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…
