How do you know?

We were at the play place at the mall last night. The children were having an amazing time. Michael loved it when a 15 month old baby followed him around trying to give him hugs. Ava was inside a tent like structure with three other girls about her age and appeared to be having a great time. It was idyllic.

Then Ava exited the tent and was running towards us. I think she just wanted to tell us something. First she tripped over one structure. I saw it. She got right back up and continued towards us looking back over her shoulder at the offending structure. So, of course, she stumbled right across the next thing in her path.

She fell with her right arm twisted beneath her. I knew right away that I needed to go to her. This wasn't a wait and see if she shakes it off kind of situation. I was concerned about the arm and shoulder. She was crying and I scooped her up and cradled her in my lap. Often, if the injury is minor, she'll be off again after a short cuddle, but not this time.

She was crying that her hand hurt. In that moment it looked like the area on the top of her hand around the middle two knuckles was swelling up and red. Her fingers weren't moving and quivered a little. I can admit it. I panicked a little. I scooped her up and rushed her over to my husband. Meeting his eyes and giving him a significant look, I told him I thought her hand was -hurt-.

Now when we looked together, I could no longer detect anything that looked like redness or swelling. She was able to tolerate having her fingers wiggled and bent a little. When we asked her to get her shoes, she held one in each hand. I was starting to feel better and a little silly about overreacting.

But then, she didn't go back to playing. And she was favoring the hand. She wouldn't use it to play "high five." She was visibly scared when I tried to hold that hand instead of the other when leaving the mall. She was extremely careful when I unbuckled her from her carseat to take that arm out from the straps of the 5-point harness without bumping the hand at all.

I just wasn't sure what to think. Even with all that it didn't seem like an ER on a Friday night kind of situation. Give some ibuprofen, wait, and observe seemed to be the most prudent choice. I hate the uncertainty though. How do you know how serious something is?