Friday, November 26, 2010
First Harley ride!
Jackson took his first ride on the Harley and did great! He's always been fond of it parked, but once Pa-Jack would start it up, he'd get a little freaked out. Not this time though! He said he wanted to ride, so Nana cleaned up my old helmet and off they went! He loved it!
Wednesday, November 10, 2010
Going with the Flo
Thursday, 10/21. Sean had a follow up appointment w/ Dr. Silver at 9:45, then his first PT appointment at 11:15. The two offices are right down the hall from each other, so fortunately there was no travel in between. Mornings were tough and we knew the night before it would be tough getting out the door at 9. As expected, Sean was in a lot of pain when he woke up - even more pain than usual. It took a while to get out of the house and when we did, Sean couldn't even get his leg into my car. The way the dash is positioned, he had to really bend his knee to get it in, and though it was tough, he'd been able to get in every other time. The pain was so intense and became even more excruciating when the knee moved or bent. Pat had just gotten to our house as we were trying to get him in the car and quickly suggested that we just get him into his car instead. We first tried the front seat, but that wasn't working either. Finally, yet very painfully, Sean was able to stretch out across the backseat with a couple of pillows around him leg. At this point we knew we were going to be very late to the appointment with Dr. Silver. And Sean was in the backseat in terrible, awful pain. I called Dr. Silver's office and explained to his nurse that I needed to talk to Dr. Silver right away. Within minutes Dr. Silver was calling us back and told us that he could skip the appointment with him and just go straight to PT. But we were already in the car and halfway there. I asked Dr. Silver to call down to the PT office and explain the situation to them, so they would be expecting him to arrive an hour or so early. Sean kept saying he didn't think he'd be able to get out of car, so I called the PT office and asked if we could have some help getting him inside. The person I spoke to, Matt, was very courteous and helpful, said someone would meet us outside. When we first pulled up, I didn't see anyone waiting, so I ran inside the building to find someone. About halfway down the hall, I noticed a lady with a Sports and More PT name tag heading towards the door. The nametag read, Flo, Owner. I asked if she was coming to help us and introduced myself as Sean's wife. As we walked and talked I immediately felt her confidence. She went right over to the car, literally climbed into the backseat with Sean and began a 5 minute or so….hmmm, chat? Pat and I stood outside the car and listened as she confidently talked to Sean. She gave him quite the pep talk and already, she had my attention. I was listening and would not be getting in her way. Then, seemingly all of a sudden, she said you're going to get out of the car now and preceded to grab Sean's leg(!) and PULL him out of the car. I've joked several times since that she was getting his leg out of the car, whether or not the rest of him came was up to him. Y'all this was the hardest thing to watch during this whole ordeal. As she was pulling, he looked at me, gave me the worst look and mouthed do something! I immediately burst into tears and hid behind a concrete column so he couldn't see me. Not surprisingly, Sean let out a few choice words during that scene and Flo immediately gave him a lesson on that. She said to him, "You will NOT use profanity in my clinic and you will NOT use the Lord's name in vain." Yes ma'am. At that point, I wasn't sure what was going to happen next, but I did have a feeling that we were at the right place. Sean on the other hand, probably thought Flo's PT clinic was the worst idea for him, ever.
That first day was obviously very, very tough on Sean. Even though his appointment wasn't for another hour, Flo took Sean over to one of the tables and let him stretch out with a pillow under his knee. She quickly pointed out that the pillow wouldn't be there much longer, but that she would allow it for the time being. She spoke to all of us about Sean's situation, explained her experience with nerve pain and CRPS, and confidently gave Sean a very positive prognosis. For the first time since the surgery, I felt like I was speaking to someone who had no doubts about the appropriate next steps. But still, Sean was the one in pain and I don't think he was quite as confident in the beginning.
Sean had a therapy session in the pool that Friday, then again on Monday. On Tuesday he went in for a second nerve block. That block went about as well as the first, but the exception was what followed this one. The block was done at 10am. At 2:15, Sean was at PT, working with Flo. Since the nerve block was providing short term pain relief, they were able to do exercises that would have normally been impossible. And all the mobility was what they were saying was going to ultimately treat the nerve pain.
