[tri-med] Nicholas update 5/12/07

Nicholas had surgery at 7 p.m. on Thursday on his left hip fracture (we were 
told mid-morning).  The surgeon had to remove the previous screw (from a 
previous fracture) and put in a plate.  He has a purple cast from his abdomen, 
around the hips, and all the way down to his left toes.  We were told he could 
come home on Monday or Tuesday if his pain was under control.
They currently have Nicholas on Methadone (Methadone is also used in managing 
chronic pain due to its long duration of action and very low cost), Morphine 
only if he needs it, Amitriptyline (for chronic pain), Keppra and Topamax (for 
seizures) and 400 IU of Vitamin D.  He is currently on continuous tube feeds @ 
50cc's a hour.

Nick's endocrinologist stated she would consider beginning Nicholas on 
pamidronate if his lab studies showed a high bone turn over state with other 
abnormalities, but his tests were normal so the bisphosphonate drugs won't help 
him.  She has suggested Vitamin D and we are currently seeking a second 
opinion.  Nick's endocrinologist is the Assistant Professor in pediatrics with 
a special interest in bone disease from Riley Children's Hospital in 
Indianapolis.  

Nick's developmental pediatrician is currently seeking as he calls it "the 
guru" of osteoporosis.  He knows of a physician in Louisiana that is an expert 
on the disease and is trying to find out if there is any other med that would 
work to help Nicholas in preventing fractures.

Nick's echocardiogram came back normal.  He hasn't had any seizure activity 
after starting the Keppra.  Nick is playing with his musical toys and keeping 
himself entertained! 

(Mark is staying the weekend with Nicholas so I can rest before he comes home.  
woo hoo!) 

Mark & Jayne

  


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