What a whirlwind of the last couple days.
Monday morning was pretty interesting. I dropped Dawson off at school, and then made my way to work. As I drove in, I made two calls: one to the surgical team (burn) and one to orthopedic. It felt oddly familiar; the last time I drove to work – really drove to work, for a day in the office – I was also on the phone, getting ahold of D’s pediatrician because of his hives. It felt surreal to be making the drive again, over 4 months later, again calling doctor’s offices.
Work was fun and exciting. But I can say that because I was only there for a couple hours, and it was a lot of playing catch up. It was fun to see everyone and find out what the heck has been going on (as I titled one meeting request). Unfortunately, my visit to work was short-lived (although that was planned). Near the end, I received a call back from someone on the surgical team that we did NOT have to do Dawson’s dressing change that night – woohoo! …And then I received a call about 5 minutes later from Dawson’s surgeon. Change of plans. He had spoken with Dawson’s orthopedic surgeon, and it was decided that Dawson needed to be admitted a day early so they could do an MRI. The concern was that there was still something MORE going on in Dawson’s leg, even though two taps and his bloodwork last week had shown no infection. The last thing they wanted to do was graft over a bigger issue.
So, I picked Dawson up from school and ran home to grab our things. Luckily, I had figured that was going to happen and had packed up most of our things the night before. Whew. There was a little bit of confusion at first as to where we were going to be admitted to, but we ended up back in the burn unit – in Dawson’s old room, even!
The hardest part of yesterday was the wait. Dawson had a snack at school around 10:30. He needed to have nothing to eat 4 hours before the sedation for the MRI, so the earliest he could have the MRI done was 2:30. Unfortunately, it turned out that he couldn’t get in until 5:30. UGH. Dawson is not very good on an empty stomach. He gets VERY hangry (hungry/angry). Eventually, they moved his sedation time to 5pm so they could do his dressing change and then he could go to MRI, but that wasn’t before we endured about 40 minutes of Dawson shouting “I’m HUNGRY. GET ME FOOD! THIS IS NOT MY FAVORITE!”
By the time I saw him again, it was after 7pm. The bummer thing about MRIs is that you don’t find out for a while what the results are, so I knew that we wouldn’t learn anything last night. Dawson was in a lot of pain after the sedation, but once we got back to the room, he was pretty excited to (finally) eat.
Still pretty tired after the MRI
Our night was pretty rough last night. He made it 4 hours until he needed more oxycodone. And by that time, it was after midnight, when he wasn’t supposed to be drinking water. He kept complaining of a sore throat and an itchy back. It all culminated around 4am, when he sat up and said “My throat hurts. I think I’m going to be sick.” As I was running for the bucket, he was vomiting on the bed. Poor guy. Thankfully, that made him feel better and he didn’t get sick again.
Around 6am, D was needing more oxy. His nurse and I had a good laugh. I’ve said before that Dawson does really well at taking pills. His oxycodone pills are tiny, so if he has to take 2, he takes them both at once. Not this morning, though. He knows that while he can’t have water, his IS allowed to use it to take his meds. So this morning he insisted on taking his pills one at a time to get more drinks of water. Seriously. He’s so smart.
I wasn’t even sure if surgery was still on when the resident came in around 6:15 or so this morning. The MRI results were inconclusive – there may be infection, there may not be infection. They did see a spot on his knee cap, at the back of the patella, that ortho wanted to look at. That being said, surgery was still on, and they came for him around 6:45am. That never gets easier. I still cried as I followed him to pre-op. Cried a little speaking with his burn surgeon and ortho surgeon.
Dawson was tired, so all I got was this fake smile before surgery.
He went back to surgery right at 8am, and I dashed off to take a shower and then grab a sugar-free Red Bull and a streusel blueberry muffin (hospital food is bad, but these muffins are soooo gooood). Back in the waiting area by 8:45. About 9:15 I got word that D’s surgeon was ready to speak with me.
