Saturday, July 19, 2008

Today

Surprisingly we were able to sleep the night through last night. I protected his road rash with a dry dressing that promised on the package to not stick to the wound. I gave him a couple ibuprofen and a benadryl, and he rested pretty well.

This morning was a different story. He insisted the dressings had to come off, yet they did indeed stick to the wounds. Bit by bit with damp wash cloths I persuaded the tissue/dressing bond to release, and he wailed every step of the way. He was wishing he was dead, wanting me to put him to sleep, and threatening to sue the dressing company. He asked if we had a case, and was insistent that he was serious and wanted an answer. Then he was unhappy with the answer: "no". He roared at Scott to leave when he came in to use the toilet. In short, he was perfectly miserable and giving everyone a taste of how he felt.

In fact, he was beside himself for a while, where he was miserable in the tub and miserable out of it and miserable because he didn't have any options. I was looking at the crust that was beginning to form on his shoulder and thinking we were going to need to soften that and clean it some more and in his state that was impossible.

In the medicine chest are the leftover hydrocodone tablets from when we've had procedures. Those are a hedge against severe pain; we often take them on back country trips. It was my ace in the hole today. I split it in two and gave him half.

Half an hour later he was drowsing in the tub, euphoric that he wasn't hurting any more. Scott came in to tell him how sorry he was that he's hurting and Connor smiled beautifically and thanked him. He was apprehensive when I suggested submerging, but he took a deep breath and tried it. To his surprise it was quite bearable. I then told him we needed to rinse it with clean water. The shower last night wasn't very satisfactory so I got a water pitcher and gently poured water above the area so it flowed over it.

6 hours later we've returned to pain and crankiness. He's in the tub again, but submerging is out of the question. I'm uneasily eying the crust forming and thinking it's going to need attending to. He's demanding to know how long it's going to be before it stops hurting and before it heals. I went online and found an informative site about road rash complete with photographs. I till him 2--4 weeks and you'd think I was personally responsible. "I don't to wait 2-4 weeks!" I told him I don't think he's going to be feeling this bad for the entire 2-4 weeks and he wants to know how much longer he is going to be feeling this bad.

So, I was hoping that Gary meant it this time when he said he'd be home 'early', by 'mid-afternoon'. Well, I wasn't betting the farm, mainly because when he was first talking about this trip he was saying he was going to be home 'mid-DAY.' He's always injured when I greet his time projections with skepticism and no one is more surprised than him when he doesn't meet them (and no one is less surprised than me.). So I was irritated, but not surprised when, 2 hours after mid-afternoon he called from above Timberline Lodge to say he was late. Duh, he was late at 3:00. And now it was going to be at least another 2 hours before there was another adult in the house. And that was 3 hours ago.

Plans for tonight--another bath session with a dose of codeine-lite on board to debride some of that eschar, followed by bed. Hopefully he'll rest well and will be feeling better enough tomorrow that we can skip the narcotic. I'm not sure how we'll protect the wound tonight, though since there's no way he's going to accept another dressing.

Scott has diarrhea. He plugged up the downstairs toilet and missed the bowl when he peed. Gary is committed to taking a group rafting tomorrow. They bid on a river trip at the Trillium Auction in May. I'd planned on having a babysitter to give myself a break, but it's beginning to look like a not-good idea.

Sigh.

2 comments:

Mrs. Spit said...

Oh Excavator:
that totally sucks. Totally.

As for dressings, go to your local pharmacy, and get burn dressings. They are designed to not stick to open wounds.

The other thing, to help with debreidment, is to use a hand held mixer in the water around the wound. It agitates the water, which helps clean the wound. I'm wondering if you put some good quality bubble bath in the water, if you could make it "fun" to make bubbles around the wound. Or even just some anti-bacterial soap?

The other thing might be to look into some polysporin to cover the wound at night - then use a light gauze dressing. Put it on thick enough, and the dressing won't stick.

Also, see if you can get some emla cream. It's a topical anesthetic, so it will numb the area. Barring that, I bet good old preparation H would work darn well. It's a topical and it has some mild cortisone in it to reduce swelling!

The biggest part of the pain is because road rash is so close to the top of the skin, where all the nerves are, and they are just constantly going off. It's like someone constantly sandpapering your skin. It's terribly uncomfortable.

Poor Connor. Poor Excavator. I'll be thinking healing and calming thoughts.

excavator said...

Hi, Mrs. Spit--

Great idea with the mixer! I don't have a hand-held, but I thought I could just agitate the water with my hand (a little less fun-factor), but I couldn't get him to dunk the shoulder today. I was able to pour clean water over it though, and he's managed to pull off some of the drainage inadvertently (it's on his pillow case). There's nice pink skin beneath, so there's progress.

He's still in agony, and my ears are ringing from the hollering before the medication kicked in. My learning curve is slow, but I think I've got it: LUKEWARM water for when he first gets in the tub--gradually warmed; medicate a FULL 30 minutes ahead of getting in.

I called the advice nurse and they called in a silvadene prescription. I'm apprehensive about the possibility of sticking, though she assures me that it won't stick. Maybe I can use it in concert with the burn dressings.

I've canceled my babysitter. I just couldn't in good conscience hand this off to a 16 year old kid. Hopefully I can make it through this day somewhat graciously.

Thank you so much for your practical advice!