Day 76 - Yes We're Movin' on Up

We were informed last night that Daniel developed HO in his right elbow. An x-ray confirmed it. Heterotopic Ossification (HO) is the presence of bone in the joints that limits movement and is very painful. The underlying cause is the burn, but there's not a clear understanding of why it happens. From what we've learned so far the rogue bone tissue is inoperable at first and will continue to grow for up to three years. Until that time operations to remove it doesn't help much because the bone continues to grow. Whatever the range of motion that you have is all you'll get until some intervention to remove the bone mass can be done. There is some research for treatment in the first six months, but it doesn't sound like anything has developed to the point where it would be an option for him right now.

For Daniel this is bad news. It means his dominant right arm will be somewhat useless for the next few years. He will have to learn to use his left hand for feeding, care and most activities while the right arm sits idle. We will continue to work and stretch his right arm, but the focus for rehabilitation may shift to his left arm more.

A short nap after breakfast

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In a short while we will be Movin' On Up to the 8th floor to begin Daniel's acute rehabilitation. The first day will be a time to get moved into his new room, meet his nurses on the floor and learn more about the activities he will do with PT/OT/ST's. Dawn and I have already visited the floor all Magnum, P.I.-like and saw the gym, peered in an empty patient room and checked out a few other facilities up there. When we visited it was a Full House of activity in the gym. I imagine Daniel will do okay whether the gym had patients in it or it was empty. The new workload for Daniel will be a Quantum Leap from what he was doing here in the burn unit, but we had to first heal the wounds before we could do much of anything else. That didn't stop us though we had him using his arms to eat as much as we could and he received therapy from OT/PT/ST here too, just for shorter durations. And the emphasis was on his healing his burns, not rehabilitation.

We've heard that as soon as he's on the rehab floor they like to get him in the shower, take body measurements (oh behave!), and perform other measurements for range of motion, assess pain levels and what-not so that Designing Women can build a daily routine for Daniel to work his way through each day. You know what they say - Diff'rent Strokes for different folks.

If yesterday is an indicator it may be Three's Company in the shower with Dawn and I helping nurses to get him clean. We've been Moonlighting as nurses around here anyway. With Daniel being as tall as he is it will be Max Headroom in the shower space. We will have to use our MacGyver skills to accommodate his needs with the limited arm ability of his right arm. I may need a Newhart after all the time and work we've been doing here.

It will be interesting to see Who's the Boss when it comes to his doing his therapy. This won't be a Love Boat cruise, but we hope he will be on the A-Team of patients and cooperates with the therapists. He may be going through some Growing Pains as he adjusts to the new routine in rehabilitation. Those are just The Facts of Life.

(In honor of the Jefferson's Movin' on Up theme and other fabulous 80's TV shows) Cheers!
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Well here's a crappy news update... :(
We're going to spend at least one more day here on the burn floor. Before they send a patient off the floor they do a final check with a draw blood all to make sure he's well enough to move to rehab where the emphasis is on rehabilitation and less on medical health.

What they found is that Daniel's liver function is a bit off. It could be due to Tylenol or Oxandrolone. He's been taken off both over the weekend, but they can cause liver issues when in use. Other medications he is taking don't harm the liver typically. It could also be issues resulting from the burn. They will draw more blood around noon tomorrow and see if he's turned things around. If so, then he can go to rehab, otherwise he will stay here until his liver is well.

...So much for the 80's.  
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After lunchtime Daniel was acting sort of like he was uncomfortable. He didn't want to do many activities and when the PT arrived to try some activities he got fairly angry. He stomped his feet and slapped his leg the way he can when he's been upset at home. After a bit of persistence we got him to do an activity with a balloon and then we took a short walk. Actually for him it was a run. He decided when he saw a group of nurses a short distance away that he would go up to them and tap one on the shoulder, turn around and book it back to his room. That was his way of saying I'm done with this walk, I'll pick a target and turn around and head back to my room. ALL DONE. I wasn't sure how this was going to go down, but he kept his cool and didn't escalate his frustration with the day's events.

I'm not quite sure if he picked up on the changes coming his way (we packed up his room and stuff), if he sensed our concern with his new problem elbow, or just didn't feel well from the liver issue. Whatever it was he made it clear that he wasn't particularly happy with how things were going. One thing he's doing that I haven't seen him do too much before today is that he's moving his hands and fingers around a lot. I've massaged them and held his hand. Not sure that it all means. Perhaps he's just having an off day?

We're going to try some dinner sitting up in a chair, then I'll see where that takes us. I hope he has a restful night and we can move forward with our plans tomorrow.