External Fixator is OFF!!!!!

We went to Orthopedics east today, after eating a full lunch. I'm not sure if this was a good idea, or a bad idea. Keep reading.

They first did x-rays as usual, and Dr. Duke explained the fracture is healing well, but still needs some immobility time for further healing. He then explained how the external fixator was going to be removed and that Johnathan would wear a cast for a few weeks afterwards. So we go to the "casting room", and the lady removed his ace wrap, gauze and stitches.

The bar for the external fixator was removed. No big deal. That thing was very heavy. Maybe we can get it melted down into a wedding band or something. (We are keeping all of the hardware. We sure paid for it!)

The screws for the external fixator were not any fun. They made Johnathan and I both nauseous. Him from pain, and I got nauseous from the blood. I can handle large wounds, hospital patients, and physical therapy, but i don't like watching needles go into the skin, and I don't like to watch oozing blood. Poor Johnathan. They did not give him a local anaesthetic, and he was in extreme pain.

She then yanked out the pins, with pliers. That was not pleasant.

We have pictures of all of these events, but I didn't have my camera (of course, it was on the kitchen table where I should have remembered to pick it up).. they are all on Johnathan's phone. We will somehow figure out how to post them on the computer.

Four screws (from the external fixator), and two large pins. We will post pictures of these as well.

They then wrapped his wrist with a new fiberglass casting and he was good to go. The casting was pretty neat, she just dipped the wrap into cool water to get the chemicals working. It heated up on his wrist, then cooled to form a hard, water-proof surface. She gave him a plastic sleeve so he can shower. I think that is the most exciting thing for him: he hates taking baths.

The cast is much better than the external fixator- he doesn't have to worry about bumping the bar (which bumped inside the bone), he has more finger room so he can button his shirts and be a little more independent, and people won't stare at him quite as much. He was waiting for me to pick him up today, and someone actually stopped the car and asked what happened to him. The external fixator was the best option for mobility and healing purposes, it strictly limited his wrist motion. He has a little bit of wiggle room in the cast, but the cast is hard enough to prohibit wrist motion and protect the fracture.

He will wear the cast for another month... he gets the cast off at 8am Halloween morning! :)

The cast is black, and we have yellow/gold pens for people to sign the cast with. Of course... App State colors!! :)


Thanks to everyone for calls and support. We have a lot on our plate right now (oh our house is a disaster), but things will get better! :) We love you all!

Johnathan is starting to get his humor back (watch out)

Johnathan was able to have a more normal day today: he was able to wake up and get ready (with increased time), go to work and go to class! A lot of people are not realizing what an external fixator looks like or the seriousness of the surgery. When he went into work, his boss gave him this week's work tasks and allowed him to go home. He showed her the fixator, and I think she was scared. He was able to finish his work this afternoon, and is currently enjoying Monday Night Football (rooting for the cowboys).

His surgery helped me out in a long, round-about way today. Today at work, I was in charge of PT orders and new evaluations on random units (APU, ASU, CEU and 1-south). I had an erroneous non-acute PT order for a post-surgery patient (fresh out of the recovery unit and being sent home soon). We cannot just cancel orders, so I went to the unit to ask the nurse what was going on with the patient. She was rude and not helpful. The receptionist did not know the patient, but recommended paging the doctor. I glanced at my paper, and the physician order was from Dr. Duke. He is the only physician I know by face, and I happened to see him in the hall five minutes later on the way back to my station. The issue was resolved immediately (normally we would have to page the doctor, wait, and the issue probably wouldn't be resolved until an hour or so later).
So yay, thanks Johnathan!


Hope everyone is doing well.

Follow up visit # 1

In surgery, they placed an external fixator, which means he has restricted mobility of his wrist. He has two percutaneous (through the skin) pins through his radius to hold the fracture in place and promote healing. He then has four percutaneous pins (two in the hand and two further up in the forearm) with a rod connecting between them. This is the "external fixator". It is on either side of the fracture to stabilize the bone and the wrist so that he does not have excessive motion, which could significantly impact the healing of the fracture.

It's been a week since his surgery. He has been in extreme pain, only relieved by the medication.. but then he sleeps more. He missed class Monday, but has been to every class starting Tuesday. His boss is being extremely helpful and understanding, and is letting him miss work as needed.



We went to a follow up visit with Dr. Duke today, and he told us that the external fixator may only need to be on for three more weeks, then a possible cast. They took all of the gause and bandages covering his arm, and checked to make sure the wound sites were clean. They left the sutures in place, and recovered his arm with clean gause and bandages. Johnathan was in an extreme amount of pain during the bandage change, but he was a trooper and made it through!

We return back in three weeks, and they will take more x-rays. They may decide to remove the external fixator at that time and possibly place a cast, and of course they gave him more pain meds.

Thanks!!!

Surgery

Thursday
7:30 pm - johnathan goes to sleep
Friday:
12:00 am - johnathan cannot eat or drink anything until after the surgery
5:00 am - i wake up to eat and get ready
6:00 am - i wake up johnathan to prepare him for surgery (steri bath, etc).
6:30 am - arrive at Pitt County Memorial Hospital (PCMH)
7:30 am - johnathan is taken back. i am called back before he is wheeled to surgery around 7:50
11:30 pm - i am called to speak with dr. duke. everything went well in surgery, he explains the procedure and external fixator.
12:30 - johnathan is back in the ASU (Ambulatory Surgical Unit). "Enjoying" crackers and a mountain dew, and cracking jokes with the nurse (the same joke four times actually... morphine works wonders).
2:00 pm - discharged from the hospital. Of course, it is raining outside.

In the hospital, all he could talk about was going home and how even though he was in pain he was doing fine. As soon as we got home, he passed out.

Wednesday

After reviewing the surgery packet given to us by the nurse at OrthoEast, I realized there was a phone number we needed to call to schedule pre-testing bloodwork etc. I called the office, and the lady was not happy that we were calling only two days before the surgery. I explained that it was considered an emergency situation, and she was able to fit us an appointment that afternoon. I had research all Wednesday afternoon, so to save time she decided to fill out all paperwork over the phone that morning. Johnathan had to go through all the questions, and ten minutes later I had to go through all of the same questions.

We showed up early to the appointment, waited, and then when we were taken back the nurse told us (quite rudely actually) that we could not be seen since we did not have our surgery packet. Not at any moment did she mention to us on the phone or did anyone at ortho east mention that we needed to bring this packet. I am normally prepared, but we thought it was just patient information. Apparently not. So we drove all the way across town to get the papers and all the way back. For five minutes of blood work. Fun.

We call thursday afternoon to figure out the time of surgery, most likely early Friday Morning.

Tuesday

I took Johnathan to the Orthopedic East office today. We waited for what seemed like forever, and finally were taken back to see the doctor. The doctor took one look at the x-ray and immediately counted 9 different fractures of his radius that had shifted (i.e. the urgent care doctors had the bone identified incorrectly, as well as the type of fracture).

The doctor recommends that Johnathan have surgery, to either have a volar plate, pins or an external fixator to repair the damage.

Surgery is scheduled for Friday morning.

Labor Day 9/1/08

Johnathan calls around noon, asking me to come to the tae-kwon-do place. He fell and his wrist really hurts.

Took him to urgent care here in Greenville. After a shot of pain medications, xrays were taken. The doctors told us he had a nondisplaced fracture of his ulna. We made an appointment with Orthopedics East for Tuesday morning. They gave Johnathan a splint and some pain medications (neurotin and oxycodone).