Author: Sheri

Sent from my Verizon Wireless BlackBerry

Sent from my Verizon Wireless BlackBerry

The Plastic Surgeons came in and removed the vacuum dressing from Josh’s leg today. They said that the graft looks “Beautiful”! We are very thankful. Josh is in good spirits and is eating better.

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What makes a hospital stay the best it can be? Lots of visitors and an X-Box 360! woo hoo!

Sent from my Verizon Wireless BlackBerry

Sent from my Verizon Wireless BlackBerry


Friends from Josh’s church brought an X-Box 360 out for Josh to play. Jay, Joe and Andy P. found a tv on a cart in a closet here at the hospital and asked a nurse if they could use it. The nurse said if they could move it they could take it. The guys even went to a nearby Game Stop store and bought an RF Modulator switch. They ROCK!

Sara arrived late night and is here through the weekend. Today is Jay and Sara’s first anniversary! Happy anniversary Jay and Sara! 🙂

Josh is doing much better today. he is playing hospital B-Ball again! Yes! His youth pastor and friends came to visit around noon. They are out looking for an RF Modulator to see if they can install an X-Box here for him.

I have a very graphic picture of Josh’s leg if you are up to it. If you are squeamish don’t click the link. It’s not really bad, but some may be sensitive. Consider yourself warned. 😉

LINK: Joshua’s leg healing progression after plastic surgery.

This morning the dilauded in Josh’s epidural infusion PCA pump ran out and he was suffering some serious pain. The alarm kept going off on the pump and the nurses were trying their best to get more from the pharmacy. The pharmacy was very slow to respond. Finally, after Josh’s repeated requests for pain relief, one nurse called down and told them angrily to get that freakin’ dilaudid up here right NOW! That produced fast results and the meds finally arrived. They called the doctor and asked for permission to give him a shot of dilaudid in his I.V. to give some immediate relief until the pump started sending steady medication again. He approved it and they quickly administered it. Josh is able to control the dilaudid in his epidural with a PCA (Patient Controlled Analgesics) unit. He hit the button about 4 times before drifting into a much welcomed drug induced sleep.

Josh said the pain in his calf is pretty terrible. He said it feels like it is laying on two rocks rather than the two pillows that it is resting on. I hope this stage of recovery doesn’t last long. I’m hoping soon he will be back to tossing balls in his make-shift basketball hoop again.

Here is some relevant information about Josh’s injury that I found online:

Compound Fracture:
Definition: An open fracture is a broken bone that penetrates the skin. This is an important distinction because when a broken bone penetrates the skin there is a need for immediate treatment, and an operation is often required to clean the area of the fracture. Furthermore, because of the risk of infection, there are more often problems associated with healing when a fracture is open to the skin…

Intrameduallary (IM) Rodding:
Intrameduallary rodding is a procedure to place a metal rod down the center of the tibia to hold the alignment of the bone. A tibial rodding is a surgical procedure that lasts about an hour and half and is usually done under general anesthesia. Patients will have an incision over the knee joint, and small incisions below the knee and above the ankle. In addition, some fractures may require an incision near the fracture to realign the bones.
IM rods are secured within the bone by screws both above and below the fracture. The metal screws and the rod can be removed if they cause problems, but can also be left in place for life. Tibial rodding provides excellent fixation and alignment of the bones. The most common risk of surgery is knee pain, and the most concerning complication is infection. Infection of the rod may require removal of the rod in order to cure the infection…

Negative pressure dressings:
Negative pressure dressings are an attractive option for the interim management of open fracture wounds. The negative pressure dressing consists of a polyurethane ether foam sponge that is cut to fit the contours of the wound. Into the sponge is placed a noncollapsable evacuation tube. The evacuation tube is connected to a canister that collects the effluent. The canister is coupled to the control box, which regulates the force applied through the dressing. The dressing is sealed with an occlusive drape…

Josh went to surgery at 7:00am and returned to his room at 3:00pm. The doctors did not come talk to us. The nurse told us that he had a rotational muscle flap rather than a free flap. They inserted an epidural for pain management with a PCA unit for him to dispense medication as needed.

From what I understand from talking to the Dr. from plastic surgery, they used two muscles, the soleus muscle, and the gastrocnemius muscle by moving them over to cover the tibia bone. They said that it is not always possible to perform this type of muscle flap due to injury to the blood vessels. He did not lose a lot of tissue and he has a good healthy blood supply so the surgery went well. The doctor said that they took some of the skin from his upper left leg to graft over the open wounds. He has a bio-degradable covering on the site where they harvested his healthy skin. They said that it will take about five days of careful monitoring before they will know if the graft is taking.

Josh has been sleeping all day following the surgery. he had an epidural inserted where anesthetic drugs are delivered to his lower extermities. Unfortunately, the tube shifted and he is getting more numbing on his good right side than he is on his injured left side.

I hope tomorrow he is feeling more himself and back to making baskets with his little tape balls and mini sports balls. 🙂 Stay tuned!