Recovery Day 3 -- Dermatology Phones it In

This morning my epidural was turned off at 6:00 and I was started on the oral medication cocktail of oxycontin, oxycodone (Percocet) and Valium.

At 7:00 Dr. LaRue came in to check my dressings and I showed him my growing rash. The itching had increased throughout the day yesterday and I could feel that the nubbly, swollen heat rash had begun again, just like last year. ::Sigh::

So far the itching caused by the pain medication has been treated with Nubain and Benadryl, and we've been trying to prevent any rash or further skin irritation with frequent sheet changings and sponge baths, but there is only so much that can be done. I think the rash was inevitable.

As soon as I mentioned the onset of the rash, I was given some over the counter anti-itch cream, but I couldn't get anything stronger until a dermatologist looked at the rash. My experience from last time told me that this would not be happening with anything resembling efficiency.

At 8:00 pain services came again (smartly this time with only one intern in tow) to check on my pain levels with the oral meds. My hips were holding steady between about 1 and 4, depending on movement and time since last dosage.

After all that frantic morning activity I fell asleep until 11:30. I ate a fruit salad for lunch. That is worth mentioning because back in March I had no appetite at all in the hospital and I barely ate anything other than broth until about Friday or Saturday of that week. This time I ate fruit salad the day after the surgery and have eaten a little bit each day since then. Not a lot of food, but a soup here, some fruit there, etc. And that must be good, right?

After lunch, I signed back on to work for a few hours to fight some fires.

Speaking of fighting fires, by early afternoon the monstrous red blotchiness was in full bloom across my back, flanks, buttocks, and down the backs of my legs from my thighs to calves. It had even begun creeping around the front of my left upper thigh and across my stomach. All the while itching violently in hot, angry welts. Although it was clearly the same rash I'd had while recovering in the hospital in March (and therefore my chart already listed all the appropriate steriod creams necessary to soothe it), a dermatology consult was requested.

Meanwhile, Kimber from PT came to help me get out of bed for the first time since my surgery. It went relatively well, despite being herky-jerky and a bit nerve-wracking, and so I spent most of the afternoon sitting in a recliner chair enjoying a break from my hospital bed and waiting for the dermatologist to show up. And waiting. And waiting.

At 18:00 Dr. LaRue stopped by to check on me and took a look at my rash, which was by then much worse than when he'd seen it in the morning. He said he'd personally order up all the dermatology meds that had been used on me in March, and would also make sure dermatology was on its way.

I literally sat in that chair for three hours waiting for dermatology to show up and tell me I had a rash (surprise!), and prescribe me the medications I'd already taken a year ago for the same condition, and that Dr. LaRue had already ordered. Not only was the dermatology consult disrespectfully tardy, but the person dermatology ultimately sent was an intern who just took photos of my rash and threw out a couple of inapplicable but complex-sounding diagnoses that ultimately translated into things like "blocked sweat glands." I suppose blocked sweat glands are what led me to be steweing in a pool of my own sweat for the last few days, right? Eventually the dermatology intern went into a back room to call her attending so she should get coached on what to say to us. Impressive. At least I should finally get some steroid creams out of the ordeal.

Overall, today was physically miserable because of the discomfort and frustration due to the rash, but from a strictly orthopedic perspective it was a great day with good pain control during the switch from epidural medication to oral medication, and a successful adventure out of the bed and into the chair for a few hours. Moreover, with the removal of the epidural, I also got to remove all the leads monitoring heart rate, breath rate, etc., so that means a night free of strangling wires and beeping machines and one more step towards wireless freedom.