The best-laid plans....

Yesterday was going to be a good day. It was Saturday! My wife and I had just gone to pick up one of our cars from getting an overdue oil change after I had finally resumed working on our tax return in earnest for the first time in about a month.  The cold I had caught overnight--lack of sleep during the week--would be nothing more than a speed bump because I was going to take a nap when I got home. Then, I planned to go to Sprouts to take advantage of their weekend 72-hour sale before grabbing a couple of pizzas to go with the salad my wife brought home from work on Friday, so that I didn't have to make dinner when she was out with our other son to see his friend's violin recital.

But, at the service center, my wife got a terse text from our younger son: "Anthony is upset." I was trying to pay for the oil change, so I said, "They need to take him to the bathroom." My wife then got a call from our daughter, so she was outside for a couple of minutes while the unusually apathetic young lady at the register fumbled through my order. When my wife came back, she informed me that Anthony was bleeding--he had hit his head on the head of a screw in a wall--and I needed to get home right away while she went on to her scheduled appointment.

Despite previous experience with Anthony, my first thought was, "how bad can this really be?" But when I got home and saw the wound, it was clear that we were in for another hospital trip despite my not fully understanding at the moment what our daughter was explaining.

My wife, with whom we were communicating via text and phone call, suggested we go to an urgent care facility rather than an emergency room (and insisted that I take Anthony in our oldest vehicle to prevent getting blood in our newer car). I asked our two other children to come in the other car so that one or both of them could explain in detail what happened, and then they could go home.

When we got to the hospital, we were unfortunately told that our insurance was no longer being accepted there as of two weeks previous. I asked about Anthony's coverage under Medicaid, but the receptionist said it covered only after first going through our primary insurance (my wife had accurately pointed out that I'm bad with insurance; I had my daughter show her card because I somehow don't even have my own).

So, we made a call to find the closest urgent care facility that accepted our insurance, and found one only about five minutes away. We got Anthony in to be examined, but were told by the practitioner there that his wound was so deep that they weren't equipped to treat it; we would have to go to an emergency room. Another call was made to verify the suggested hospital took our insurance, and we got in our cars for the third time.

I was having our daughter explain at each stop what had happened, so I pretty well had the story down by the time she recited it again for the emergency room doctor. Unfortunately, it was something of a perfect storm: Anthony had gotten upset in the bathroom for reasons we still don't know (and incidentally put a hole all the way through our bathroom wall by targeting the other side where he had previously damaged it). Our daughter (now 21 years old) got him into his bedroom and had him get on his bed. This is normally as good a tactic as any when it comes to keeping him from attacking us; he may writhe and scream on his bed, but at least he is away from us. But this time he was so upset that, from his prone position, he propelled himself back into the wall behind him to bang his head against it.

Earlier this winter, I bought some heavy black plastic to cover his outer wall both to keep him from tearing it up further, and to add another layer to the insulation inside it (some of which he had already exposed). However, when we first moved into this house, my parents had purchased thin foam layers to secure with screws into the wall to keep him from hitting the wall directly. What we found in short order, though, was that Anthony would not permit the foam to stay attached; he ripped it all off within a few months. And all of the screws remaining in the walls had been removed in areas where we might normally anticipate him to bang his head; he doesn't intentionally bend down to hit a wall, nor is it likely that he would target a spot where a screw head was evident.

But there was one screw that hadn't been removed. I can't say now whether I didn't notice it before, but it was close to his bed level. And Anthony propelled the top of his head, almost in the middle and a little to the left, into the wall, driving through the plastic over the top of the screw head. Then, as he came away from the wall, the screw head ripped through the flesh to create a 4-centimeter gash before he pulled away from it.  The immediate bleeding clearly got Anthony's attention, as he came over to his sister to have her address it, even as he was still upset and trying to hit her.

After giving the doctor the details, my daughter left and obliged her younger brother by going to the frozen custard shop we had passed on the way as a way of dealing with their "PTSD". The doctor then surprised me by saying it would be a "pretty simple fix". That fix involved the doctor numbing the wound (assisted by me holding Anthony down while he winced), then a nurse coming in to irrigate it a few minutes later, and finally the doctor stapling it together without the head-shaving we had predicted. Interestingly, although the nurse had cleaned the top of Anthony's head, nothing had been done about the blood that had dripped down the back, so after the doctor was gone to take care of paperwork, I spent several minutes wetting the towels they had around his neck for the irrigation, and cleaned him up as well as I could.

There of course is an element of shock involved when something like this happens, so I was still uncertain as to what would be acceptable to do with Anthony. Because there was not a long wait at the emergency room this time, the time of day was still around when I had planned to run errands despite the two stops prior to the hospital. And, amazingly, Anthony didn't seem to be noticeably out of sorts. So, as I was driving I thought I could take the chance with him, and we did go to the store briefly, and also picked up pizzas on the way home!

Nevertheless, one doesn't "recover" from such an incident immediately, and we were all feeling the effects of it later in the day. My wife and other son canceled their evening plans, and we all finished a movie we had started watching previously rather than attending to other things we might do. Additionally, I still hadn't had a chance to rest, and I felt like my cold was going to take a serious turn for the worse, so I lay down late in the evening for about an hour when I would otherwise have planned to shower with Anthony. Even after that, I didn't feel like jumping right up and getting in the shower with him. When I did, though, I faced more problems: of course, Anthony wanted to have his head washed off, and that was absolutely forbidden. I was trying to do what I could to wash off the rest of his head without getting to the wound, but he kept trying to dip his head into the shower stream. Also, he started trying to touch the staples. Both times, I found myself reacting with, "No, don't do that!" But the cardinal rule of dealing with Anthony is to find another way to change his behavior without saying "No!" Because I hadn't anticipated what he would do and therefore didn't think about how to react, he started trying to hit me. That's very dangerous normally for me in the shower, but potentially even more so for Anthony right now. So, I had him sit down temporarily. He may eventually break the tub as he slams himself down when he's mad, but for the time being that's the safest way to deal with him.

I was hoping that he would make it through the night and morning after he had awakened without taking out staples. I did note this morning that he probably tried to, because his fingers were bloody and it appears that one of the staples was sticking out a bit. I am guessing (and hoping!) that attempting to pull out staples would cause him enough pain that he would not be successful.

Our daughter, who has been at the center of both cases of Anthony seriously cutting himself, wonders if this isn't a blessing in disguise for her to have been involved this time as well. She noted that she wouldn't have known what to do on her own--and she did initially panic again--if this happened while my wife and I were away from home. But, having gone with me to three medical facilities, explaining what happened, and calling insurance companies has given her confidence if this happens again.

And, my wife and I do have a trip planned. It's an overseas trip that we have had planned for years. We wanted to go last year because it was a milestone anniversary, but to be on the safe side we did a trial run for three days domestically. Anthony could clearly tell then that we were not at home, because he became more of a handful to his sister and brother than he normally is. Nevertheless, there were no serious incidents. So, while this incident may have been some form of blessing in disguise, we obviously don't want anything to happen while we are out of the country. In fact, if something like this is to happen again, we have no problem whatsoever with waiting another nine years.