experiences in Vienna, at the more centrally located hospitals, the nurses here spoke no English.  Not a bit.  We did fine at the beginning, because Liam’s teacher helped with translating, but eventually they said she and Dan had to step out and I was left to manage on my own.  They took a pretty quick look at it (reopening the wound in the process) . . . and decided that it didn’t need any treatment.  I was so prepared for him to get stitches (or at least that glue that Benjamin got when he hurt his chin a few years ago) that I was absolutely sure I’d misheard them.  But no, no treatment.

It took a while for me to understand what the nurse was explaining in terms of home care.  “Nothing hot, nothing spicy, nothing salty.”  I manged all of that.  But she kept saying something else that I just could not understand.  She finally tried “Like Wiener Schnitzel!” and I realized she’d been saying “nothing with crumbs”.  “It will be fine”, she told me.  “It won’t be his only accident!”  So, in a little bit of disbelief and with a still-bleeding Liam, I went home.  (We took the train.  We should have taken another cab.  I certainly felt odd . . . and very conspicuous . . . carrying an obviously injured and still bleeding child on the subway.)

055I wasn’t convinced, though, that everything was ok.  Although the doctors and nurses at the hospital seemed very kind and quite certain about their advice, I wasn’t so sure.  Things are just so different here, and I really longed for American medical practitioners.  In general, I’ve really enjoyed the difference in Austrian beauty standards.  I like that there is much less emphasis on physical perfection here.  There is less plastic surgery, less makeup, and less of a fight against the aging process.  But, on the other hand, you do see more people with obvious scars and physical impairments.  Which is fine . . . until I was contemplating the consequences for MY child.  Medical care here is excellent.  The standards of care and medical education are very high.  I just didn’t trust the Austrian aesthetic opinion of “It’s going to be fine.”  By what standard?  I was really, really, wishing I could be back in good, old, superficial, perfection-minded America, where if an ER pediatrician said, “It’ll be fine”, I’d know, more or less, what that meant.  Here, I didn’t feel like I knew, and I didn’t know if their “fine” would really be good enough.

So, we consulted our pediatrician.  She’s an American/Austrian with two small kids of her own.  She looked at the pictures we sent her by text, and agreed that it didn’t need treatment.  When she said that if it were her kids, she wouldn’t stitch it, I felt sufficiently convinced.

And, I have to say that we’ve been pleasantly surprised, bordering on shocked, actually, at how well and how quickly he has healed.  The ER gave him clearance to go back to school the next day, but I kept him home the rest of last week (out of an abundance of caution, and because I was worried he’d reopen or reinjure himself playing with the other kids again).  It’s a week later, and looking at him now, it is so much better.  The interior part of his mouth is completely healed (that actually only took about 48 hours, which was amazing, given the original injury).  The outside is still healing, but it’s no longer an impressive wound.  Our pediatrician said she expected it to heal without a scar, and I think it’s going to turn out that she’s completely right.  He looks great.

So, all’s well that ends well.  But this stuff is hard.  THIS is the really, truly hard stuff about living abroad.  Not just not knowing where to go when your kid gets hurt.  Not just not being able to communicate well enough to find him right away at the hospital.  Not just having to resort to creative explanations to understand how best to take care of him.  But fundamentally, basically being outside of what you know and expect and take for granted.  Not being able to trust the answers you get because the people you’re talking to are speaking from a completely different frame of reference.  Any urgent trip to the ER with a child is stressful and scary, no question.  But this is a whole different ballgame.  These are the moments I most wish I could teleport back home.

A trip to the Spital

This was not what I had planned for my Monday.  I’d had a nagging pain in my back for a few days — nothing unusual for an over-tired, semi-out of shape mom with two very active little guys.  As Monday went on, the pain got worse.  I finally decided to take a moment to grab two Aleve, and just when it I was about to take them, I got a crushing pain across my chest and back.  It took my breath away.  I felt like I was being squeezed with a giant rubber band across the left side of my chest and back.  I’ve never felt anything like it.

Of course, it freaked me out.  It could not have seemed more like a heart attack.  But, I’m 37, and other than being overweight, I have no other risk factors related to my heart.  I exercise regularly, eat reasonably well, have good blood pressure and no family history of heart problems.  So, seriously?  But, I also worry about EVERYTHING, and though the pain subsided a little, as the afternoon went on I found myself having a hard time taking a full breath from time to time.

