Two Weeks Post-Op

Gone with the Wind posterPeterYes, we’re still here. Jon was off Tylenol about four days ago. The clue was when he was rolling on his stitched up leg without meds, happy as a clam.

He was allowed to have a bath as of the weekend (and there was much rejoicing). Zimmer-less and fragile, I did carry him gingerly to the bath, and yea though we both anticipated pain, there was none. Given that, I’m no longer forced to carry him in the Gone with the Wind pose, which is good news for my back; there just wasn’t an easy way to lower him using just my legs.

The two-week mark also means that Jon can lose the zimmers for a period of time during the day. The doctor said he’d like to see them on for bed and 3-4 hours a day. Since we’re in early days, we’re still having Jon wear them a lot longer than that, but that will change as time goes on.

Jon’s back into spelling lists and reading. He’s read some early fun readers, sometimes reading the 56- or 62- page books through in one session.

Trying to fight boredom, we’ve been out a bit. Since Jon’s pressure sore seemed to be as a result of him AFO and Zimmers on the first trip, we’ve been careful of straying too far walking, but we did get out for a drive north during the extreme hot weather (it wasn’t any cooler) for a project yet to be discussed on the blog. And Jon and I went to see Cars again, with Meghan. He enjoyed it even more the second time.

But for the most part, we are still at Jon’s beck and call. Generally, his calls (which are often, and often rhetorical) are tactical in nature: urgent calls for whoever is farthest, and potentially busy keeping the household going in some way. Can’t have that.

So we are exhausted. But things as about as good as can be expected.

Shades of Wile E. Coyote, Genius

PeterTime for a non-Jon post, but still medical.

Remember when Wile E. Coyote baited Bugs Bunny with an iron carrot and ended up pulling satellites out of orbit with his 10,000,000,000-volt electric magnet?

Well, combine the fact that an MRI machine has a huge standing magnet that takes half a day to power down and the fact that many, many things are metal and you get the non-fiction version.

Comfort

Jon in armchair, happy

PeterThe pain has lessened and Jon, despite his restrictions and the occasional discomfort, is pretty happy. He sleeps in his bedroom, and I carry him downstairs for the day’s events. He sits in an armchair with his zimmered legs on an ottoman.

His legs have to be in the zimmers pretty much full time for the first two weeks, so aside from showering and a bit of range physio, there he is. With the help of a makeshift tray and a new small table, Jon can enjoy his meals there, as well as all of his usual vices: The Weather Network, LeapPad, videos, PlayStation and computer. The universe more or less revolves around him in this configuration, which is probably a really bad precedent. 🙂

Jon’s already rolling around in bed on his own, though sometimes he needs help in the middle of the night stacking/balancing the zimmers if he wants to sleep on his side. Pain medication is still necessary at night, but not so crucially. We attempted an experiment with Tylenol 8-hour, which purports to serve up two 325mg doses of Tylenol in a row in one pill. Jon woke up at the 4 hour 20 minutes mark with pain (but nothing another dose of Tylenol didn’t fix). Richard just did a little digging for and found:

88% of the total amount of drug is released into the system within the first three hours! This is perhaps not as bad as it sounds, because you have to remember that once the drug is released, it still has a 1-4 hour half life. Still, there’s a lot more drug in the serum during the first 4 hours than during the 2nd 4 hours of the 8 hour period the extended-release formulation is supposed to cover.

So, Jon is not nuts. The extended-release formulation is not what it’s cracked up to be.

Thanks, Richard.

So back to setting the alarm clock for every four hours.

And coping with pressure sores. As usual, if you more or less immobilize somebody, no matter how you cover or pad their bonds, there will be a pressure point. The clever folks at the hospital thought we could protect Jon a bit by using his AFO’s (his regular orthotics that stretch his Achilles tendon), but in practise somehow the AFO made a particular point on the zimmer worse. So now Jon has a nasty sore spot on his right Achilles tendon area, and it’ll be really hard to get rid of until the zimmers are off for good.

But otherwise Jon is happy, and clever enough to try to avoid school homework, like reading or creative writing. And given that he ate 1/2 of a medium-sized pizza last night, his appetite is back too.

Pain

Peter Home is not an analgesic. Asleep, he was so peaceful that Laura and I forgot about his 10 p.m. dose of Tylenol, and Jon awoke at 12:45 in major pain, including the first muscle spasms we’ve seen since surgery. We pulled out some heavier pharmaceutical guns, and with that and a half hour of hugging Mom, he calmed down and slept the night through. Except for us waking him up every four hours for Tylenol—we’ve learned our lesson.

Home

PeterAbout an hour after we were told that Dr. Narayanan was in the OR and we’d have to wait until late afternoon or early evening to be discharged, in he walked with a huge entourage. Residents, the head nurse, our nurse, even the physiotherapist. He gave us our final marching orders, the nurse took a half hour to cut those orders and off we went. Well, with a stopover at the pharmacy, which did test a boy’s patience.

(With regards to pain, Jon is doing amazingly. This is not nearly as bad as last time, and he is on Tylenol, with some optional extras if need be.)

The drive home was just as bumpy as the drive to the hospital, but the difference was now Jon was not uttering tiny ows for each bump in Gerrard. As we approached our neighbourhood, Jon put his head back, and in the two minutes it took to finish the trip he was in a deep, relaxed sleep. There had been so much talk of getting home; it was as if his nervous system could finally relax.

It was so hard, but I had to wake him from by moving him from the car.

But later at bedtime, as Laura read to Jon in his own bed, he drifted off even as she read. With a beatific smile on his face. Home.