We eventually left after a whole week and a couple of hours. All in all Joe had 3 different procedures which meant that he had to go through general anaesthetic. Fortunately each op was shorter and less complex and meant that the recovery from each was faster. In addition he had two procedures that didn't include aneasthetic...
No.1 was the initial putting all the bones back and pinning them up and repairing the big tear across his leg from what seems to have been a result of bending so much before the snap. At that stage they were only able to pin that wound together at the ends leaving a big hole in the centre. (I'll try and do diagrams of all these things). At this stage they were talking about the possibilty of plastic surgery.
No.2 Op (Tues): The initial cast was a shorty from just below the knee. In the 2nd op, they had another go at closing the big split and they checked the puncture wound, where the Tibia had come through the skin, there had been some concern about the flap from that dying off, but on the 2nd look that was recovering well. They had another go at the tear and put reebok stitches on it, saying that they have to look at that again later. At this point the surgeon was saying that tear looks as though it will heal with a hole in his skin - so I'm assuming a big indentation in the scar? But overall they were saying that everything was going well.
No.3 Op Weds:
During the this Op the short cast was replaced with a massive plater of paris cast which went right up to the top of his thigh, at the same time they've set the cast so that it holds his ankle in a funny position and this is to help the big tear fix more readily. During this op which was very quick, they cleaned up the tear again and closed it slightly and re-dressed it. When the he came back the new cast had a big bulge where the wound is and they said that the next procedure would be to cut a window in the cast at this bulge so that they can access it to check and dress the wound.
Procedure 4: Thursday:
On Thursday, I took Joe down to the Plastering room and the bloke there cut the access hole in the cast over where the wounds were. This went okay with very little pain and the bloke removed some of superficial dressing and replaced with a more comfy version and replaced the cut section and simply taped it up.
Procedure 5: Friday
This was the scary one, I didn't want to see this and figured that it would hurt. An appointment was made for the consultant to come down to the ward and do this in there early in the day (07.30), the idea being that if it didn't go well and it turned out to be more distressing than envisaged, it would leave time in the morning to go back to theatre and do the procedure under general aneasthetic. So I arrived at 07.00 having gone home over night and Michelle said that the nurses had given Joe some pain killers and morphine prior to me getting there. Then just after 07.30 the consultant surgeon came along and removed the cover and cut away all of the dressing. This included all the stuff that was stuck to the congealed blood, so as you can imagine Joe was screaming and crying with pain. I noted that as the pain increased and the wailing and screaming got under way, all the other parents on our ward ushered all their kids out as it was probably distressing them as well!
The bloke did the job really quickly though drizzling a clear liquid into the wound and re-dressing it and sealing it up, it must have taken around 5 minutes and once he got the bulk of the new clean dressing on, the pain diminished and soon after the cover was placed back into the plaster Joe was back down to pain level 4 out of 10, whereas during it the pain was "15 out of 10"! Within another 5 minutes he was stable and back to 1 out of 10. But all through the process I hadn't been able to bring myself to look at it, so didn't really know what the state of play was.
After, the bloke spoke to me and said that it was all going well and that the biggest concern, albeit it not too much of an issue was the tear. The tear was still open in the middle and still quite big, but he said that in time it should be okay and that they would have to keep an eye on it.
I've not said much about the physio, but this in itself was a whole other set of problems. Obviously because of where he is and what has happened and the fact that he's full of drugs his appetite wasn't on par with a normal week. Then add to that the fact that he'd been lying flat on his back for 5 days not doing anything, it was going to be slightly diffrent when the Physio girl came along and insisted that he get up and get active...
The shot here below is prior to the visit to the 'Plaster men', you can see that the consultant surgeon has marked where the opening needs to be so that they can access the wounds to clean them up.
Joe at home again.