Saturday, March 24, 2012

On the Bike Again

Randy and my brother-in-law, Rich, put together a recumbent stationary bike for Ben. Here he is on it, pedaling for the first time. Whew! That is nice to see.

Homecoming - Where You Ben?

We are so happy. Ben came home on Tuesday morning after being in the hospital for over a month. We were so pleased with his care at the hospital, but it is always nice to come home. He has been doing so well. He is able to transfer from the bed to the wheelchair and back without any assistance which I didn't think would be possible at first. Also he can get into the bathroom easily without help. So nice.

When we arrived, Randy had signs and balloons all over the yard.

Ben was really touched. Two of his other biking buddies came over as well and we had a pizza party.

What a nice way to be welcomed home after such a long time in the hospital.

John is not the only one with a possum problem

At some point before we get started on building a house for John, I will elaborate on John's possum problem. Let's just say that they are involved in making his current abode less habitable than it should be.

I put some cat food out on the front porch for the only remaining feral cat left - Blackie. (Big Head disappeared, probably the coyotes got him or perhaps a jealous husband.) I noticed that my house cats were all clustered around the front door extremely interested in what was happening on the porch. 

This is what I found - a possum convention. That's 3 different possums making themselves comfortable on my porch. You can even see one of them sitting on the kitty bed, grooming himself. 

You can see the door is slightly open when I took this photo. One of the cats is peeking out. 

Monday, March 5, 2012

More X-rays

I've got some photos of the "after" x-rays. You can see where the ortho doc re-created the hip joint, the acetabulum. It looks really nice except for the size of the screws. I've include the scapula X-rays as well, but I really can't interpret them. It's not an area they operate on very often and it's not an area I am very familiar with. Children don't break their scapulas.

Hip X-ray during surgery. The large metallic objects are retractors holding open the surgical site.  But you can see what a nice hip joint they re-established. 

Post-op surgery X-ray showing the sizes of the screws. Whoa! You can also see the hip joint well on this view.
Shoulder post-op films. Don't ask me about it. I don't really know what they did except stabilize the fracture.

I also included a photo of the current "bump in the road" as the doctors and therapists at the rehab hospital call it. Ben developed a DVT - a deep vein thrombosis, despite getting heparin regularly. It happened due the nature of the injury, surgery in the pelvic region, and his degree of immobility. Pretty frustrating for me. Wildly frustrating for Ben. He's back getting therapy now after a 3 day hiatus. Also they put him on coumadin, an oral anticoagulant to prevent any further clot formation or extension of the clot. Basically it is up to his macrophages to consume the clot which can take months. 

I couldn't understand the ultrasound that showed his DVT except for the words that said "thrombus" so I am including the drawing which clearly shows his DVT.  
Obviously, home repair and energy upgrade plans are on the back burner. Just trying to figure out how to set up the house for him. Fortunately, Ben lives in a one story ranch which was set up for my mother who had serious rheumatoid arthritis and is pretty accessible. 

I need to go deliver a chocolate milk shake to the wounded cyclist. Ya'll take care.  Keep your helmets on.

Thursday, March 1, 2012

Interesting X-rays

As I wrote in the previous post, my brother was hurt in a cycling accident. We have no idea what happened except that he was apparently launched from his bike, landed in the road until someone called 911 and reported that an injured man was lying in the road. His bike was totally off the road and is not damaged. My brother is a different story. 

Since I work in the medical field, I was somewhat clinical when he first got hurt. I could list the injuries, discuss surgical options with the surgery team, discuss rehab, but it took me a little while to realize how HURT he was. 

The day after his shoulder surgery, the physical therapist, a nurse and I got him up to sit on a bedside commode for a few minutes. I stood beside him to make sure he didn't fall. He could not even hold his head up. You could tell he was in agony. It was heartbreaking. I just didn't realize the magnitude of injury to his body despite seeing all his X-rays, labs, etc. I guess I was being the clinician, not really a member of the family.

He is WAY, WAY better now. He has been in rehab for 5 days now and has come a long way. He will probably be there for 1-2 more weeks. He has to be able to transfer from the bed to a wheelchair before he can go home. He cannot bear weight on either his right arm (his dominant arm) or his right leg for about 3 months. 

Anyway, I thought you might want to see what his CT-scans of his most significant injuries look like. These are 3-D reconstructions of the scans so it is easier to visualize the damage. 

This is an anterior view of his fractured clavicle and scapula. You can see clearly see the crack in the collarbone and the large fracture running down the scapula. The posterior view photo below shows the scapula fractures better. 

You can see that the lower body of the scapula is displaced. When he was thrown from his bike, his weight on the shoulder pushed the upper part of the scapula and clavicle to the middle. The orthopedic team operated because it was not a stable fracture. His arm drooped when he sat up. So now he has screws and plates in the scapula as well as in his right hip. I don't have photos of the repair yet. I will do that though. 

These next two photos show the pelvic fractures. They are a little harder to see because the pelvis is round and bones overlap. 

This is the anterior view of the pelvis. You can see the fractures to the pubic bone. The hip joint on the left (you are facing the patient so his left is your right) is the way your hip should look (except for the pubic fractures). The head of the femur is well-situated in the acetabulum, the cuplike structure that forms the joint. 

The right hip is NOT right. Again when he landed on his right side, the ball of the femur punched through the hip joint. You can see it better on the posterior view below. This shows how far the femur went through the joint. 

Do see the fracture where the head of the femur is sticking in the pelvis through the joint?  The orthopedic surgeons did an absolutely beautiful job recreating his hip joint. I'll get a photo of that and show you guys later. 

The good news? Like I said he is doing way, way better. He is in surprisingly good spirits. Trying to figure out when he can get back on the bike (knowing that it is probably 6 months away.) He is really enjoying the visitors. He has occupational therapy and physical therapy most of the day. He is usually free by 5PM. The rehab hospital discourages visitors before 5PM. He is happy to text all day long so feel free to text him on his phone. 

We are so thankful he is doing so well. The accident could have been so much worse. His care has been wonderful. I've been very impressed with the staff at the hospital. That's where we are now. More updates in a few days.