Last night, Cristina and I noticed that Bertrand was unusually grouchy about changing clothes, and slightly grouchier over all. We thought it could be the recent changes with diet and medication. Similar grouchiness had followed prior changes in diet, so we assumed this was no different.
Changing him this morning, he seemed extra grouchy about having his right arm touched. At school, he refused to play with his favorite spinning toy. We both thought it was strange that he let his right arm sink into the bean bag, instead of pulling it into his chest like usual. But, he wasn't upset about it. In fact, he was flirting away with his teacher and enjoying his books.
When we picked him up, we again noticed (extra) sensitivity in his right arm. At home, we saw he wasn't moving his right arm at all. We sought expert medical opinions, tried a few things, observed him for about 10 minutes, and then made the decision to go to the ER. (Luckily, our good friend Jimi Malcolm was with us, and he consulted his dad, an orthopedic surgeon, for advice.) We feared a dislocated shoulder.
They x-rayed him in the ER, and to our shock, Bertrand had a break in his humerus at the shoulder. We're still not sure exactly how this happened. He took a spill when a snap broke loose on his stander on Saturday, but he didn't fall with enough force to cause such as injury.
The ER told us that Bertrand also appears to have a bone cyst at the site of the break. If true (and we'll confirm with the fracture clinic soon), then the cyst may have weakened the bone, so that it could break under "normal" behavior, or perhaps during an intense tonic seizure.
Whatever caused the break, Bertrand has been bandanged into a sling for the next four weeks. He seems to be in less pain already, though he doesn't seem thrilled about having his movement constricted.
Bone problems come with some metabolic disorders, so we're going to pursue the bone cyst issue vigorously, in the hope that we can prevent future breaks. We have complete skeletal surveys of Bertrand, and we'll be scrutinizing those for early signs of bone cysts. This might be the clue that cracks Bertrand's case.
In the mean time, you'll see Bertrand bandaged up for at least the next four weeks, and his already paranoid parents just got a notch more frantic.