We took Rayden to his orthodist for a new AFO fitting on Thursday, 1-2-20. When I took his sock off a pressure sore was revealed on his right ankle. Rayden's anatomy is not like everyone else and his tibia bone sticks out at his ankle so it had been scrubbing his AFO for a while. Bob, his orthodist, placed a doughnut inside the AFO to prevent the scrubbing
months ago. I had noticed that his ankle was getting aggravated but I dismissed it because I knew we already had an appointment to get new AFOs. It certainly was not this bad or I would have taken his AFOs OFF! After our visit with Bob, I immediately contacted his orthopaedic surgeon, Dr. Anna Vergun, to get advice. With his ongoing respiratory issues and fever (he had been fighting bronchitis for three weeks now) she recommended we go to the ER. Our PCP, Dr. Mary Ann Chiodo, worked Rayden in Friday, 1-3-20, at 11:00 in hopes of preventing a trip to the ER. She ran some tests and found that Rayden was negative for mono, but positive for Flu A! (yes, he had a flu shot) His white blood count was fine, lungs and ears were clear, so she didn't feel the need to rush him to the ER. Even though he had already completed a round of steroids and antibiotics a week ago for bronchitis, she prescribed Sulfame-temp 200-40mg twice a day along with foot soakings twice a day.
Dr. Mary Ann called me every day throughout the weekend and wanted to see him again on Monday morning. After Sunday's picture (1-5-20) she decided that he may need a
debridement of the wound. She would probably send him to the wound care clinic in Dunn to do this. With his wound being so close to the bone she recommended that I contact his UNC surgeon for advice first. Dr. Anna Vergun called me early Monday morning, 1-6-20, to admit that she DID NOT want anyone else cutting on Rayden's feet because she knows him best. She wanted to do an X-ray of the ankle before proceeding. So we went to UNC. X-rays revealed no infection and Dr. Vergun believes the infection that WAS in the abscess is gone now. She wants us to continue soaking and taking the antibiotics. She also wants us to be extra cautious about his feet, taking his AFOs off every 30 min to look for redness now that they were altered to accommodate the pressure sore. His hip hardware removal is still scheduled for Jan. 30th and she even mentioned the internal rotation of his left leg/foot that our orthodist was referring to last week. She mentioned three different surgical corrections (foot, tibia, and femor rotation). She ran through each scenario. She even mentioned rotating the femor on Jan. 30 (while she was going in there anyway) and putting in a metal plate that did not have to be removed. We really don't think his internal rotation is that bad right now to warrant putting him through another intensive surgery, therefore we are going to try
derotation straps instead.
Dr. Mary Ann called me every day throughout the weekend and wanted to see him again on Monday morning. After Sunday's picture (1-5-20) she decided that he may need a debridement of the wound. She would probably send him to the wound care clinic in Dunn to do this. With his wound being so close to the bone she recommended that I contact his UNC surgeon for advice first. Dr. Anna Vergun called me early Monday morning, 1-6-20, to admit that she DID NOT want anyone else cutting on Rayden's feet because she knows him best. She wanted to do an X-ray of the ankle before proceeding. So we went to UNC. X-rays revealed no infection and Dr. Vergun believes the infection that WAS in the abscess is gone now. She wants us to continue soaking and taking the antibiotics. She also wants us to be extra cautious about his feet, taking his AFOs off every 30 min to look for redness now that they were altered to accommodate the pressure sore. His hip hardware removal is still scheduled for Jan. 30th and she even mentioned the internal rotation of his left leg/foot that our orthodist was referring to last week. She mentioned three different surgical corrections (foot, tibia, and femor rotation). She ran through each scenario. She even mentioned rotating the femor on Jan. 30 (while she was going in there anyway) and putting in a metal plate that did not have to be removed. We really don't think his internal rotation is that bad right now to warrant putting him through another intensive surgery, therefore we are going to try derotation straps instead.
