If there is one thing I have learned about burns, it is that they evolve from the moment they happen and are difficult to predict. When we first were in the ER there was concern that some of the deep second degree burns on William's neck, chest and right arm would evolve to an even deeper burn, but the doctors were optimistic that the Oasis treatment they did the following day would allow some of these areas to shrink and possibly heal.
At the follow up visits, the doctors were pleased with the take of the Oasis...on his face, chin, most of his arms and lower chest the treatment was peeling away and revealing areas of brand new pink skin. While the doctors knew areas on his chest and right arm would need grafting they were insistent this area was becoming smaller and smaller as we waited the two weeks from the initial burn.
On Thursday we checked in and did all of our pre-op stuff. This included a very difficult blood draw that the resident doctor came to do himself. While I had been insisting something was up with a putrid odor from William's wounds and extreme discomfort leading to sleepless nights for a week, it wasn't until he was in close proximity to Williams wounds that he realized the extent of the smell was more than just an overly scent sensitive pregnant woman's complaint.
While I was told there would be no dressing changes until William was sedated in the OR the night nurse came in with orders for one due to the strong odor. While these are always hard I didn't think much of it as I assumed we were just removing the outer layer of gauze. As we started removing the dressing more and more layers of the treatment and gauze were falling off and I was soon staring at his chest, as open raw and exposed as it was the night of the burn. While I am no burn specialist, I have researched enough to have known at that point that his whole chest would need a graft. Though extremely painful, the wound clean allowed William the best night of sleep he has had since this whole ordeal began but I was up dreading the surgery as I knew it would be longer and more involved than we were led to believe as I had just seen a very large third degree burn.
They came for William at 6:30am and by 8:15am they sedated him in my arms and I placed him on the stretcher to be taken in for surgery prep and the general anesthesia. We were told the surgery would be two hours but mid way a nurse came out and said they were only 2/3 done. At this point they had harvested skin from one side of his butt to be stretched to cover his whole chest and they were next taking skin from the other side for his right bicep and forearm.
The surgery was four hours long in which they grafted 11 percent of his body. The Oasis only saved 5 percent from grafting. Due to the more extensive skin harvesting there was a concern about blood loss and while there was discussion of a transfusion it didn't happen yesterday and I am hopeful that it won't be necessary.
Seeing him so raw and beat up in recovery after that horrible dressing change and four hours of stressful anticipation was my lowest point so far. However, by the time we were back up in our room, William was asking for Shrek and ordering me to snuggle. Within an hour he was drinking his "seltzer" and ate 4 chocolate munchkins. He then slept relatively peacefully through the night with little medication.
He was in a bit of discomfort this morning but after some Motrin was able to laugh at Shrek with me and at Dad's silly jokes and now is napping. They will do another blood draw today to see if he still needs the transfusion but he looks pretty good to me so I don't think it is necessary.
Because grafts are sensitive to infection and he has open wounds now on his butt we aren't taking any visitors in fear of infection. This could prevent the grafts from taking and mean another surgery and I think we have endured all we can take. I am not taking any chances until the doctors look at the grafts either Sunday or Monday.
Initially we were slated to go home on Monday but with the size of the graft anticipate Tuesday is the earliest we will discharge. Until then, we have Shrek and The Wiggles (though thank goodness he only wants this every now and then because the song "fruit salad yummy yummy" is just torture). We assume the "snuggle" position except for the negotiated bathroom break and there is a rotation of amazing nurses who know us very well and go out of their way to take care of William and Mom...they have really helped me through this ordeal. Most of all my little guy has a very strong and resilient spirit so I know he will pull through and heal. For a week at home he was bouncing around and riding his bicycle with a very painful open wound on his chest. While his poor little tush will be raw now too, his chest will finally heal. This hopefully is the road to recovery and I am certain he will want to be back on that bicycle as soon as he can.
As I first noted, burns are very unpredictable so the doctors are giving us no promises about recovery. But this Mom is pulling and praying that this is the beginning of the end and soon this will just be a time in our lives we look back on as our most difficult hurdle and one that made us all stronger and closer as a family.