Last month, my eight-year-old daughter took a spill while riding her bike. Afterward, she could not straighten her arm and was in severe pain.
I am no model of grace, but I have been a mother long enough to know that it is important to stay calm. Children play, they get hurt and sometimes medical attention is needed.
We have been to the urgent-care centre many times, and the emergency room as well. This time though, all I could think was, “This is not the time for a broken arm.”
At a time when there is a shortage of personal protective equipment like masks in medical practices, it is understandable that patients are concerned about trips to the doctor
Like millions of other children, in the United States and elsewhere, mine are at home as the world battles the novel coronavirus pandemic.
Biking is one of the few outdoor pleasures kids can still enjoy while we wait this out and follow social-distancing and hand-washing protocols.
But parents like me are also worried about having to take their kids, or themselves, to the doctor for issues not related to Covid-19, the disease caused by the virus.
Not only do these injuries tax the currently overburdened health care system, but by going to the doctor, we are potentially exposing ourselves to the virus. Or if we are unwitting, asymptomatic carriers, we risk exposing others.
For my daughter, we first did a telemedicine visit with a doctor who was certain she had a fracture and needed a cast. He recommended the emergency room at the children’s hospital nearby, where she could see a paediatric orthopaedist and get a cast on the spot.
Instead, to avoid the ER, we made an appointment at our paediatric urgent-care centre. It was after regular business hours and there was no orthopaedist available, but we could get X-rays done and return for a cast, if needed.
“If it were me, that’s what I would do,” the receptionist told me as she made the appointment. “You don’t want to go to the hospital right now.”
My husband and daughter left for the urgent-care centre, and I stayed home with our son, wondering whether I should have been more cautious and not let the kids ride bikes.
I asked some paediatricians what they thought. They assured me that biking was not a bad choice. Kids need to play. Mental health is important. Life is not normal right now, but we must carry on.
“You don’t need to stop,” said Lee Beers, a paediatrician at Children’s National Hospital in Washington and the president-elect of the American Academy of Paediatrics. “I think you should practice the same level of safety and caution that you always would. If you’re riding a bike, wear a helmet.”
Spending time outdoors and getting in movement and exercise is important for children and adults, she said.
Concerned about trips
Nonetheless, at a time when there is a shortage of personal protective equipment like masks in medical practices, it is understandable that patients are concerned about trips to the doctor, Beers said.
In late March, novelist Rebecca Makkai’s husband burned his hand while cooking and the couple made the decision not to seek immediate medical help even though he was in pain.
“I’m always on the side of go in and get it checked out,” said Makkai, who lives in the northern suburbs of Chicago. “We do have decent insurance, and under other circumstances, I would say you absolutely have to go in.”
But the urgent-care centre near them was closed, and her husband’s primary care doctor was not available. The closest hospital to them was a Level 1 trauma centre, which she feared might be overwhelmed with Covid-19 cases.
Makkai is considered high-risk for serious illness with Covid-19 because she has asthma. Since the virus started spreading, she has tried to remain at home.
“He’s the only one leaving the house, and we’ve been really careful,” she said.
Makkai wrote about her husband’s accident on Twitter; he had placed his entire palm on a cast iron pan that had just come out of the oven.
She described the white spots on his hand that looked like they might be cause for concern. She received more than 100 replies.
“I got a lot of advice, including from actual registered nurses, on both what to do and what might be prescribed,” she said.
She and her husband took some of the advice and he slept on an armchair in the living room, his hand in a big glass mixing bowl filled with cool water.
He felt better by morning, when he was able to see a nurse who said the burn was mild but on the borderline.
“If it had been just a little worse, it would have been such a bad call to stay home,” Makkai said.
For her, the incident felt like a warning call. Her children, 9 and 11, have food allergies that could require medical attention, and if they need it, she wants to have a plan.
“There will be other decisions in the weeks ahead, where the decision is not so clear,” she said. “I think I want to think it out ahead of time and maybe talk to their doctors.”
Beers said that certain issues could also be addressed through a phone call or telemedicine visit.
“Potentially with things like rashes and hives, a brief conversation with the family can help us discern what to do,” she said. “The doctor may be able to address it that way, or recommend that they come in.”
Another parent, Jenn Yates, 44, of Arlington, Virginia, went on a bike ride recently on the Custis Trail and fell and hurt her left arm.
Outside during pandemic
The accident has left her in a cast, unable to do household work and assist her two young children. She has decided to give up biking outside during the pandemic.
She went to Virginia Hospital Centre in Arlington and was greeted by an eerie scene. There was a tent set up where medical personnel were receiving patients with coronavirus symptoms. Other patients were offered a different entrance.
“It had a disaster movie, scary vibe,” Yates said. “Even just handing someone my ID and insurance card, I was concerned. You worry about every interaction.”
Her kids are four and seven, and until she recovers, her husband is taking on more of the household responsibilities. It’s painful for her to move her fingers, she needs help dressing herself, and she can’t cook.
The other day, she was outside watching her kids bike when her four-year-old fell down, face first. She could not pick him up and had to ask a neighbour for help, although she is otherwise following social-distancing protocols.
“I realised I can’t even be the supervisor of my kids right now,” she said.
Still, she will not be stopping her children from biking, although she is in the market for a stationary bike.
“For the kids, I can’t restrict them from these activities when so much has been taken away right now,” she said.
I agree with that sentiment.
My daughter came back from the doctor with a sling. An hour later, we received a call from the paediatric radiologist. No break.
It was rainy and overcast here in Austin, Texas for a few days, so she didn’t get back on her bike. But then, the sun came out.
Sindya N. Bhanoo is a reporter and columnist based in the San Francisco Bay Area