Dr. Merritt, the pain management physician, injected about 20% more numbing medicine during the second block, so Sean was hoping to get a little more relief from this one. And he may have. Although, since he worked out as hard as he did, the nerve pain was only replaced by knee pain.
Sean had two more tough therapy sessions and Wednesday and Thursday. Thursday afternoon his pain was again intense and excruciating. We were all frustrated because it seemed like he had been making progress all week. We were in Wilson that night b/c we wanted to watch the NCSU v. FSU game with the crowd. Once Sean was medicated enough that the pain was relieved and couldn't keep his eyes open to watch the game, I convinced him to go upstairs and sleep in a bed…next to his wife. That was the first night we'd spent together in exactly one month.
The next morning, Sean woke up and actually felt pretty good. We came back to Raleigh for an afternoon PT appointment and before his session had a little sit-down with Flo. We talked to her about the progress, the set-backs, and the next steps. It was a great 'therapy' session, even though there was nothing physical about it. Sean left the clinic that day with a new outlook on his recovery. He realized that he had a choice. He could let the pain control him or he could take control of the pain. He knew it was time he took charge of the situation.
Coincidentally, I had my own 'session' with Flo on Thursday. I had called to talk to her about what I should be doing and what I should expecting. Her biggest suggestion was for me was to make things as normal as possible for Sean. Before I went to Wilson that afternoon, I came home and transformed our couch back to a couch. I took all of Sean's 'bedding' away and the air mattress upstairs. I wanted him to come home to a 'normal' house and for him to go to bed at night upstairs, like 'normal'. That was my first step. So when we came home Friday afternoon, after our mental session with Flo and his physical session with Beth, his normal therapist, the house was back to normal. Friday night marked Sean's first night sleeping in his own bed, next to his wife.
Sunday (Halloween) was a big milestone day for Sean. He lifted his leg with no assistance 5 times, twice! He showered completely own his own. He even did a few chores around the house. How's that for normal!?
On Monday, he went down the stairs with no help for the first time! He also got in and out of the car with no assistance, even lifting his leg, using his strength. WOW!
November has continued to bring significant improvements. Sean has made a serious commitment to exercising at home. He even went back to work this week. He's still on crutches, but bearing significant weight on his leg when walking. This Friday, Sean will be working out with Flo. She's told him last Friday what they'd be doing. He will be standing on his right leg (the bad one) and writing the alphabet in the air with his left left. But only A through F, the first letter in Flo.
Here a few pictures from one of Sean's pool sessions. These were taken on 10/29. Did you know that a pool noodle was a favorite therapy tool?
Sunday, November 7, 2010
Wednesday, November 3, 2010
The Aftermath (continued)
Saturday morning in the ER, we all felt that Sean needed to stay in the hospital for a few days, until the doctors could get his pain under control. Since Dr. Silver practices in Raleigh, it made sense to us that he be admitted to either Rex or Wake. The ER doctors had been in contact with the on-call orthopedic in Raleigh throughout the night. That doctor recommended Sean be evaluated in their Urgent Care office, then admitted to Rex from there. This would require a car ride from Wilson to Raleigh and even though Sean was heavily medicated, he would not have tolerated a 45 minute car ride. We arranged for a transport service to pick him up from WilMed and comfortably get him to Raleigh.
The EMS guys were great. They took extra care with Sean, even taking him into the Urgent Care office on the stretcher. The PA, Laura, who evaluated Sean that morning was wonderful. We made very clear to her that we felt the best next step was a hospital admission. Our efforts to get his pain under control had been unsuccessful for too long. I had already spoken to Dr. Silver before we arrived at the Urgent Care office, so he was aware of the situation. Once Laura contacted Dr. Silver to give him her assessment and I explained to him that I didn't feel comfortable taking Sean home on stronger narcotics, he had Laura start the paperwork process to get Sean directly admitted to Rex. And by 2pm that afternoon, Sean was resting inside the four walls of Rex.