I finally texted Dan and asked him to come home early — less because I was actually worried and more because I could not shake the horrible image of me passing out while home with both kids.

Since I have a lot of anxiety, and I suspected I was getting myself worked up over nothing, I honestly expected my symptoms to disappear as soon as Dan came home.  They didn’t.  And as I played Wii with Benjamin, I struggled to focus through intermittent waves of pain and short breath.  I finally decided I needed to get checked out.

So, off we all trekked to the Emergency Room.  We pretty much all HAD to go because Dan didn’t want to risk me passing out on the strassenbahn or anything, and we didn’t have a sitter.

Long story short, I’m fine.  After getting checked in with lots of expected eye-rolling (this is Austria after all), I had an EKG, had some blood screenings done, and ultimately had a CT scan to rule out a pulmonary embolism (which apparently matched my symptoms better than a heart problem).  I was completely fine.  The doctor suspects I have a pulled muscle in my back that was basically seizing up every time I tried to take a breath.  Frankly, that’s what I thought it probably was, too, but I just couldn’t shake the worry that it might be something worse.  Ultimately, I was sent home with a prescription for some pain medicine in case the muscle pain comes back, and a suggestion that if it does, I should probably see an orthopedist.

Since Monday, I’ve been completely fine.  The pain in my back was gone by mid-day on Tuesday, and I’m back to feeling good.  I also feel a little silly for dragging us all to the hospital, but it is comforting to know that I’m ok.  And we had a much more adventurous Monday than anyone had planned.

Delaying the dentist

I’m kind of an oral hygiene nut.  Actually, I’m not as bad as I used to be — in college, my friends used to make fun of (and also, I think, kind of marvel at) my level of fastidiousness about my teeth.  I really like to take care of my teeth.  I’m religious about brushing and flossing, and I don’t even mind my biannual dental cleanings.  I’m weird like that.

007I’ve tried to be careful with my kids’ teeth, too, but since I’m admittedly a bit overly enthusiastic, I’ve tried to temper my concern with age appropriate expectations.  It’s only been moderately successful — I still remember the time I woke up in a cold sweat worrying about Benjamin’s teeth and how he hadn’t yet been to the dentist.  (He was 18 months old at the time.)  Ever since my kids have had teeth, we’ve made sure they brushed regularly (maybe not EVERY day, but very nearly).  We even floss their teeth (although that’s been less consistent).  When B was little and we were in the US, we were sure to use the non-flouride toothpaste, and when he was old enough, we took him to the dentist in the US.  We had a fairly disastrous first experience with a pediatric dentist, and then we started taking him to our friendly, gentle and kind regular dentist, which went MUCH better.  After that first experience, I was worried B would be traumatized, but with the help of our great dentist, he gradually got over his trepidation and would accompany both Dan and I to our cleanings and have his teeth “counted” when we were done.  And all was well.

Living abroad has complicated matters somewhat.  First of all, the water here is not fluoridated.  Some doctors recommend supplements, some advise against (reasoning that if you use a fluoridated toothpaste, which is pretty much the only thing you can find here, the kids will get enough incidentally).  We went without for the first 6-8 months we were here, and then I decided to go for it (I’m still not 100% sure of that decision, since over-fluoridating can cause problems, too).  Also dental care here is not, on average, up to American standards.  After some trying, we found a dentist that we’re reasonably happy with, but it’s not like it is at home.  There’s less focus on comfort with more focus on efficiency, less focus on aesthetics and more on finances.  I’m happy to go there for a cleaning, but we weren’t confident that the kids would have good experiences.  I took B along with me for the first time last fall, and he got his teeth “counted” again (all looked well) — but he’s used to the procedure now.  I wasn’t sure how Liam would take it, since he had no positive experiences to build on, so we haven’t taken him.  I’d just recently been thinking that I would probably try to make him an appointment when we next visited the States, most likely this winter.

And then, about 3 weeks ago, we noticed a spot on one of Liam’s front teeth (not the very front ones, the ones just next to those).  And, of course, being the dentally obsessed person that I am, I freaked out.  Does he have a cavity?  Did he damage his tooth?  Have I been over-fluoriding him?  Is it going to get worse?  Is it going to hurt him?  Will he lose his tooth?  Will this happen to his other teeth?  Will it happen to his permanent teeth?  (That was all in the first 2 minutes of discovering that it wasn’t a small piece of food and I couldn’t scrape it off with my fingernail.)

