Well, we made it through the wound vac change but boy, it was rough! A good 45 min. of very anxious screaming, in spite of the meds. Some of it was anxiety and another part was real pain I know. The nurses did the best they could. And I already had a call from one of them this afternoon to see if we can get a better game plan for Thursday's change.
They were just getting their first introduction to his wound, so they are now able to brainstorm how to better approach it and make the actual process goes faster (there's lots of tape and sponge cutting, etc.). Plus we may try a stronger medicine. I sure hope we can find some ways to improve it...this was one of the most difficult procedures he's had including the 7 surgeries! Believe it or not, one of the worst aspects is all the tape stuck to the little hairs on his leg. They didn't put this one up as high, so it will be a little less big tape to remove next time.
He has complained a little bit about it hurting more and of course the wrap is different and the place the drainage tube comes out is different, so those are some little adjustments he has to make. But the good news his anxiety and pain didn't last too long and after we got home and had some comfort food, he has been fine. He did ask me how long until Thursday.... :(
They tell me the wound looks "good" - not sure how they came to that conclusion as we were all looking at the same thing and it didn't look "good" to me. His tendon is still exposed and there is still blood and an open wound with no skin on it. But I suppose they mean it's healing...which is our goal of course. The pics from today will be faxed, as well as the measurements they took, to Dr. Klingele who will note how it's going and maybe we'll get some feedback.
I asked Dr. King (the trauma doc) today how many stitches he removed...his administrative sec. says 20, but I counted 20 myself in just one location, so I'm sure that isn't right. He sounded like he was "guessing". I'll have to count myself next time we do a bath. I'm sure there are AT LEAST 30 just on the buttocks area (maybe more).
Monday, June 28, 2010
Sunday, June 27, 2010
The weekend and Monday's procedure
We had a pretty uneventful weekend so far, except learning to live with "the machine". It has "much power" (ha, that's what we say about it...like toy story, "the claw is in control"), only has so much battery life and has various hic-ups which shut it off. The restart is always uncomfortable for him because it has a vacuum seal and the pressure kicks in when it is on. He gets used to it fairly quickly, but the start up bothers him.
He is still pretty immobile, but he hasn't had any real pain or problem with itching, so that is a great praise. We had Vacation Bible School this week and he actually attended every day. His class helpers were wonderful at getting his wheelchair up and down the steps to and from his class. They had to do it often...Josiah laughed at being called a king! The pictures of him are kind of sad...he is expressionless most of the time, kind of his feelings about his life right now.
My friend Ann's kids came to VBS for a few days and stayed with us. They have been some of Josiah's best buddies. Them being here was a great encouragement and a boost. He is frustrated, of course, that he can't jump and run like everyone else. They did play "mother may I one" day, wheelchair style!
I hope we are on the count down to him being able to walk some...maybe another 5 or 6days (the ortho doc told me two weeks on the 17th, so that would be July 1st). If it were just the bones involved, they would be letting him walk already, but the skin is the bigger issue now and they were concerned about pushing off on the tendon also. He may need therapy to help him learn how to reuse the tendon anyway...
The docs are saying tomorrow's wound vac change could be the most painful. We are giving him a strong pain med before we go. Pray that he will tolerate it well and that the wound is actually making good progress, even better than they anticipate.
He is still pretty immobile, but he hasn't had any real pain or problem with itching, so that is a great praise. We had Vacation Bible School this week and he actually attended every day. His class helpers were wonderful at getting his wheelchair up and down the steps to and from his class. They had to do it often...Josiah laughed at being called a king! The pictures of him are kind of sad...he is expressionless most of the time, kind of his feelings about his life right now.
My friend Ann's kids came to VBS for a few days and stayed with us. They have been some of Josiah's best buddies. Them being here was a great encouragement and a boost. He is frustrated, of course, that he can't jump and run like everyone else. They did play "mother may I one" day, wheelchair style!
I hope we are on the count down to him being able to walk some...maybe another 5 or 6days (the ortho doc told me two weeks on the 17th, so that would be July 1st). If it were just the bones involved, they would be letting him walk already, but the skin is the bigger issue now and they were concerned about pushing off on the tendon also. He may need therapy to help him learn how to reuse the tendon anyway...
The docs are saying tomorrow's wound vac change could be the most painful. We are giving him a strong pain med before we go. Pray that he will tolerate it well and that the wound is actually making good progress, even better than they anticipate.
Thursday, June 24, 2010
What is a Wound Vac?
The wound vac has a clear tube running out from his cast that is attached to a sponge on his heel, which is vacuum sealed, preventing infection and keeping the wound dry. It promotes faster healing at the same time. It runs constantly...sounds like someone has gas all the time - ha! It is housed in a portable bag with a strap that you can sling over your shoulder. It's as unobtrusive as it can be I guess.
We actually have the weekend "off" from appointments. Monday is our next one and it is local, at the wound care center at the local hospital. They gave us a very strong pain med for him to take BEFORE the wound vac change (this is when then pull the sponge off and attach a new one). He has been asleep for all the other changes which were in the hospital on his bottom.
We are on a Mon-Thurs rotation for changing the sponge. The doc tells me it will get less painful as the wound heals.
He is back to wanting to not being seen with his new apparatus...and he is not interested in moving himself around at this point. Pray for his mental comfort with all that is going on. At least stitches are no longer giving us any problems!