Most people probably think a hospital stay is the worst idea ever, but in this situation, we were all breathing a bit easier once he was there. Even though his pain wasn't better, he was under the care and supervision of professionals trained in dosing and administered strong doses of narcotics. The plan for the hospital stay was to figure out a regimen to manage the pain and we were hoping that by being here, we would be able to stay constantly ahead of the pain. But, Sunday morning around 4am, he woke in more excruciating pain - these episodes were unlike anything I'd ever seen. It was awful and so frustrating to experience with him. There's so little that can be done to help relieve the pain. All I could do was try and help him relax. There's only so much relaxing that can be done when you're in that kind of pain. Later that morning Dr. Silver upped the nerve meds pretty significantly. With that, in combination with the arsenal of other meds, he was able to stay ahead of the pain for most of the day, as long as he didn't do much moving.
Since it was the weekend, the Rex pain specialists were not making rounds. The nurses explained that we could request a visit from them on Monday. We had an appointment with the pain specialist at Triangle Ortho for Tuesday, but that was Tuesday. We needed some answers sooner than that. So Monday afternoon, Sean met with a nurse practitioner with the Rex Pain Management office. She did an examination and determined that the pain Sean was experiencing was definitely nerve related. When the compressed nerve became freed up after the surgery, it was pretty much just pissed off. It began firing constant pain signals to the brain. The slightest touch or sensation was a million times more intense than it should have been. Sean felt like he had a severe sunburn on his whole leg. She suggested a sympathetic nerve block procedure that could help relieve some of this nerve pain. She was unsure of whether Sean was dealing with a compressed nerve or if he was suffering from a condition known as Complex Regional Pain Syndrome (CRPS). Either way, it seemed the treatment was the same. A nerve block to relieve the pain and physical therapy to regain mobility, which would essentially re-train the nerve on how to function properly. She left that day to consult with the physicians in their practice and said that it was possible that he could have the block procedure done the next day.
That night I, of course, spent a couple of hours googling the procedure and learning as much as I could about what could possibly be going on. We said a prayer together before falling asleep sometime around 10. When the nursing assistant came in to check Sean's vitals a little while later, she noted that he had a low grade fever and his blood pressure and heart rate were a bit elevated. At first his nurse didn't seem too concerned. When she came in to give him his narcotics about an hour later, she did a routine oxygen level test. That number had dropped since her last check. So given all the changes in his vitals, his nurse made a call to the hospitalist on call. Sometime shortly after midnight, there was a knock at the door from a very kind doctor, who asked Sean how he was feeling. He explained that he felt a CT scan of Sean's lungs was an appropriate next step, in order to determine what could be causing the change in his vitals. Around 2am, after getting essentially no sleep, Sean was wheeled away for the scan. Then at about 6am there was another knock. This time from Dr. Lam, with Rex Pain Management. First off, he was the bearer of good news that Sean's scan came back clear. Then he went on to tell him that he agreed with moving forward with a nerve block. Fortunately they were able to get Sean scheduled for a block that morning.
In terms of success of the block, medically speaking it went well. Sean had quite a bit of pain relief through the day. He was able to move his leg more comfortably and looked great. They had explained that the block works in two parts. What happens is they inject numbing medicine into the sympathetic nerve region of the spine. This essentially puts those nerve to sleep for just a few hours -- actually, anywhere from a few minutes to several hours. While the nerves are resting they aren't constantly sending pain signals to the brain. The 'hope' is that when the nerves wake up, they will forget how screwed up they were and start functioning normally again. In Sean's case he got about 8 hours of pain relief, but when his nerves woke up they were still all kinds of pissed.
Sean was discharged from Rex Wednesday morning after being evaluated by the pain management folks. The previous week Dr. Silver had set Sean up with a very hands-on PT clinic. His first appointment with them was supposed to have been on Monday. Since he was still in the hospital that appointment had to be rescheduled....for Thursday. So come home from the hospital and begin PT the next day. Brutal. But necessary. Everyone had told us that PT was the answer. Nothing is going to treat the nerve pain better than regaining normal functions with the leg. Getting Sean there that morning was the beginning of a new journey. One that would finally show significant results 1 week and 1 day later. Buckle up kids, you are about to meet Flo...
