Wednesday, March 23, 2011

Pain Management a Success.

We've luckily gotten past the bump in the road.  
She had been getting a very regular dose of Tylenol, on top of that we've had to use her dressing dose of morphine far more often then in recent memory.  In the last two weeks it was a given we'd be forced to use it, for each of her changes.  This was something I was very proud we'd been able to work past because of either how well her bandages were working or how we'd been able to avoid many other blisters and issues due to her attentive care (Renata, Nurses and Grandparents).  
Of course we have had the odd blip where things lapsed into chaos, but a week or a few days would go by and we'd get out of it and she'd be a happy kid. Many moments in a day we'd be able to look at her and see a bright, beautiful happy child (yes she's always beautiful, but dark clouds of grumpiness SUCK! and can be very trying to one's outlook).  This past two weeks or so it was getting difficult to see that playful fun kid on a regular basis, through my eyes anyway.  
We were simply not able to get over the hump.  
The sores on her feet as evidenced by the recent photos shows the obvious pain she would be in or what I now suspect being a prime culprit - 'The Itch'.  I've started to believe this is one of the issues which drove her and us to our wits end through the evenings.
She'd wake in an uncomfortable squirm rubbing her legs and feet ferociously.  
I have my own little battle with psoriasis and it finally occurred to me, 
'When is it most itchy?'.  
When I'm at the edge of deep sleep or calming down for the evening.  Depending on what I've eaten (chocolate) or drank (beer, scotch) I'll go into fits of scratching mayhem that drive Renata as batty as myself. 
This pushed us to make an earlier then scheduled visit to our pain management Dr.
After some deliberation of what we are seeing in her and how we were able to get past other cycles of pain and obvious suffering, it was decided to up her daily dose for the time being by 50%.  Same dose every 4 hours not every 6 as was a couple days ago.
What we have since is a wonderful baby, back to normal.
Talking, engaging, happy to be held, interested in everything, content.  No grog, no dreary eyes, no constipation, nothing negative (just yet, but this is being monitored very closely).  
We had to leaned on Janet today to come in for help on her bad foot for a change outside the weekly Monday Wednesday Friday routine.  The foot was smelling too much like a brewery and the green layers in her bandage was reason enough to get it cleaned daily.
Today's change went really well.
Honestly I was shocked at how quickly this foot had healed in 24 hrs.
March 21st, unfortunately it's covered in Bactroban but it's easy to see how big the red raw area is

March 22nd and a solid 24hrs of pain management

What a difference.
She had been waring on me a bit lately.
As much as I love her, it is very difficult attempting to be the calming influence when you are spending half the time while holding your child in panic struggling to wedge a hand or various blankets between her ankles so that she doesn't continue to push any of the remaining and healing skin off her feet.  
Deep into the night over the past two weeks it would often require both of us to hold her down to take either her morphine, Tylenol, or get her started on the bottle or simply stop her thrashing.  Otherwise her feet and face get pounded which of course eventually occurred.

Anyway, things are good and I expect a good sleep tonight.

This is Raquel in her first experience with a cat.
I was very proud of her that her first inclination wasn't to pat to the head of a cat, but to give it a firm right jab to the chin.

That will teach this cat not to sit on the couch next to a kid with boxing gloves.

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