So how did surgery go? In a word: good. I’ll try to relay this as best as possible, but even I get all confused by all of the medical jargon sometimes. In regard to Dawson’s knee, on the orthopedic side of things: first, they went ahead and irrigated the joint and gave it a good flushing. The joint itself looks good – yay! Then, they looked at something they had seen on the MRI – that spot on the patella. It turned out that he did have a dead spot there, most likely from all the way back when he got sick. When they worked a probe up into the cartilage, they discovered a small hole behind it where bone should be, and when they poked through the cartilage and into the hole, fluid came out. That fluid was sent in for cultures. What was the fluid? Infection? The remnants of his bone (ewww…)? We really don’t know right now. The good news is that dead spot/missing bone is surrounded by good, healed tissue and cartilage. As for what that area means for now – we don’t know. It may heal itself down the road. It’s just another thing that we have to keep an eye on it in the coming months.
The next step was the grafting. Dawson had this one little strip on his left leg, above his grafted skin. There was a previous donor site, and in between the donor site and the grafted skin was this sweet little strip of regular…normal…sweet Dawson skin that had somehow started to grow long black hair. Oh, that’s right my friends. (The same is true on his back! Black hair! On his back!) So, the doctor took skin from there, and he was able to also grab from the previous donor site next to it, since it was healed enough.
The grafting itself went really well. They were really happy with the tissue that Dawson had there to graft onto. If all goes well, it should take quite smoothly. The area that is grafted is on top of the area with the missing bone, so that may have had something to do with the skin not taking there initially. Or it may not. (Ah, modern science!) With this newly grafted skin, Dawson needs to keep an immobilizer on his leg at all times for the next week or so, to give that skin a chance to attach. That’s awesome from a grafting perspective, but a bummer on the ortho side of things, because it will be that much longer before we see if the removal of that additional fluid helped his poor knee.
Dawson in recovery this morning. I’m so dense that I didn’t realize until just now that the drip was in the middle of the picture…
Next steps are hanging out at the hospital. It is 2:00pm, and Dawson still hasn’t really woken up from his surgery. Well, of course he woke up some – he’s been in his room since about 11am – but he’s been solidly zonked for a good 2.5 hours. And in the time before that, he was asleep, waking only to take pills and ask for apple juice (of which he downed about 20 ounces of. Kid was thirsty!).
We aren’t sure if he’ll be discharged tomorrow yet. It really depends on his level of pain. His pain may be reduced because of the removal of that extra fluid in his knee. Or it may be magnified by the probing that they had to do (plus that grafting and all…). If we feel like his pain is managed pretty well, we can probably go home tomorrow. If he’s still having issues…well, we’ll have to wait and see.
On the dressing changes side of things, we have a good break from it. His left leg is wrapped and doesn’t need to be changed until Friday – he’ll keep his immobilizer on the entire time. Sponge baths until then! On Friday, we’ll come in for a sedation dressing change (whew). Then, he’ll come back in on Monday for another (double whew). After that, we’ll see how things are going.
It’s a little crazy to be back, because it almost feels like we’ve never left. It’s both awesome and sad that I recognize SO many people here. I think about 80% of the people we’ve worked with yesterday and today have worked with us in the past. That being said, it’s AMAZING not to tell his story over and over and to have these familiar faces. It definitely makes it not so scary. I did have to chuckle some yesterday when I was going over some consent forms for surgery. I was getting the usual spiel, including a talk about propofol. “Propofol is a white, milky drug…” Oh, lady, I am WAY more familiar with propofol than I ever thought I would be. I don’t think she realized just how many times Dawson had been sedated with it in his initial stay.
Dawson currently refers to his left leg as “the bloody leg.” We’ve been trying to correct him, but he’s told me that he will call it his “left leg” once it’s no longer bleeding. For now it’s the bloody leg. Hopefully not much longer…