The EMS guys were great. They took extra care with Sean, even taking him into the Urgent Care office on the stretcher. The PA, Laura, who evaluated Sean that morning was wonderful. We made very clear to her that we felt the best next step was a hospital admission. Our efforts to get his pain under control had been unsuccessful for too long. I had already spoken to Dr. Silver before we arrived at the Urgent Care office, so he was aware of the situation. Once Laura contacted Dr. Silver to give him her assessment and I explained to him that I didn't feel comfortable taking Sean home on stronger narcotics, he had Laura start the paperwork process to get Sean directly admitted to Rex. And by 2pm that afternoon, Sean was resting inside the four walls of Rex.
Most people probably think a hospital stay is the worst idea ever, but in this situation, we were all breathing a bit easier once he was there. Even though his pain wasn't better, he was under the care and supervision of professionals trained in dosing and administered strong doses of narcotics. The plan for the hospital stay was to figure out a regimen to manage the pain and we were hoping that by being here, we would be able to stay constantly ahead of the pain. But, Sunday morning around 4am, he woke in more excruciating pain - these episodes were unlike anything I'd ever seen. It was awful and so frustrating to experience with him. There's so little that can be done to help relieve the pain. All I could do was try and help him relax. There's only so much relaxing that can be done when you're in that kind of pain. Later that morning Dr. Silver upped the nerve meds pretty significantly. With that, in combination with the arsenal of other meds, he was able to stay ahead of the pain for most of the day, as long as he didn't do much moving.
Since it was the weekend, the Rex pain specialists were not making rounds. The nurses explained that we could request a visit from them on Monday. We had an appointment with the pain specialist at Triangle Ortho for Tuesday, but that was Tuesday. We needed some answers sooner than that. So Monday afternoon, Sean met with a nurse practitioner with the Rex Pain Management office. She did an examination and determined that the pain Sean was experiencing was definitely nerve related. When the compressed nerve became freed up after the surgery, it was pretty much just pissed off. It began firing constant pain signals to the brain. The slightest touch or sensation was a million times more intense than it should have been. Sean felt like he had a severe sunburn on his whole leg. She suggested a sympathetic nerve block procedure that could help relieve some of this nerve pain. She was unsure of whether Sean was dealing with a compressed nerve or if he was suffering from a condition known as Complex Regional Pain Syndrome (CRPS). Either way, it seemed the treatment was the same. A nerve block to relieve the pain and physical therapy to regain mobility, which would essentially re-train the nerve on how to function properly. She left that day to consult with the physicians in their practice and said that it was possible that he could have the block procedure done the next day.
That night I, of course, spent a couple of hours googling the procedure and learning as much as I could about what could possibly be going on. We said a prayer together before falling asleep sometime around 10. When the nursing assistant came in to check Sean's vitals a little while later, she noted that he had a low grade fever and his blood pressure and heart rate were a bit elevated. At first his nurse didn't seem too concerned. When she came in to give him his narcotics about an hour later, she did a routine oxygen level test. That number had dropped since her last check. So given all the changes in his vitals, his nurse made a call to the hospitalist on call. Sometime shortly after midnight, there was a knock at the door from a very kind doctor, who asked Sean how he was feeling. He explained that he felt a CT scan of Sean's lungs was an appropriate next step, in order to determine what could be causing the change in his vitals. Around 2am, after getting essentially no sleep, Sean was wheeled away for the scan. Then at about 6am there was another knock. This time from Dr. Lam, with Rex Pain Management. First off, he was the bearer of good news that Sean's scan came back clear. Then he went on to tell him that he agreed with moving forward with a nerve block. Fortunately they were able to get Sean scheduled for a block that morning.
