Walter Update

You might be wondering how Walter is doing. He is doing great. It has been almost 3 1/2 months since he was burned, 2 1/2 months since we got back home from Harborview. The kid has grown and grown. He can't really wear the first set of burn pants we got. The second pair fit, but just barely. Sometimes he just wears the larger Tubi-grip on his lower leg and we call it good. He is quite comfortable with his "ouchy" as he calls it. He doesn't mind us manipulating his leg, examining it, putting lotion on it. We do our "open and close" ROM exercises when we get dressed and changed. We think his leg is looking wonderful -- the scar is smoothing out some, the inclusions are mostly gone.

He is sleeping better at night, especially if he doesn't get a nap during the day. Some days are definitely worse than others, but if we can make it through until 4 PM, then the rest of the evening is usually OK. He is still very attached to his binkies, but the dinosaur pajama obsession seems to be gone, although he does prefer to wear pajamas of any sort instead of real clothes. Good thing we have lots of hand-me-down pajamas! He still treats his bed as his "safe place" (his crib at Harborview was his safe place -- nothing really bad happened in his crib -- he was always taken somewhere else for bad things). When he is really upset about something, he goes up to his room and snuggles up in his bed with his binkies and his latest toy of choice. He usually stays there for 15-20 minutes, and then he comes back downstairs when he has things sorted out. At this point I think that is OK. Now, if he is still doing it say, in 10 years then maybe we should get some counseling! At least about the binkie part!

Does he remember? Yes. He will be the first to tell you that his leg was on fire. I don't think he remembers much of what happened at Harborview though. Thank goodness. Does he have nightmares? Yes, but they are getting fewer. It is heartbreaking for Mom and Dad to hold him at night when he has woken up screaming and holding his leg. Some nightmares are too real.

Walter the Director

Walter has decided to not just sit back and let life happen to him, he wants to direct it. Last night for his bath and dressing change, Walter had to direct Daddy how and when to take off the dressings, get washed, get out of the tub, and put the dressings back on. Gone was the screaming, frightened Walter--he was OK with everything. He had to look at his leg this way and that--lifting it up and pointing to this spot, then the next spot. Also, I don't know if you have noticed or not, but he has not needed his binkies near as much as he did in the hospital. He is talking like he was before his burn. And best of all, this morning just after I had an awful conversation with the insurance company, he came walking into the living room and said, "Hi, Mom." What a brave little man. He made my day.

Tomorrow we will be heading back over the mountains for our first check-up. Hope it goes well.

Brothers enjoying a fun-filled gift basket. Thank- you!

Dressing Changes

Every evening Walter has his dressing change. From start to finish the dressing changes take about 1 hour. It is not the most pleasant process for Walter, but he is getting more used to it. I think he is tolerating it better at home than he did at the hospital. The process starts with preparing and cutting the xeroform dressings and the tubigrip stockinette. Then we get Walter undressed and cut off the old tubigrip with bandage scissors. As you can imagine, he does not like anyone getting near his leg with scissors, but it is better than pealing the dressing off. Next, Walter gets to have a long soak in the tub to get the xeroform dressings off. Some of them float off, others have to be picked off. It is not fun--much screaming and thrashing around. Once the pieces are all off, he is fine. After the bath we reapply his dressings, put the Beta-glucan cream on his donor sites, and get him dressed. Big breath....all done.

Here is a picture of his leg last night after his bath. It is looking better and better every day.


Here are three brothers having a screaming contest while eating "cicles" as they are called by Walter.

We continue to need prayer for Walter to start walking. After the first day, he has refused to extend his legs and put weight on them. I have been able to get him to stand for very short periods, but if you try to get him to walk, he collapses. I am quite sure he is physically capable of walking, but for some reason he must think he can't. If you have any ideas, please let me know.

As Good as it Gets

Waiting for the bandage takedown

Last week Dr. Pham said that in children they hope for a 90-95% take on the graft. Well, Walter's graft is as good as it gets. There may be one little spot that will slough and have to granulate in, but >95% of the graft took! There are no signs of infection. The donor sites are almost healed. Overall, we couldn't be happier! The next couple of days we will learn how to do our range of motion exercises, how to manage the remaining wound, and how to take care of the graft. Then we will be headed home! Yeah! (Have I included enough exclamation points?)

Walter was anesthetized for the procedure this morning, so he was not allowed to eat or drink after midnight. He of course woke up ferociously hungry. How do you tell a 2 1/2 yr old they can't have anything to eat or drink? It is difficult. Within 30 minutes of coming out of anesthesia he ate 2 ice cream cups, one ounce of Tillamook cheese, and started into the chocolate. A boy after my own heart.

