Doing super!!

Yesterday was a long but uneventful day. Max was remarkably comfortable. He spent the day watching movies and napping. He ate some, not his usual appetite but it's coming along. He's drinking fluids well. No pooping yet...not surprising with all the narcotics though. I dread that though. Not sure how to handle that with casts that are up to his butt!! The covering peds orthopedist yesterday was not concerned about how high his casts are...but, he's not the one taking Max home. They come right into his groin crease to his scrotum and all the way to his little butt cheeks...I am very worried about rubbing and chafing. We will see what Dr. Ain says on Tuesday. They did say that Max's osteotomies (cuts in the bones) are very high on the tibias and the long casts are needed to help stabilize. Some kids have their cuts down lower and even down by the ankles...makes sense but will be challenging with these super high casts. The rounding peds Ortho team was great. (Sometimes the rounding teams, especially on the weekends, are clueless.) Dr. Tes was the attending and was very knowledgable and answered all of my questions. Again, I am impressed!

The nurse and Eric and I gave Max a sponge bath last night and washed his hair. He didn't love it but looked so much more comfortable afterwards. We changed his bedding and brushed his teeth and hair. He looked so handsome;-). He ate some of a subway turkey sub and watched Toy Story 3. Eric left for the children's house about 10 and we gave Max a dose of Valium about 11:30. He haven't had any other Valium since 8:30am yesterday. They had stopped his basal rate dilauded yesterday morning and we only pushed the button for a bolus twice all day. He has been on Tylenol and ocycodone every 4 hours and it has been working well:-). He fell asleep and slept very soundly until the 4am meds and then woke up. He was complaining of a lot of back pain and was literally writhing around in bed, not crying but saying "it really hurts". :-(. He finally fell asleep after an hour. We had pushed for a bolus of dilauded so that may have helped. I think (as does Ortho) that it is positional. He has been laying on his back since surgery... Peds Ortho came around about 6a and pulled the drains out. He didn't even wake up (actually, it's 7:48am and he's still sound asleep). They are very pleased and are getting all of our stuff ready for discharge. The whole time he was here, the pain management team has managed his pain medications (these are anesthesiologists). We met them yesterday and they (also) were great. (Actually, the doctor grew up in Youngstown and went to NEOUCOM (my medical school). He was 2 years ahead of me...small world!) I need to ask them for specific instructions on what they recommend as a pain regimen after discharge. I would hate to go home and have him start with a lot of pain... We will get the prescriptions filled here today.
I ordered Max his pancakes for breakfast. He was asking all last night for them! Hopefully they will be here by the time he wakes up. He will be so excited when the IV comes out today:-). I'm still explaining to him that the casts come home with us...he's hoping those will be gone today too!! We are headed back to the Children's House until we leave on Tuesday.
Thanks again for all your prayers and thoughts and good wishes! We appreciate each and every one:-)

Think BIG!
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Michelle M. Platz M.D.