In terms of success of the block, medically speaking it went well. Sean had quite a bit of pain relief through the day. He was able to move his leg more comfortably and looked great. They had explained that the block works in two parts. What happens is they inject numbing medicine into the sympathetic nerve region of the spine. This essentially puts those nerve to sleep for just a few hours -- actually, anywhere from a few minutes to several hours. While the nerves are resting they aren't constantly sending pain signals to the brain. The 'hope' is that when the nerves wake up, they will forget how screwed up they were and start functioning normally again. In Sean's case he got about 8 hours of pain relief, but when his nerves woke up they were still all kinds of pissed.
Sean was discharged from Rex Wednesday morning after being evaluated by the pain management folks. The previous week Dr. Silver had set Sean up with a very hands-on PT clinic. His first appointment with them was supposed to have been on Monday. Since he was still in the hospital that appointment had to be rescheduled....for Thursday. So come home from the hospital and begin PT the next day. Brutal. But necessary. Everyone had told us that PT was the answer. Nothing is going to treat the nerve pain better than regaining normal functions with the leg. Getting Sean there that morning was the beginning of a new journey. One that would finally show significant results 1 week and 1 day later. Buckle up kids, you are about to meet Flo...
Tuesday, November 2, 2010
Knee Surgery: The Aftermath
We expected Sean to spend the first few days after surgery on the couch. We knew he was going to need the pain medicine he was prescribed at discharge. What we didn't expect was for there to be no-nada-zero improvement in the way he felt by the end of the weekend. The surgery was on Wednesday. He totally expected to be back at work on Monday. We were even prepared with a wheelchair for the NCSU v. Va Tech game that Saturday. As the first few days past, we kept thinking the pain would improve. I've always heard that the third day is the worst. But the fourth day brought no improvement.
Early Tuesday morning Sean woke up feeling sweaty and nauseous. His blood sugar was crazy high by 5am he had started vomiting. Can you imagine? Bad leg and bad belly! Not a good combo! I had spent the first few nights on the air mattress next to him, but since I was planning to work on Tuesday and the kids had been having their own night-waking issues, Sean suggested I sleep upstairs to try and get a good night's sleep. When I came down first thing that morning, I felt so bad that he had been awake and sick and all alone. We really weren't sure what was causing his symptoms, so we made an early morning call to the endocrinologist on call. He advised Sean to use a syringe to take insulin, in lieu of the pump, and to see how he responded to that. Fortunately, his blood sugar began to come down after the syringe of insulin, but not before he was zapped of all his energy. Sean concluded later that morning that the problem was with a bent cannula connected to his insulin pump, which was causing the insulin to not deliver properly. We also called the orthopedic office and they advised us to come in that day.
Dr. Silver, the orthopedic surgeon, examined Sean and agreed that the swelling was still quite significant and he felt Sean's pain could actually be nerve pain. He explained that the swelling could be putting pressure on the nerve thus causing the pain. Or, the nerve could have been caught up in the retractors during the surgery and may be recovering from the compression, which could also cause pain. Either way, it seemed the pain Sean was feeling was nerve related, not meniscus related, so Dr. Silver prescribed him Neurontin, which is used to treat nerve pain, and a steroid pack to help with the swelling. He also recommended Sean begin physical therapy as soon as possible. He acknowledged that beginning physical therapy seemed like a crazy thought, but explained that they would start with techniques to improve the pain and swelling reduction, rather than working on his range of motion. We left the office that day hopeful that the new med would relieve some of his pain and thankful that his blood sugars had come down. However, the next few days went on with no improvements with the swelling or pain.
Sean continued in the same excruciating pain through the weekend. Once he would finally get comfortable on the couch, he would have to get up for the bathroom. And that was about all the moving he would do. The pain when walking on his crutches was awful -- and I just watched. It seemed that every move his leg made was unbearable. Just touching his leg would send him through the roof. I wanted to help so much, but there was nothing that could relieve the pain.