Look Ma, new leg!

Graft #2 & Good-bye Ped ICU!!!

We are so done with Peds ICU! Don't get me wrong--we love the special care we received on pediatric ICU and the wonderful nurses, but we are glad to be back on the "floor". Walter's graft is looking wonderful. Randy was allowed to go in with Walter for the examination of his graft this morning so he snapped some pictures for me. Having never seen a skin graft at this stage before, I didn't know what to expect. The pictures are a little gory, but the attending surgeon is very happy with how Walter's graft looks. The upper part of his leg is black from the silver impregnated dressing covering the doner sites. The dressing is light grey when applied, but turns darker as the serum from the donor sites ooze out of the skin. So his thigh looks bad, but it is actually good. The silver has antibacterial properties and is used in a lot of burn wound dressings.

Dr. Pham, our attending surgeon, said today that if all goes well we may be able to go home next Monday or Tuesday! I about fell over in a swoon! That is very exciting news! I will try not to get my hopes up too much, but at least the end is in sight. Yeah! Please pray that Walter's leg continues to heal well and remains infection free.

It's a Ten Binky Hurt

Walter is sleeping now in ICU, but in the above picture, he was hurting so badly that he had to have all his binkies for comfort. The first couple hours after surgery were pretty sketchy as he was disoriented and in a lot of pain. It was hard to see him so distraught and painful. I would gladly have given skin off my own backside or thighs if I could have.


The surgeons decided to do a sheet graft instead of a mesh graft when they got into surgery. A sheet graft is better than a mesh graft because it will heal faster and look better in the end. The downside is that they had to harvest more skin than if they had meshed the donor skin instead.

Tomorrow the docs will anesthetize Walter again so that they can look at the graft and make any slight changes that may be necessary. They will also re-insert the NG feeding tube as that was the first thing Walter pulled out after coming out of anesthesia. (Remember my post from this morning?) This is the last time. If it comes out again I will not let them knock him out a third time to put it back in unless absolutely necessary....for this is what Mom has decided!

Wound Rounds

Ten o'clock is an unpleasant hour on the burn floor. This is the time when the Burn Team (surgeons, pediatricians, residents, and nurses) descends upon 8 East and look at the burn wounds during the scheduled bandage changes. By now, Walter is well aware of what is going to happen. Even though he is given a sedative and pain meds, his anxiety overrides the meds. I think that he is developing tolerance to one of the oral pain meds so that he doesn't get as much pain relief from each dose. We will be starting a different pain med today that will hopefully even out the peaks and troughs of his pain.


Today was the first bandage change after Graft #1. The docs were looking to see if the artificial skin, called Integra, was showing any signs of infection or tissue rejection. They decided that it was looking very good for this far after surgery. We will continue to have bandage changes everyday now with the Burn Team checking his leg on Wednesday and Friday. Hopefully by Friday we can try to get Walter to do some moving around on his leg.

I have some new directed prayer requests for Walter. Please pray that he will be able to deal with the bandage changes a little better, have less anxiety and pain. Also please pray that he will start eating soon. He has not eaten much of anything since his surgery on Friday. I have tempted him with every favorite food at my disposal with no success.

On a brighter note, Winona has learned that her hands can reach out and grab things. She is changing so fast. Luckily she is not crawling yet. That would be difficult with to deal with on hospital floors.

Graft #1

One down and one to go. Sitting here next to Walter's crib in the pediatric ICU, I can finally unwind a bit. Walter will be in the ped ICU overnight because he has a cough and is running a fever. They were having some difficulty getting his vitals regulated so of course Mom has had some stressful moments. His lungs sound good, but the docs are just being cautious. Tomorrow we should move back the burn floor.

Today they removed all his dead/damaged skin (about 500 cm. sq.). The area extends from his ankle to up above the knee circumferentially all around the leg. Then they applied an artificial skin that will serve as a matrix for the dermis (a layer of the skin) Hopefully, if all goes as planned, in 10 days they will go back in and harvest skin from his upper legs and graft over the artificial skin. The artificial skin has many benefits, but it also has some complications associated with it. Please pray that Walter's body does not reject this skin and that it does not become infected. Also pray that he does not develop pneumonia.

I know his leg will heal, and he will be walking and running again soon, but my mommy heart is very scared for his mind. His whole personality has seemed to change in the past 6 days. He has gone from and very loving and really rather calm little boy, to a very frightened and frantic little one. It may be normal for children this age who have traumatic experiences and long hospitalizations, but it is very hard for this mom to watch. I worry so much that he will never again be a trusting and happy little boy. I see him go into another place where no one can touch him or hurt him, and it makes me want to cry and take him in my arms and run all the way home with him. (OK, so at least a few blocks from the hospital.) The next 3 weeks, yes that is the expected stay, will be torture for his poor little mind. Please tell me he will not be scarred for life and that he will come to trust again.

