Day 12: Cautiously Optimistic

We decided to wean him off the codeine.
I think it was negatively effecting his mood and causing his emotions to be exaggerated.
In addition, I think that the "drop off" of the narcotic was making his pain feel more intense when the meds wore off.
We switched to 10 mL (2 tsp) of over the counter Children's Ibuprofen every 6 hours and 10 mL of Children's Tylenol every 4 hours.

After a few rough nights & mornings, we have seen 2 decent middays, which lead me to believe that the medication switch is working, and that when Josiah is tired, we see more outbursts. I think when he's tired, he just can't handle anything.
Last night when he was getting belligerent again, I remembered that Dr. Nelson said that if Benedryl calmed him down, we could use that too. I knew he was exhausted, and I was tempted to give him the codeine though he hadn't had it all day, just because i wanted a good nights sleep for all of us! When I checked the Benedryl bottle, I realized that the active ingredient in Benedryl (diphenhydramine) is the same ingredient used in sleep-aids like Tylenol pm. So I gave him a dose at 10pm.
He slept until 3am. He woke up complaining, and since it had been 5 hours, I gave him Tylenol again and another dose of the Benedryl. He slept until 9:30am and woke up without screaming for the 1st time in 10 days!
My husband took the baby and let me sleep in; I was expecting to be woken up by Josiah's screams, but when I got up at 9:45am and went to check on him, I was surprised to find him sitting in the recliner playing his Wii! I said, "Good morning! How are you feeling?" 
"Good."
"Wow, so no pain this morning?"
"Nope."
"Praise the Lord, Josiah! That's great!"
"Ya, God's helping me."


It had been over 6 hours since he had any meds, so I gave him fresh doses of the Ibuprofen and Tylenol. From everything I've read, nipping the pain in the bud is the best policy... proactive pain management instead of reactive. 
I think I'll use the Benedryl just a night for a while if it helps him sleep.


Another praise report is that we got him in the tub for the first time yesterday. Dr. Nelson cautioned us against soaking the fixator in warm water because it fosters bacteria growth; however, he said that we could do a chlorinated lukewarm bath. (A shower would be best, but Josiah hates showers; if he was willing to get in the tub, I was not going to fight him on it! He needed to get clean, period!)
After some drama (fear) of the potential pain of putting the foot in water, once he got in he was pleasantly surprised that it felt good.  

Thank God for the little victories! They keep us hopeful. 


We are cautiously optimistic that we're turning a corner here.