The next Tuesday (almost two weeks post-op) Sean went back in for a follow-up with Dr. Silver. Since the only noticeable effect the steroids had was on his blood sugar (over 200 and not moving), Dr. Silver suggested aspirating the knee to try and relieve some of the swelling. Three syringes and 140 cc's later, Sean had a visible knee cap for the first time in almost two weeks. Dr. Silver was confident Sean would feel some relief. And he did. For about 8 hours. The relief he felt was isolated right around the knee. The nerve pain was still there. Then the swelling came right back and with it all the pain.
Wednesday night (10/13) Sean started running a low grade fever. When he continued to feel clammy throughout the night, we decided to check in with Dr. Silver that morning. Since infection can be a very serious side effect associated with surgery, and given Sean's condition for the past two weeks, Dr. Silver wanted to see him right away. He examined Sean's knee and suggested running some tests to eliminate possible concerns. He wanted to aspirate the knee again to send the fluid off for labs. Sean was not thrilled about that idea b/c he knew how little it helped before. And the additional pain from having a needle jabbed into his knee was still lingering. Dr. Silver ended up aspirating twice -- he didn't get much fluid the first time, though he did get enough for the lab work. Sean reluctantly agreed for him to aspirate a second time, and even then he didn't get much more. He said it could be clotted around the knee and just not flowing well. Not a concern, but still not cool b/c that meant Sean had endured a total of three aspirations with essentially no improvements. Yuck! Dr. Silver also ordered some blood work and an x-ray of the knee. Everything came back normal. The pain was still Sean's primary concern at that point. Dr. Silver gave Sean a prescription for a longer lasting narcotic to use in conjunction with the short acting. He also recommended that Sean make an appointment to see the pain management specialist within his group. We had hoped to see that physician later that afternoon, but it turned out that he couldn't see Sean until the following week. Really? He's in this much pain and we have to wait yet another weekend! Not cool!
We went over to Wilson Friday afternoon b/c Pat and Beth had planned a party for the NCSU v. ECU game. We all thought a change of scenery would be great for Sean, so I was really looking forward to the weekend. Amazing how things can change. By 11pm that night I was frantically calling Dr. Silver on his cell phone, asking for advice on treating Sean's pain. Nothing he was taking was touching the pain. We followed Dr. Silver's recommendation for the increased narcotic dosage, but the pain was still unbearable. I was mentally exhausted at that point and ended up crawling in bed with Jackson. Pat stayed down next to Sean and when the pain continued into the early morning hours, Pat made the call. He came in and woke me to get Dr. Silver on the phone. We were getting Sean to a hospital and needed to know where to take him. Dr. Silver didn't answer the 2am call, but it didn't matter. The Wilson EMS arrived and informed us that it was there policy to transport Sean to the nearest hospital. It was a good thing too, b/c once in the WilMed ER Sean was given IV narcotics that finally began to relieve some of his pain. By 5am, he was resting comfortably and Pat was busy making sure that our next steps were the right ones.
to be continued...
Early Tuesday morning Sean woke up feeling sweaty and nauseous. His blood sugar was crazy high by 5am he had started vomiting. Can you imagine? Bad leg and bad belly! Not a good combo! I had spent the first few nights on the air mattress next to him, but since I was planning to work on Tuesday and the kids had been having their own night-waking issues, Sean suggested I sleep upstairs to try and get a good night's sleep. When I came down first thing that morning, I felt so bad that he had been awake and sick and all alone. We really weren't sure what was causing his symptoms, so we made an early morning call to the endocrinologist on call. He advised Sean to use a syringe to take insulin, in lieu of the pump, and to see how he responded to that. Fortunately, his blood sugar began to come down after the syringe of insulin, but not before he was zapped of all his energy. Sean concluded later that morning that the problem was with a bent cannula connected to his insulin pump, which was causing the insulin to not deliver properly. We also called the orthopedic office and they advised us to come in that day.
