The good news first.

The hamstring reattachment went well, the skin grafting has held and while he will likely need some cosmetic work for the hamstring area down the road, and a tremendous amount of physical therapy, structurally it seems ok.  And, we have an important appointment tomorrow with the neuromuscular/electromyography/ultrasonography doctor this week to create the best conditions for nerve growth and muscle preservation for as long as possible. 

But, whatever happened Wednesday night got worse, and then worse.  Carson’s pain has regressed to something like 2.5/3.5 weeks ago.  It’s not nerve pain now, it is orthopedic pain.  It might be related to the MRI techs mishandling and dislocating his knee (most likely is), but he is now in this huge splint wrapping the entire leg, and that is creating its own issues. It’s been massive regression as he hasn’t been able to move in 5 days and his pain has been off the charts since Thursday evening, but it at least comes and goes. 

So now, today, Monday the 14^th of September. The ortho team is trying to decide if they need to go back in to surgery and put the X-Fix back on because the knee is so unstable…We are trying to make that decision today. 

As of writing this, I don’t yet have the full radiology report and haven’t had a conversation with the Ortho Surgeon yet today (PA this morning, but not the surgeon yet) but the trauma doctor said she read the radiology report and (no exaggeration here) said Carson’s upper and lower leg is being held together by the skin.  Meaning, all other structural soft tissue is gone. Umm…

That leaves Carson in a bit of rock/hard place.  The knee is so unstable and painful because nothing is holding it in place and the mechanical devices currently on his leg are not quite sufficient to create stability.   The X-fix would do that. But, they also need to move his need during a surgical procedure as he is at high risk of arthrofibrosis setting in.  Think of that like concrete hardening.  It’s the body protecting itself, but means long term chronic issues. 

But…they can’t yet fully manipulate his leg because they don’t want to damage the sciatic nerve in doing so.  So…I dunno.

Fortunately, we have a team of people internal to Swedish hospital and external who are strategizing and going to bring us proposals. One of those options is to transfer him to yet another hospital so the long term ortho team can take over from here, while partnering with vascular and nerve doctors. 

Sad but true, we don’t want to transfer. This place kinda feels like home (Maybe an abusive one) and we are hesitant to leave.  Carson, Barrie and I know all the staff, say good morning to them like they are our co-workers and friends, know every single trauma doc, know how to navigate the bureaucracy, and I’m on a first name basis with the people at the Starbucks across the street, the information desk people and the valet team. 

Aside from my Starbucks addiction (I’m two-4 shot lattes into today already), we think we’ll have a path forward for Carson in the next 24 hours and are hopeful that means getting back into Rehab by the end of this week or early next week, surgeries pending.