Yesterday Ru woke up in a great mood – it was the first time in almost a week that he wasn’t crying for the first part of the morning. And his good mood continued for most of the day.
Today he was back to being fussy and clingy for much of the day. We had his appointment at the West Penn Burn Clinic this afternoon. We went to the exam room and answered lots of questions for the nurse and unwrapped his arm. A lot more skin is starting to peel which looks bad but it’s a good thing. Under that peeling skin we are finding skin that is starting to heal. The nurse asked Scott and I to wash his arm before the Dr examined him – easier on children if their parents are the ones involved. We washed him up and waited. This is how his arm looked this afternoon.
First a resident came and walked through the injury and the treatment steps from the past 6 days. He examined Ru’s arm and told us that he would be back with the surgeon shortly. Then we waited for a while. I heard talking in the hallway that Dr Kelly was finishing surgery and would be there shortly. Eventually the nurse came back to check on us and told us it wouldn’t be much longer. Ru was mostly content to relax on my shoulder and suck his thumb. On a few occasions he pointed at the door and asked to leave and go to the car, we used fruit snacks to distract him for a while.
Dr Kelly came to examine Ru with a team of people trailing to observe – I think there were 5 other people in the room. They stood back and listened while Dr Kelly talked to us. He was impressed with the amount of healing that has already occurred – for this injury after 6 days it looks really good!
We discussed the area around his elbow at length and learned that the 3 most difficult areas on the body for burns to heal are the neck, underarm and the inside of the elbow. The reason: when new skin grows it contracts and it is important to make sure that the area retains its flexibility as the new skin grows. His arm is burned all around this area, but in that critical spot there is a 1 inch strip of skin that appears to have been untouched – his arm must have been closed protecting that area when the hot water spilled on his arm. That small area that was protected has good implications for his long-term recovery.
As of today there are only a few areas where deeper burning occurred that require more treatment with the burn cream. The rest of his arm is still peeling and a thin layer of new skin has started to form over most of the burned area.
– Within the next two weeks we can expect new skin to be growing over all of the burned areas – the fact that so much new skin has already started to cover his arm is a great sign!
– Dr Kelly cautioned us that his arm is not going to look good for a while. In 2-3 months his arm will be rough as the area continues to heal. He specifically told me not to worry; what I see on his arm 3 months from now is not the way it will look for the rest of his life.
– Since he is young and his arm is growing his arm will take longer to return to “normal”
– 8 months from now is when we can expect his arm to look the way it will look long-term, so sometime in the late spring we will have a better idea of how his arm will look.
– We should expect there to be some scars, but he cautioned that they would be something that only a mother would notice.
– We will continue with burn cream on the areas with the deeper burns and keep his arm clean and wrapped for another week or two
– I need to track down a good vitamin E rich cream to keep his arm moisturized throughout the next 8 months
– The sun is our biggest enemy to the healing process. Thank God we are heading into long-sleeve season because his arm needs to be covered any time we are in the sun, even brief time periods. And Dr Kelly recommended sunscreen with an SPF of 90 in the future if his arm is not covered.
This is one of those times that I am so happy that we live close to world-class medical facilities. People travel a long way to visit this burn clinic and it was a quick trip for us. Dr Kelly was gentle as he touched Ru’s arm and spoke to us and Ru was calmer when being examined by Dr Kelly than any other doctor or nurse in this process. We were able to ask every question on our list and we have a much better understanding of what to expect. Without this visit today I know I would have been very concerned in a few months when his arm didn’t look better. Now I know what to expect and I know that if we have more concerns in the coming months we can go back to have his arm examined again.
When the nurse came back to wrap him she apologized that we had to wait for so long while Dr Kelly was in the OR. I replied that I didn’t mind because Ruslan won’t need to be in an operating room as a result of this. As difficult as the last week has been (I still start shaking when I think about last Thursday), I know that it could have been worse. I am incredibly grateful that he won’t need surgery.
Ruslan is back to jumping and climbing and his mischievous laugh has returned. Hearing him laugh is the best medicine for me to recover from this ordeal.