After calming down, and realizing he didn’t seem to be in any pain, I consulted with our pediatrician.  She wasn’t sure what it was, either, but recommended I have a dentist look at it.  She (also an American, and a parent) suggested that if we were visiting home anytime in the next two months that we just wait until we go home.  But we’re not, so I can’t.  But, I’m with her — I’d rather have it looked at in the US, too.

But, that’s not an option.  So, we made him an appointment with our dentist here.  I’m encouraged by the fact that they didn’t seem alarmed, concerned or overly urgent (nor did they refuse to see a 2 year old, so I’m desperately hoping that they do this all the time and will be shockingly impressive at comforting and reassuring him).  That appointment was supposed to be today.  But, since Liam is still recovering from his recent illness, including being so congested that he can’t breathe through his nose, I decided to postpone it another two weeks.  I just can’t imagine things going well if he’s sick on top of having a new (potentially scary) experience, and I want to set him up for success.  So, in two weeks, we’ll go in and get his tooth looked at.  It hasn’t gotten worse in the past 3 weeks, so here’s hoping it doesn’t get worse between now and then.  I’m worried about my guy.  And I’m really missing the excellent quality of dental care in the US.

Baby teeth

Being a mom comes with an inexhaustible capacity for worry.  It starts during pregnancy:  in the beginning, you worry if everything is ok.  Once you can feel the baby moving, you worry that he isn’t moving enough, or maybe too much.  Every ache or pain causes concern — it’s the physical equivalent of being in a dark and creaky house after seeing a scary movie:  everything is interpreted as a potential threat.  As the nine months wind to a close you start to desperately wish for the baby to be born, in large part because you feel like it will be so much easier to know if they’re ok once they’re on the outside and you can see them and touch them.

But it’s a bit of a nasty trick:  you don’t realize how safe and secure they were until they are on the outside.  The first nights a new mother spends with her baby are sleepless.  Not just because of baby’s need to eat so regularly, but because even when he is asleep, the mother will lie awake listening for each next breath, attentive to every sigh, every movement, every sound.

It gets a little better as the days, weeks and months go on, but the faith you begin to get that they will survive the night is replaced by other worries.  You worry that they’ll get sick — or they do, and you worry about that.  You worry that they aren’t sleeping enough, and then the one day they take a long nap, or sleep through the night, you wake them up just to make sure you can.  You worry that they aren’t growing enough, or that they’re getting too big.  You start to worry about development.  There are milestones that you read in the books, on the websites, that your doctor provides.  Anything that doesn’t quite “make the grade” will inhabit your mind and fester.  You compare your child to the others you see, and try to figure out, constantly, if everything is ok.

I’m going through this with Liam right now.  It’s his teeth.  His first two teeth arrived “on time” (according to the books, websites and doctors) which was a relief.  (Which really just means it allowed my mind to move on to worrying about the next thing on the list of required accomplishments.)  A few weeks later, he started to get his next two teeth, also on schedule:  hooray!  But, a week or so ago, I noticed that those two top teeth aren’t where they’re supposed to be — they’re really far apart.  I can’t tell whether his two front teeth are coming in really far apart, or if he hasn’t gotten his two front teeth at all, but rather the two that are located next to those.

So, worry, worry, worry.  What does this mean?  Will his teeth grow in properly?  Will his two front teeth ever come in?  What will we do if they don’t?  Is there something “wrong” with him?  (Because that’s the worry that is really always in the back of our minds — is there something WRONG.  Which could mean any number of things, but generally means “something that will prevent his life or childhood from following a typical path and/or will make said path significantly more difficult than usual”.)  Consult the books!  To the internet!  Ask the doctors!

Right now, I don’t know.  The books and the internet tell me it could be that his teeth are coming into the wrong spot, or it could be that they’re coming in out of order (more likely).  The doctor looked at him for about 15 seconds, said she thought they were coming into the wrong spot and shrugged (lots of help, thanks).

So, I’m going to keep worrying.  What does this MEAN!  What is going to happen?  Where is my crystal ball when I need it?!?

I get the impression that this doesn’t ever end.  There’s always something to worry about.  And even though I know the energy spent worrying is wasted (it’s not like I could do anything about how his teeth are growing in) I can’ t help myself.  I’m a mom.