Holiday Break

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Kasey Fuqua

The unseasonably warm weather on Christmas Day offered a perfect opportunity for Joel White to try out his sister’s new gift – a specialty skateboard with a single wheel in the front and back. The active 12-year-old quickly got the hang of it, gliding along his quiet neighborhood street in Chesapeake.

Suddenly, one of the wheels caught an edge of concrete, and the board shot out from beneath him. Joel flew forward, stretching his arms out to brace himself for the fall. As he hKidstuff_Joel Whiteit the ground, he remembers pain exploding in his arm as he clenched his eyelids shut.

“Momma, my arm, my arm,” he yelled, cradling his left forearm to his chest. His mother, Monica, ran to his side, instinctively aware that Joel was seriously injured; he never called her “Momma.”

One look at his arm confirmed her instincts. Joel’s left forearm drooped unnaturally between his wrist and elbow.

Moving quickly, Monica packed Joel into the car and headed for the nearest place she knew to be open on Christmas Day – CHKD Urgent Care on Volvo Parkway in Chesapeake. “I knew they would be able to help Joel and get him any special care he needed,” Monica says.

CHKD Urgent Care is no stranger to broken bones. “We see a couple of fractures in our urgent care centers every day,” says Dr. Theresa Guins, medical director of CHKD Urgent Care. “Most of the time, they are minor forearm fractures that result from falls. Usually we can send a child home with a splint and a referral to an orthopedic specialist.”

Joel’s break, however, was much more serious than a common fracture. By the time he arrived at urgent care, shock was setting in – Joel was pale, sweating and in obvious pain.

The urgent care team sprang into action. Dr. Vicky Leff, a pediatrician at CHKD Urgent Care, ordered X-rays and an intranasal spray of quick-acting pain medicine to begin managing Joel’s discomfort. “This was a bad break,” says Dr. Leff. “We knew he would need to see a surgeon immediately.”

Urgent care staff called the CHKD transport team to pick up Joel and take him to the main hospital in Norfolk. At the urgent care, a pediatric radiology tech took X-rays of Joel’s arm, sending them electronically to CHKD’s emergency department. Nurses then placed an IV to give pain medication and stabilized Joel’s arm in a splint.

Joel’s father, Joel Sr., rode in the front of the transport to the hospital with his son. “I was really worried when I saw how bad his arm looked,” Joel Sr. says. He watched from the passenger’s seat as the transport team kept Joel calm during the trip to the hospital.

In Norfolk, CHKD’s emergency department received Joel’s X-rays before the transport team arrived, identifying severe breaks to the boy’s radius and ulna, both bones in his lower arm. CHKD pediatric orthopedic surgeon Sheldon St. Clair was on call that day. He reviewed Joel’s X-rays and recommended immediate surgery to realign the bones before his arm became too swollen.

Within 30 minutes of his arrival at CHKD, Joel was being prepped for surgery.

In the operating room, Dr. St. Clair realigned Joel’s radius and ulna, inserting titanium rods into each broken bone to hold them in place as they healed. The surgery took nearly an hour, and Joel would spend two nights in the hospital recovering. His arm was then cast from his hand to his shoulder to keep his injury as stable as possible. CHKD’s child life specialists helped brighten the family’s unexpected holiday stay.

Though a trip to the hospital wasn’t part of the family’s Christmas plans, Monica and Joel Sr. were impressed with the smooth and quick care Joel received during the entire experience and grateful that CHKD Urgent Care was close by and able to coordinate care from the beginning.

“We know how valuable urgent care is to busy families when their child has an unexpected urgent medical need and their pediatrician’s office is closed,” says Dr. Guins.

In an effort to provide convenience and integrated care to even more families in Hampton Roads, CHKD opened another urgent care center at Loehmann’s Plaza in Virginia Beach this spring, and plans are underway to open additional centers at Landstown Commons in Virginia Beach, at the Tech Center in Newport News, and in Williamsburg.

Kidstuff_Joel White 2“We really operate like a well-oiled machine. CHKD has set up a pretty seamless system that is extremely beneficial to patients, saving time and stress,” Dr. Guins says. Monica agrees. “Everything went so smoothly, and the urgent care staff was amazing,” she says. “I’m so grateful we lived close by - it made a tough situation so much easier.”

As he healed, Joel worked hard to keep up with school and activities. By February, he was fitted for a shorter cast that ended at his elbow, and by March, he was able to wear a soft black cast. He performed physical therapy at home with his mom, rebuilding strength and flexibility in his arm and was pleased when Dr. St. Clair told him his bones were healing faster than expected.

Today, Joel has turned his attention from skateboarding to soccer. The rods in his arm will be removed this summer. The only reminders of his broken arm are three tiny scars on his wrist, forearm and elbow. And, of course, he’ll always have an interesting story to tell about his holiday break.


Dr. Vicky Leff practices with CHKD Urgent Care.
For more information on CHKD Urgent Care, visit CHKD.org/UrgentCare.

Dr. H. Sheldon St. Clair practices with CHKD Surgical Group's orthopedic surgery and sports medicine practice.
For more information on CHKD orthopedic surgery and sports medicine, visit CHKD.org/Ortho.

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