We actually have the weekend "off" from appointments. Monday is our next one and it is local, at the wound care center at the local hospital. They gave us a very strong pain med for him to take BEFORE the wound vac change (this is when then pull the sponge off and attach a new one). He has been asleep for all the other changes which were in the hospital on his bottom.
We are on a Mon-Thurs rotation for changing the sponge. The doc tells me it will get less painful as the wound heals.
He is back to wanting to not being seen with his new apparatus...and he is not interested in moving himself around at this point. Pray for his mental comfort with all that is going on. At least stitches are no longer giving us any problems!
Wednesday, June 23, 2010
After surgery
He's out...the bottom looks great. We don't need to see that doctor again - wha hoo!
The heel needs 3-4 weeks of wound vac treatment...meaning we take a vac home with us and get changes every 3-5 days. Part of the tendon died, meaning it isn't as thick as it should be. It also separated...they want it to heal where it is. It will heal completely. It may permanently affect the strength of him pushing off, etc...but time will tell for sure. In maybe 2 weeks, he will let him walk on the leg...
They are sending us home with lots of equipment and training...and we will be able to do some of the changes locally before we have to come back to Columbus...so that's good. There is a wound care center at our local hospital just five min. away. We aren't supposed to be here too long today.
Steve is doing much better today.
The heel needs 3-4 weeks of wound vac treatment...meaning we take a vac home with us and get changes every 3-5 days. Part of the tendon died, meaning it isn't as thick as it should be. It also separated...they want it to heal where it is. It will heal completely. It may permanently affect the strength of him pushing off, etc...but time will tell for sure. In maybe 2 weeks, he will let him walk on the leg...
They are sending us home with lots of equipment and training...and we will be able to do some of the changes locally before we have to come back to Columbus...so that's good. There is a wound care center at our local hospital just five min. away. We aren't supposed to be here too long today.
Steve is doing much better today.
Tuesday, June 22, 2010
Night Before Surgery
Steve is doing some better today - not 100%, but making improvements - they called it cellulitis and gave him an antibiotic shot plus follow up pills. Praise God we were able to treat it when we did.
We have to be at Children's Hospital at 6:30 AM!! so it will be an early beginning. He has been complaining about his stitches a lot, so we trust the stitch removal will be a relief to him. We don't know how long the surgery will last or anything at this point...but since both surgery teams will be in, I would expect at least 2 hours plus an hour of recovery. I will post from the waiting room as I am able. THanks for praying for us.
We have to be at Children's Hospital at 6:30 AM!! so it will be an early beginning. He has been complaining about his stitches a lot, so we trust the stitch removal will be a relief to him. We don't know how long the surgery will last or anything at this point...but since both surgery teams will be in, I would expect at least 2 hours plus an hour of recovery. I will post from the waiting room as I am able. THanks for praying for us.
Monday, June 21, 2010
Today
Josiah had a pretty uneventful weekend...did pretty good getting around in the walker, doesn't have much pain to speak of.
However, Steve is taking his place for the day :) He has had an "annoying" place on his finger of his left hand for several days, it has had some draining pus, etc... and last night there was a lot of pain running up his arm, today he notices a red line from the finger to his elbow. So, we are going to the Er (our doc can't see til much later). We are assuming some kind of infection that can be treated with antibiotics...hopefully this won't mean an admission or anything. Sigh...God is in control.
In addition, tonight is the first night of our Vacation Bible School 6:30-8:30 and Steve is the main teacher.... We'd apprecitate the prayer.
However, Steve is taking his place for the day :) He has had an "annoying" place on his finger of his left hand for several days, it has had some draining pus, etc... and last night there was a lot of pain running up his arm, today he notices a red line from the finger to his elbow. So, we are going to the Er (our doc can't see til much later). We are assuming some kind of infection that can be treated with antibiotics...hopefully this won't mean an admission or anything. Sigh...God is in control.
In addition, tonight is the first night of our Vacation Bible School 6:30-8:30 and Steve is the main teacher.... We'd apprecitate the prayer.
Sunday, June 20, 2010
This week...
We received a call on Friday this past week that they are going to move his surgery to Wednesday for stitch removal so the orthopaedic team can also be there to do remove dead skin on his heel and attach a wound vac. This is good to combine the two, so we only have one more time of being under anesthesia. However, it means a few more uncomfortable days with the stitches in.
He is getting along pretty good...something I said about making his arms strong must have motivated him to want to try the walker more, because he has been trying to get along more with it. And today he told me of ways he can "move himself" from place to place, including crawling and hanging on to furniture. This is good in that it shows he has some motivation to get going again, which he has been kind of lacking of late. We aren't as worried about a fall now because his stitches on the bottom are past popping open being a concern and the doctor said his foot bones are healing really well.
We celebrated Korrin's high school graduation yesterday, which was a great day. It was hard for him to be an observer and not a participant like usual...but he did find some alternative activities, like coloring. And he did go outside several times and seemed to enjoy at least watching.
He is getting along pretty good...something I said about making his arms strong must have motivated him to want to try the walker more, because he has been trying to get along more with it. And today he told me of ways he can "move himself" from place to place, including crawling and hanging on to furniture. This is good in that it shows he has some motivation to get going again, which he has been kind of lacking of late. We aren't as worried about a fall now because his stitches on the bottom are past popping open being a concern and the doctor said his foot bones are healing really well.
We celebrated Korrin's high school graduation yesterday, which was a great day. It was hard for him to be an observer and not a participant like usual...but he did find some alternative activities, like coloring. And he did go outside several times and seemed to enjoy at least watching.
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