Loopy Drugs

I just downloaded all the pictures and videos from my camera and found a video of Kaitlyn from Monday. She had been given the loopy drugs and they were taking effect by this point.

Sure she can still count so she must be okay right?! Notice it makes her a bit ADD though. She quickly discovers the mystery of pushing the fingers in.

Ahhh... Starting to relax.

Neal didn't take pictures while I held her the above photos. She was really loose then. I tried to keep her as close to me as possible and support her head in hopes of her not freaking out. Once her head moved a bit to much (aka slight bobble) and she started to panic, but as soon as I pulled her in more she stopped. It seemed if she felt like she's in control of her body it kept the panic mode down. She never did scream and freak out like she did the other two times.

Notice Maddie, her ever faithful doll, was right there in the mix of it all. When she woke up from surgery she had Maddie with her.

One LOL moment was when a nurse and anaesthesiologist were talking about all the things that have gone back in the OR. Mind you we are talking about children having surgery so they encourage you to bring a blanket or toy that comforts the child. One said, "I've seen them go into the OR decked out in pistols, holsters, and cowboy boots." And the other one quickly threw in, "And that was just the doctors." Hahaha...

Third Surgery

Kaitlyn had her third and final surgery yesterday. Dr Brock removed the plate and four screws from her right femur. Afterwards he came out and talked with us saying she's a good bone grower. He said the screw tips had been sticking out the other side of the bone when he put them in, but they were covered (by bone) when he went in to remove them. We asked about pain meds and he said with some children Tylenol will be enough and with others they need prescription drugs. He decide to send us home to try out Tylenol and for us to call if that wasn't working. Seeing how she did so well after her second surgery with just a little Tylenol we decided going that route was fine. I should have said "no, give us the perscription." Right after getting Kaitlyn to my parents house she fell asleep. I took off for Walmart to get some Tylenol. I gave her a dose around 2pm. The poor thing woke up in a lot of pain. Her diaper was wet and had soaked through so Neal took her brace off, but she wouldn't let him touch her beyond that. I told him to leave her alone for a little bit so the Tylenol could do it's magic. She went to sleep shortly there after so I left her in the pee diaper. I figured it wasn't poo so she could stay there a little longer. Two hours later I figured I better see if the pain was gone. It wasn't. She was crying about her leg hurting and not wanting to be touched. I immediately called Dr Brock's office and asked them to call in the pain meds. They told me to give them an hour then call the designated CVS and see if they have the prescription. An hour. When your 2.5 year old is in pain an hour is a long time. It really only took them about 15 minutes to call me back and say it was done. Mind you, when they say an hour, it's not so they can twiddle their thumbs, but Dr Brock was probably in surgery again.

Now the hunt was on. I called the CVS I had picked pain meds up for Kaitlyn before and they said they didn't have it yet, but their prescription line was blinking. They said it would take 15 minutes for them fill it. My parents are almost 15 minutes from the CVS so that was perfect. Of course when I got there they said they didn't have it. I quickly went to the other CVS in the city and they didn't have it. I even checked a Walgreens just in case. I kept calling Dr Brock's office just in case they were all on the phone and not really out of the night. By this point it was just after 5pm; an hour since I had called about getting the meds. I called Neal and he checked for another CVS in the area. Nope. He then searched for Dr Brock's and his assistant's cell numbers. He couldn't find the paperwork which means we took it to San Antonio. Finally he remembered he had Dr Brock's cell in his phone from when he had to call and give verbal consent for her first surgery. He called and got his voice mail. Augh!!! I went into the second CVS and asked if there was anyway to search all stores for the prescription. They did it and they called the one it should have been at. I asked if I could give her something besides Tylenol for the pain. They said no. Augh!!! Neal was able to talk with Dr Brock's aid and she said because of the nature of the drug she had to fax it in. I went back to the first store and asked them to check their RXNT. They were in he middle of printing off several prescriptions when I walked up. They said they just got it and they were filling it now. I said, "Good because my toddler is laying in bed with an overflowing diaper in to much pain for us to change her for FOUR hours." They didn't say another word. They quickly got me the drug and sent me on my way. I would just like to say SHAME ON CVS for not checking your RXNT for two hours. My poor baby was in pain longer then she should have been because your people don't check all means that prescriptions come in. Dr Brock's aid said this IS COMMON with CVS. So if you ever go to your local CVS for a prescription and they are sitting on their thumbs saying they don't have it tell them to check their RXNT just in case it was sent that way.

Oh, sorry, rabbit trail. The Hydrocodone has to be working, but Kaitlyn still cries about the pain. I'm not sure what we are going to do about going home. We are supposed to head back to San Antonio today. Neal has to go back because of work so no matter what he is leaving. If Kaitlyn doesn't start acting better soon then her and I will have to stay behind.

Please pray Kaitlyn's pain goes away. We would really like to get her home to San Antonio.

Pray for Dane

Please remember Dane in your prayers. Every time your little one toddles by or you see a young child playing think of Dane and say a quick prayer for his speedy recovery, his parents sanity (I'm only half joking), that they will all be well rested both in and out of the hospital and that the one surgery is all he needs.

Does this picture look familiar?

