Samuel's 42nd Update

Just wanted to update everyone and let them know that Samuel has broken his right shoulder. He fractured his humerus bone just below the ball of his shoulder. We do not know what caused the break. Nothing occurred other than his normal daily routine. The one thing we know for sure is that no one did it intentionally, but Samuel’s lack of activity and excess weight create extra risk factors.

The break occurred sometime Monday night or Tuesday morning. By Tuesday afternoon there was a definite increase in his heart rate and discomfort. By Thursday night my mom was able to identify that Samuel’s right shoulder was causing him noticeable pain. It took awhile to settle on his shoulder being the problem because he became very sensitive to being touched. He postured and cried if you touched his leg, he postured if you touched his arm; he cried just being touched period.

So Friday morning my mom and our nurse loaded Samuel up for the ER at Glennon. Upon arriving at the hospital Samuel was taken in for x-rays. When the results came back we found that the right shoulder had fractured. The good news was that it was still in proper alignment and was starting to heal. The ultimate decision was to create a strap that immobilized his arm against his body by wrapping around him. This would be something we could remove to give him baths and allow us to isolate his hand and elbow to be able to do range on them and keep those joints from freezing up.

Samuel is being given Tylenol with Codeine every 4 hours for pain management instead of Ibuprofen because of how much harder Ibuprofen is on the stomach. Since Samuel has already had the bleeding ulcer the decision was that the Tylenol would be a better option for him. However the Tylenol is only taking the edge off Samuel’s pain. His trip home from the hospital was not fun for anyone. He cried and his heart rate was in the 180’s (typically between 106-114) most of the way home.

We are trying to stay ahead of the codeine’s constipating effects; we had just gotten a handle on that earlier this week with the addition of a magnesium supplement. As you already know, any changes we make to his medicine or food causes Samuel to have a decrease in his Urine output. So after 12 hrs on Tylenol he was down to 39% output (our goal is 75%) and had gained 14 oz. overnight. It continues to be down today (24% so far). Samuel’s response to his Diuretics hasn’t been good in the past so we’re not sure that increasing diuretics will take care of the problem or just make things worse.

The concern with continued fluid retention is the stress it will put on his body which can ultimately lead into congestive heart failure and fluid in the lungs. It’s a vicious cycle. Anything we do for pain management compounds the problems he’s already been having. We already didn’t know how to deal with these issues in the first place.

Samuel has a follow up in two weeks with the doctor. Because he is a baby his body should heal very rapidly. Our prayer concerns primarily are for Samuel’s distress and fluid retention. Please keep our nurses in prayer as well. They are all distressed by the situation and blaming themselves even though no one knows how it happened. We thank you all for your prayers. I will keep you posted on his progress.

Kaitlyn