Friday, October 17, 2008

Recovery Watch, Day 5

So much has happened! It's hard to believe it's Friday already. His second night in PICU he developed a fever. That's pretty expected for all those hours of anesthesia, all the work they did on him, and all that laying around. So he got a chest x-ray. No pneumonia. The lower part of his lungs weren't being mini balloons, they were compressed. So he had some breathing therapy. Which pushed more air into his stomach than into his lungs. They decided that he was doing good enough using the inspirometer instead. For the next two days, someone would come and listen to his bowels and press on his belly and ask if there was any pain. Then they'd comment on the gas or noise down there and say that his bowels were moving and that was good.
He had a flat stomach when he went in. Yesterday he had a beer belly, except it was all bloating from gas. Last night, he was starting to deflate and look more like himself.
In PACU (recovery): The anesthesia made him forgetful. He kept checking to see what was attached to him. I found out why the morphene is kept in a locked box. It's because in the past, hospitals have had a problem with staff siphoning off some of the strong drugs for their own use. Locking it makes sure the patient gets all of it. It's sad, and it happens. I can't criticize people I don't know for self medicating to cope with a high stress job or whatever. And I'm glad my son got what he needed and didn't hurt.
In PICU:
Every hour or two they would shift him. He says his pain levels were between 1 and 3 (on a scale of 1-10) when he was resting. When they "log rolled" him to one side or the other, it would go up to 6 or so. Log rolling isn't as bad as I thought it would be. They have a pad under him. Two nurses would grab the pad at his shoulder and hip and gently lift and push while guiding his back and legs. They'd get him about 30 degrees sideways then stuff pillows under and gently roll him onto the pillows. And hour later, they'd pull the pillows out. And hour after that, they'd log roll him on the other side and bepillow that side. So he cycled through left, flat, right, flat, etc. On day two, the rolling to add pillows was accompanied with a little IV painkiller before they moved him. On day 3, they removed his arterial line. Then somebody came round a few hours later to draw some blood.
The whole point of the art line was to 1) rigorously monitor his pulse and blood oxygen and 2) so they wouldn't need to stick him with a needle. He has a strong needle phobia. Actually, needles don't scare him. knowing the needle is going into his flesh is what makes him panic. He can now actually LOOK at the needles the nurses use, and watch them remove the needle and plug the syringe into his IV.

He's being great about his pain. If he hurts, he hits the nurse call. When they ask his pain level during a check up, he tells them. He's not being tough and sucking it up; and he's maintaining a tolerable level of discomfort.
Now for the fun parts!
Dr. Anderson came to change his dressings yesterday afternoon. Everything looked great. He's got 50 million steri strips holding his back closed. They're so much more comfortable than stitches, although he's got stitches underneath that will dissolve over time. There's only one incision. Dr. Anderson didn't cut him a second time to chisel bone scraps off his hip for the fusion graft; he just cut a longer stripe down the back. L doesn't have any discomfort at all where they took a piece of his hip. His blood count is low, but not low enough to need transfusion. He'll be taking a multivitamin with iron for a good long while because his body is making lots and lots of half grown red blood cells to replace what he lost. Once his body decides he's got enough blood, it'll go back to growing big blood cells. Anyway... Dr. Anderson changed the dressing, decided everything looked wonderful, and removed the drain and epidural. Drain removal was neat and didn't hurt at all. It was cool watching them press around the hole and seeing fluid spurt, then dribble out. The last few presses, his drain site made a noise like a whoopie cushion. Taking out the epidural wasn't so fun. They used a stretchy tape to hold that tiny catheter tube in place, stuck right over the incision. Dr. Anderson had to pull off about 6 inches of tape before he could free the epidural cath. L was not happy about that. But! With the epidural out, they could remove the foley catheter too. No more pee tube! Which had been taped to a nice hairy part of his thigh. Sheesh, don't they LOOK where they're putting tape? The nurses took it off as fast and gently as they could.

Freed from all those tubes and tapes, L progressed rapidly. In the last 24 hours he's gone from bedridden in PICU with all kinds of monitoring devices to walking (walking!!! On his own!!!) to the bathroom, sitting up, reaching for and holding his own drinks and pudding cups, and swallowing pills instead of getting a drip. He's on percoset instead of morphene now.

Today, He's getting his first solid food since Sunday evening. And he's going down to physical therapy for an hour. He will learn to log roll and get out of bed without assistance, and show that he can go up and down at least one step. Some time today, they're taking out the active IV. They'll leave the inactive IV just in case they need it. Removing the IV is the last link in the chain. Unless he backslides, he's coming home tomorrow. 6 days of hospital, 6 weeks of recovery, 6 months of no heavy lifting. And then my MIL wants to take him on a trip somewhere. I wonder if he'll pick Japan?

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