The Fall of Roman

Living in a developing country with no quick access to good medical care, like we're used to in the US, has always been a concern for us since we moved to Indonesia. MAF does carry a service that will evacuate us quickly in case of a life-threatening emergency, but the bottom line is that Tarakan is not really a place we'd want to be in case anything more than stitches were needed. So what about a traumatic event, like in an emergency? Having three small kids, I've always kind of thought that our day was going to come where some sort of trauma would occur, and one of the kids (or us) might need stitches or worse. Well, on Sunday afternoon, our day came when we were taking a bloody kid to the hospital.

I was carrying Roman on our back porch and went to step off into our back yard when my foot slipped off the porch, and Roman went flying forward, landing face first on a flat concrete step in our back yard. I immediately picked him up, turned him around, and was horrified to see his face covered with blood. What exactly was bleeding? Were all his teeth there? I took him in to the bathtub and washed off his face. All his teeth were there, and it appeared that his lip was mostly intact. I called Heather, who was spending the night at the local hotel, trying to get away and relax for a night. This night would be anything but relaxing for her!   She came home, and we took Roman to the hospital, leaving Drew and Ella with Steve & Laura, our new neighbors. Steve was actually at our house when Roman went flying out of my arms.

On the way to the hospital, we talked about whether he even needed to go to the hospital. His lip and mouth actually looked OK by this point, though swollen, and there was no wound that really looked like it needed to be stitched up. Going to the hospital here is always somewhat of a challenge, because, to be quite honest, I don't always trust the doctors. But we ended up taking him in anyway. As they were checking him out the doctor noticed a cut on the roof of his mouth that was still bleeding. He called a surgeon, and they almost immediately determined that since it was still bleeding (though only slightly bleeding), they needed to stitch it up, and since it was inside his mouth, they'd need to put him under general anesthesia to do that. The doctor was worried that Roman would asphyxiate on his blood while sleeping, since it didn't seem to stop bleeding. At the same time, we were trying to get in touch with any of our English speaking doctor contacts in country. I called one, and got a text that he was in America. I ended up texting him back and forth, while Heather tried to call an Australian nurse we know of in Balikpapan. Her number wasn't working. All this time, the doctor in the ER was pressuring us and asking us about calling the surgeon in to do surgery on Roman's mouth. We were getting frustrated that we couldn't get in touch with any English speaking doctor, and honestly it just seemed crazy to put a kid to sleep just to do a few stitches in his mouth. I started thinking, "Maybe we can take the Kodiak to Balikpapan (bigger city in East Kalimantan)...it'd only take a little under two hours to get there." There are about 6-7 flights a day on the airlines to Balikpapan, but it was almost 8pm at this point and our only option would have been on an MAF plane. Finally, I got in touch with "Dr. Di," as she's called, an expat doctor living in Papua, Indonesia. She was very helpful, and gave us some instructions on how to stop the bleeding. At that point, it had stopped on its own, and we went home from the hospital, having avoided surgery on our little guy.

The next day, he looked beat up, but was healing up nicely. He did, however, wake up with a fever and runny nose. Nothing on his face looked infected, and his fever was fairly mild, so we weren't too worried about the fever.



Later Monday afternoon, I got a message from my good friend and former roommate, Daniel, who is a brilliant doctor working at a hospital in Bangladesh. He saw the pictures of Roman on Facebook, and was a little concerned about the clear fluid coming out of his nose, in combination with the fever. Though it was likely just a cold, there was a chance Roman could have a basilar skull fracture, and the fluid leaking out of his nose wasn't just snot, but was cerebral spinal fluid. He emailed another brilliant doctor friend of his (I feel so fortunate to be friends with someone like Daniel), who works at the Pediatric Emergency Department at Columbia University Medical Center in New York. After emailing back and forth with this doctor, who has worked in other developing countries around the world and understands our predicament here, he gave us some tips on how to determine whether this clear fluid running out of Roman's nose was cerebral spinal fluid (CSF), or just snot.

So this morning I went out on a mission to find glucose test strips, the kind you may have to put in urine to test for glucose. If the fluid had glucose, it was CSF; if not, just snot. Pretty simple, all I have to do is find these glucose strips. I went to the hospital where we took Roman two nights before, but they didn't have any. I went to a pharmacy, but no luck there either. I went to the main public hospital, and while waiting at the pharmacy, I got a text from one of our teammates that they had some. Finally!

Even if we believed Roman was leaking CSF out of his nose, there wasn't necessarily anything they'd do if we were in the USA, other than observe him. But, the main thing they observe people for when they have a basilar skull fracture is signs of meningitis, which is a very bad thing. So we were basically trying to determine if we needed to go to Jakarta, which is where we'd go for something serious like this. Thankfully, the fluid tested negative for glucose, which we honestly believed all along, since he was coughing and had all signs of having a bad cold. Still, it was really hard not to be worried these past 36 hours or so.

For me personally, this has been a big lesson in trusting God. Sounds simple, and is the basis for being a Christ-follower, but man was it hard for me not to worry - especially combined with the fact that I was feeling slightly guilty for dropping him. We did a LOT of praying, and almost as much as I prayed for Roman, I asked God for strength to just trust him and not worry. There were several times where my whole body just felt numb in the midst of wondering if your son is leaking brain fluid out of his nose because you dropped him on the ground.  I've got to say, I've never been so happy to hear Roman coughing and having raspy breathing (which he usually gets when he's sick).

Now, I've just got to get Heather back to the hotel so she can spend a night away from here!  If she trusts me with the kids, that is.