Here's the one I posted of Kaitlyn back in January after her surgery. Dane has gone through the same kind of surgery. He actually had the same doctor too.

This little guy has a long road of recover and cast time ahead of him. At times it can be really hard. His parents need God's help getting through it all. If you would like to peak into his life you can do so at the Wittschen's website.

Spica Cast Diapering And Taping

I've read several sites talk about how to diaper a child in a spica cast. I have yet to post anything about because I figured others have covered it even if I do it a bit different. However, I've decided it's time share a bit of what I've learned from personal experience. From what I have read you should us a size 1 or 2 diaper; I would like to strongly disagree. Dr Brock's nurse gave me a paper before leaving the hospital that says use a diaper one to two sizes smaller then the one they wore pre spica. I totally agree! When Kaitlyn poos it can go up the back, front, or even in the sides of the cast. A smaller diaper allows the poo to freely go up. A bigger diaper pulls the poo out of the cast as you remove it.

Another thing I've learned has been about diaper styles. In the hospital we used size 3 Pampers; they worked well. If we didn't put a diaper over the one inserted into her cast it would fall out because of the smaller size. On the way home from the hospital I bought size 3 Huggies; these were a bad purchase. Huggies have a lot of elastic in the back which pulls it all together preventing it from staying nicely tucked into the cast. If you have a smaller opening in your cast then more power to you on using Huggies. I don't suggest them. My suggestion is to save those Huggies until your little one is cast free. Our third package of diapers were size 4 Luvs. Luvs are our normal brand. For someone who hasn't ever used Luvs, they are cut like Pampers. The larger size is working great!!! I have been thankful on more then one occasion we're using the bigger diapers. By the way, before surgery Kaitlyn was in size 5.

For a while we used the shell to her cloth diapers to cover the diaper area and to hold the inserted diaper in place. The more she started getting around the harder the cast was on the cloth diapers. We moved to a simple rotation with disposable diapers that is working well. We insert a size 4 diaper (with a super absorbent pad) and strap a size 4 diaper over top her cast. Did you know those diapers can stretch? If you are using a really cheap diaper that doesn't have stretch... pay a little more. So your child is diapered. At the next diaper change you take off the outer diaper and set it aside. The inner diaper and pad are thrown away. The outer diaper now gets the tabs pulled off (you don't need those scratching your little one), a super absorbent pad placed inside, and the combo inserted into the cast. Now diaper outside her cast with a fresh diaper and you're done. Rotating the diapers keep you from throwing away your money on a larger diaper to cover the cast. The stretched out tabs are going to be pulled off anyway so don't worry about the stretch you put on that diaper.

Diapering at night... Even when they aren't in a cast nightly diapering can be a challenge. Since being in the cast Kaitlyn seems to pee more at night. I have yet to do it, but putting the mattress at an incline (head up) will cause the pee to run down into the diaper rather then up the cast. We had a lot of trial and error at night until we learned what really works for us. I put two pads in Kaitlyn's nighttime diapers and I use a size 5 diaper. The first time or two I tried this it did okay, but I still had a partially dry diaper that leaked. I thought about buying different pads at night that didn't have a plastic back, but then came up with this...

I cut two pads up the back.

I pull the back open a little so there's a nice gap for all the pee to flow through to the diaper.

Here's the diaper with two pads, cut up the back, as close to side-by-side as I can get them. The smaller the diaper you use the more these two will have to be overlapped. Because more pee runs to the back I insert this mega diaper with the pads starting at the back cast edge.

Taping the cast has little to do with the actual diapering process, but it's important. While I had the camera out I thought I would take some shots of her taped cast.

All the white you see is waterproof medical tape. It comes in different sizes, but mine is 1" wide. I tried the slimmer stuff and goodness was that a pain to put on. Under all the white is a Gortex lining that covers the underside of the cast, some foam, and gauze. If you don't tape the Gortex within a day or two of the child coming home from the hospital the lining will rip. You don't want this happening. On her second cast the Gortex ripped on both knees before I could get it taped down. Thankfully I was able to pull it together and tape it down. Once you have waterproof tape all around the cast openings you then need to add Duck tape to hold it on. The waterproof tape sticks well to the Gortex, but not the cast. Duck tape comes in most to all cast colors. As you can see the hospital Kaitlyn had her surgery at uses a darker purple then Duck tape supplies a color for. However, their pink is spot on. As you can see from the front shot the tape between Kaitlyn's legs is damaged. From time to time I have to take off the Duck tape (carefully) and add more waterproof tape, then more Duck tape. Near the end of her being in the last cast I wouldn't take off the old tape, I would just add to it. When she had her cast down to her toes I still put both tapes on the toe area. I also put Duck tape around her ankle/heel and knee areas to protect them from all the crawling she was doing. I found myself almost nightly adding more tape to the knee of her one fully casted leg so I started putting a man's tube sock on that leg. My main reason for taping the knee and heel was to keep more cast from being applied to her existing cast, making her even heavier. Heaven knows I don't want her heavier.

EDIT: Near the end of Kaitlyn's cast time I realized we still had a lot of size 4 diapers. I swapped the size 5 at night for the 4. We never had an issue with leaks with the smaller diapers. I think the pads were the trick not the size of diaper.