59 more days and counting before Joe can starting being totally normal...
Friday saw another hospital visit at 5pm, so I had to leave work a little early. In the days leading up to the visit, Joe had increasingly been not fussed on having the bandage on his leg. The bandage was only there to limit the bending of his leg and stressing the 'Steri-strips' that were holding the wound together while it was healing. Over the week we noticed that despite the Steri-srips he was able to bend his leg considerably without compromising them, so the bandaging was more or less pointless. So today he walked into the hospital with no bandage.
We didn't have to way long to get seen and the old dressings were removed ready to be re-dressed. A different doctor saw us, Dr Khan and like 'Bob' he too was more concerned with the progress or rather slow progress of the damaged wound. The other 'Pin exit wound' because it stayed intact during the fall in the snow is now 95% healed. But the wound which had the stitches ripped out is a
very different story (See images)
Joe, awaiting treatment.
This is the last Xray that was taken last week and if you look closely towards the top of the tibia where it fans out towards the Tibia plateau, you can see two very feint lines on the bone and these were the anomalies that caused the concern and confusion last week that led to Joe being platered up again for a week.
This is the last remaining hole in Joe's leg, and this is the dressings that they've been working with. The dressing in the last week has been covered with a plaster of some sort and then the bandaging on over the top.
This is the wound without any dressing and the nurse called the Dr in to have a look and like Mr Wakeman, he was also slightly concerned at how far behind it is in comparison with the wound on the other side of the Tibia. Mr Khan had said that we wouldn't be required to be seen for another 4 weeks, but having seen the wound and how open it was, a discussion was had and it was decided that because of this wounds slow progress, we'd have to come in again in 2 weeks. He also agreed with the nurse and said that the wound would also have a little bit of the seasweed packing put in the hole to help with the healing. The seaweed stuff looks like strands of white cotton wall and they lay it in the wound where the wound oozes fluids, the seaweed kind of contains the fluids and prevents it from scabbing. This means the skin grows back in a way that reduces the amount of scar tissue and the scars are far less obvious than if left to scab over.
The wound had the seaweed put inside, 3-4 steri-strips laid across it holding it in and that was it. The nurse said we'd be advised to go to the treatment clinic at Laindon and have it all renewed on Monday and see what the nurses there would say about continuing to come in and have it dressed. But we left with no plasters and no bandage.
With regards to what Joe can and can't do... He'll be back in the playground again next week, but he's got to be careful - no fighting, no over-exhuberant activities where he might fall again and just generally take it easy and build up slowly (59 days) towards normal activities. The sense I get is that the main concern is this wound and getting closed up and sealed in the short term. With regards the bone, limp, leg strength
and physical activities, very little has been said with the inference that because he is young, he'll just gradually get back to normal activities and strength over the coming weeks. But, there is the clear message that for the next 4-5 weeks
he cannot do sports and anything that might push him too far, the build up to the decision to resume normal sport activities has got to be gradual.
NHS Physio does seem to be a bit piecemeal and subject to abuse. When you go into the clinics, there's aways a chart that tells you about how many last minute (Less than 24 hours) cancelations and 'No-shows' that have happened over the previous month and it's a horrifc number - 50% or somewhere near that. So they have a policy where if you do this to them, they just cancel your program, allowing others to use the facilities. But, because of the 'Incident' we weren't able to attend our usual session and we must have fallen into the 'Crap customer' catergory and as a result, Joe's not able to get in to a Physio session for the next week. Michelle's going to ring them again and see if she can wangle something, but if not it's not a problem, it's something we've been doing for 9 months now, so we'll just do some of the usual stuff. This was also what the Dr suggested, when Michelle mentioned it to him.
In conclusion, it's all going well and my only concerns now are the potential for a life-long limp, (which the Doctors are non-commital about) and Joe's weight, but while we were at the hospital the Greek Dr (Can't spell his name) who operated on him on day one with Mr Wakeman said... "You'll be fine, just do your physio at home and slowly build up your activities and you'll lose all the weight you've put on as well". So, I was pleased to hear that.