Dr. Silver, the orthopedic surgeon, examined Sean and agreed that the swelling was still quite significant and he felt Sean's pain could actually be nerve pain. He explained that the swelling could be putting pressure on the nerve thus causing the pain. Or, the nerve could have been caught up in the retractors during the surgery and may be recovering from the compression, which could also cause pain. Either way, it seemed the pain Sean was feeling was nerve related, not meniscus related, so Dr. Silver prescribed him Neurontin, which is used to treat nerve pain, and a steroid pack to help with the swelling. He also recommended Sean begin physical therapy as soon as possible. He acknowledged that beginning physical therapy seemed like a crazy thought, but explained that they would start with techniques to improve the pain and swelling reduction, rather than working on his range of motion. We left the office that day hopeful that the new med would relieve some of his pain and thankful that his blood sugars had come down. However, the next few days went on with no improvements with the swelling or pain.
Sean continued in the same excruciating pain through the weekend. Once he would finally get comfortable on the couch, he would have to get up for the bathroom. And that was about all the moving he would do. The pain when walking on his crutches was awful -- and I just watched. It seemed that every move his leg made was unbearable. Just touching his leg would send him through the roof. I wanted to help so much, but there was nothing that could relieve the pain.
The next Tuesday (almost two weeks post-op) Sean went back in for a follow-up with Dr. Silver. Since the only noticeable effect the steroids had was on his blood sugar (over 200 and not moving), Dr. Silver suggested aspirating the knee to try and relieve some of the swelling. Three syringes and 140 cc's later, Sean had a visible knee cap for the first time in almost two weeks. Dr. Silver was confident Sean would feel some relief. And he did. For about 8 hours. The relief he felt was isolated right around the knee. The nerve pain was still there. Then the swelling came right back and with it all the pain.
Wednesday night (10/13) Sean started running a low grade fever. When he continued to feel clammy throughout the night, we decided to check in with Dr. Silver that morning. Since infection can be a very serious side effect associated with surgery, and given Sean's condition for the past two weeks, Dr. Silver wanted to see him right away. He examined Sean's knee and suggested running some tests to eliminate possible concerns. He wanted to aspirate the knee again to send the fluid off for labs. Sean was not thrilled about that idea b/c he knew how little it helped before. And the additional pain from having a needle jabbed into his knee was still lingering. Dr. Silver ended up aspirating twice -- he didn't get much fluid the first time, though he did get enough for the lab work. Sean reluctantly agreed for him to aspirate a second time, and even then he didn't get much more. He said it could be clotted around the knee and just not flowing well. Not a concern, but still not cool b/c that meant Sean had endured a total of three aspirations with essentially no improvements. Yuck! Dr. Silver also ordered some blood work and an x-ray of the knee. Everything came back normal. The pain was still Sean's primary concern at that point. Dr. Silver gave Sean a prescription for a longer lasting narcotic to use in conjunction with the short acting. He also recommended that Sean make an appointment to see the pain management specialist within his group. We had hoped to see that physician later that afternoon, but it turned out that he couldn't see Sean until the following week. Really? He's in this much pain and we have to wait yet another weekend! Not cool!
We went over to Wilson Friday afternoon b/c Pat and Beth had planned a party for the NCSU v. ECU game. We all thought a change of scenery would be great for Sean, so I was really looking forward to the weekend. Amazing how things can change. By 11pm that night I was frantically calling Dr. Silver on his cell phone, asking for advice on treating Sean's pain. Nothing he was taking was touching the pain. We followed Dr. Silver's recommendation for the increased narcotic dosage, but the pain was still unbearable. I was mentally exhausted at that point and ended up crawling in bed with Jackson. Pat stayed down next to Sean and when the pain continued into the early morning hours, Pat made the call. He came in and woke me to get Dr. Silver on the phone. We were getting Sean to a hospital and needed to know where to take him. Dr. Silver didn't answer the 2am call, but it didn't matter. The Wilson EMS arrived and informed us that it was there policy to transport Sean to the nearest hospital. It was a good thing too, b/c once in the WilMed ER Sean was given IV narcotics that finally began to relieve some of his pain. By 5am, he was resting comfortably and Pat was busy making sure that our next steps were the right ones.
to be continued...
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