My child amazes me...

It is 4:57am and Max has been awake since the nurse came in at 4am to check his vitals and give him some Valium and Tylenol. He is very comfortable and extremely chatty!!

Yesterday was not nearly as bad as I had anticipated. Immediately post op in the PACU was hard. The cast is enormous and the bar between his legs is literally made of if a piece if wood..looks like something made in shop class! Max was pretty groggy and wanted water, but overall seemed comfortable. He wasn't in PACU for long because he had no issues and came out of anesthesia without any problems. He even had a Popsicle down there (they gave him a purple one...probably not the best choice because his purple lips made him look totally cyanotic to the nurses on the floor...we had to keep saying "purple Popsicle" everything a new person came in!)

He moved up to the floor and I posted a picture of him being transported. He had his monkeys and George was propping up my iPhone so he could watch Curious George on it:-). He was so quiet and content.

When we arrived at 9S, the reception was amazing. Our nurse, Jess, was so great! She helped get him transferred to the big bed (that I can sleep in with him:-) and got him all comfortable. She was here until 7p and was truly a fantastic caregiver! He had periods of crying and pain and he HATED the casts but mostly he hates the IV board on his left hand that is covered with a sock. He flaps that around like a bird trying desperately to take flight when he is agitated (and you have to watch out, I got smacked in the face a few times!). He was pretty uncomfortable for a few hours and pushing the PCA button only gave him about 10 minutes of relief, so they ended up increasing the continuous basal rate on his pump, which made a huge difference. We rarely have to press the button for a bolus of dilauded. He is also getting Valium every 4 hours for muscle spasms, which helps immensely with when he gets agitated with the IV and casts. I would have thought he would snooze after getting the Valium, but instead he gets very mellow and extremely chatty!! He talks and talks and talks about anything and everything and is happy as can be (we all need to get some of that good stuff!).

Last evening he was way more comfortable and ate some green beans, grapes, applesauce and a few bites of Mac and cheese. He got a bit nauseous and threw up a little so he got some zofran, which helped. He has been peeing like a champ in the hand held urinal. It takes 2 of us, one to lift him straight up and one to hold the urinal. He has very little discomfort being picked up. He gives big hugs while being held:-). He's watched a ton on George movies and finally settled into sleep around 11p last night. He slept very soundly until 4am. The overnight nurse, Kirstie, is also amazing. He loves her! She has been in every hour, on the hour to check on him. I got some sleep in the pull out couch (after he fell asleep I was able to sneak over there. He prefers me right next to him in his bed. I love the snuggles but it's not the most comfortable! I am in his bed now and he fell back asleep:-). He needed a couple of boluses of dilauded since 4 (he can get one every 8 minutes) because he was saying I was on his legs, which I was not, so I new he was having some pain. He doesn't cry with the pain, he just says "owwww."

I am assuming the Ortho team will be here any minute (it's 5:25 now). Dr. Ain is not on call this weekend so we won't see him until Tuesday in the office. I am very concerned that the casts are up too high on his legs. They are almost up to his butt cheeks and I'm afraid that when he sits for long periods of time (which he will be doing a lot of) this will be very irritating. The nurse called the Ortho team last night to check on the casts and 3 residents came by. They were very nice but, having been a resident, the main goal of the covering residents is to keep patients alive overnight and defer everything else to the primary team in the morning. First of all, they were adult Ortho covering for peds (which is fine). They pretty much just assessed him for compartment syndrome (bad potential complication of this surgery) making sure the casts weren't too tight (which they weren't) and deferred to the primary team. I still think the casts need to be cut down. We'll see what they say shortly.
The goals of today are to get him off the PCA pump and on oral narcotic pain meds and Valium. He's already eating and drinking well. He is an amazing patient. Despite what happened to him yesterday, he lets them do anything to/with him without so much as a peep. He talks to the nurses, smiles and takes all the oral medicine they give him in syringes like a champ!! (Although he HATED the stool softener...he may refuse that one today!). I just look at him and am amazed by his bravery and charm. I was afraid having the surgery he would become scared that it would make him fearful of people examining him but he is the same extroverted, charming little boy as he was before. He is truly amazing to me:-). I absolutely adore him...even more than I already did! I am sure he will handle the next 8 weeks in casts like a pro:-).

Eric went back to the Children's House last night so he will come in today nice and rested and I will try to grab a snooze on the couch here. Max is a mommy's boy though and really doesn't want me out of arms reach (which I love!)

So, that's the up to the minute update. Thank you all for your prayers and support! We so appreciate it!!



Think BIG!
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Michelle M. Platz M.D.