So for now, thank you again for your prayers.

Sx scheduled for Friday Morning

Real quick as I try to get out the door headed for Seattle. The surgery is scheduled for tomorrow morning. I am not sure what time yet. They are planning on using a synthetic skin this time around . From what I understand, it is made from shark cartilage. If it takes well, it will make his final graft (from his own skin) look and work so much better. This is what the surgeons think will be best. Please keep Walter in your prayers tomorrow. I am already so nervous I can hardly keep the tears in check. (Note to self: KEEP IT TOGETHER!!!! Your boys need you to be strong.)

Wound Care 101

It's not very much fun for Walter or Mom and Dad. Luckily they have some good sedatives to help with anxiety and good pain meds. Although some of the skin is sloughing off, the tissue underneath is nice and pink. Yesterday right before I left to come home I got to help with the wound care and give Walter a bath at the same time. He was really sticky from all the medicine that he spit back out when it was forced into his mouth. I guess he is doing better today about just taking the medicine when it comes. He also walked 10 steps today! The first he has walked since Sunday. They have an excellent little therapy room for kids with a large fish tank full of tropical fish, big push carts, and lots of toys. He likes the colorful fish. He also likes all the ambulance sirens he hears day and night. He has to point out the window every time he hears one.

Here are some pictures of his wound yesterday.

We also got some good news today. The social worker came and talked to Randy this afternoon and said that since we are a "special case" they would make an exception for Winona to stay the night as long as they had a private room for Walter. Most of the time if someone called me a "special case" I might be offended! But this time I will take it and say "Thank you", and send up a prayer of thanks to our heavenly Father. So, life will be easier now. Thank you for all your prayers. I know God is listening and helping us.

Here is a picture of Walter resting with his ever present binkies and watching Dora--two of his favorites.

Fire or Water?

This seems to be the question we are asked by other parents of toddlers on the burn floor. So far two couples just stopped by our room and introduced themselves and told us their stories in the past day. It is sad, but comforting to know other people understand.


Walter had a relatively good night last night. He slept pretty well without too much medication. Last evening he was taken to surgery for escherotomy on either side of his right lower leg to relieve the pressure of the band of dead skin around his calf. His foot was starting to swell and turn bluish before the procedure and now it is pink, warm, and less swollen.

Winona got kicked out of the hospital, silly girl (hospital policy that was just today enforced). So since I am still exclusively breastfeeding, I have to head home and try to play a little catch up until Thursday evening when we (with Reid and Wyatt) head back for the weekend. Walter's skin graft is scheduled for Friday morning. We will try to get Winona to take a bottle, and I will bring back the pump--just like an ol' milk cow--so I can still spend some nights with Walter.

I took some pictures of his leg today during his wound cleaning so I will post them maybe tomorrow. Don't look if your are too squeamish. I think it is not too bad considering. Thanks again for all the kind thoughts and prayers.

Day 2 at Harborview

I finally found the public computers. There are only 4 of them in this huge hospital. Walter is resting now. He had his soak in the whirlpool where they changed his bandages and cleaned his leg. I didn't go in, but Randy did. He said it is looking no worse at least. The burn docs say we will do skin grafts either later this week or early next week. They will use skin from both thighs and possibly his bottom. The skin grafts will actually be much more painful than the burn.

My heart aches for him--he doesn't know why he has to stay in the room and cannot leave. He is pretty heavily medicated, but it keeps him from crying too much. He has his binkies and his light toy that he likes so much. He is actually much better off than most of the kids in ICU, but it gives me little comfort. The physical therapist is making a splint for his leg so he can start to practice walking.

Thank you all for your prayers and offers of support. We will be here another couple of weeks. I think Randy may go home tomorrow until the weekend as Reid and Wyatt are still in Colfax. I know Randy and I will be forever terrorized by the vision of Walter's leg on fire, but I thank God that it was not much worse. A matter of seconds and all his clothes would have been aflame. He still has some of his little cowboy boot melted onto his leg. Of all the strange things I think the loss of the cowboy boots is the saddest. All the boys wore these boots. I was going to save them forever. Maybe I still will.

Please Pray for Walter

A real quick note as I am rushing around trying to leave for Harbor View in Seattle. Please pray for our little Walter. He and Randy are in a medivac plane right now. Walter has 3rd degree burns on his right leg from ankle to knee. His pants caught on fire from a smoldering brush fire this morning. Please pray that he will heal quickly and will not have too much pain. Thanks, Wendy