Ketamine

Yes, that's right, that "date rape" drug we've all heard about more than we should have from television.  That's what they used on my son today as anesthesia.  It is a fine medication, when used as designed.  My son had a single injection in his leg and in just a few minutes he was nodding off in a "twilight state" of sedation.

The doctor was then able to open and explore via a small incision the abscess on his shoulder and the possible abscess on his cheek.  He flushed out both areas and packed them with some strips of sterile cotton. 

Follow-on treatment is for us to remove an inch of cotton packing each day and trim off the freshly removed portion.  For his cheek, there are only about two days of packing (i.e. two inches) to be removed and that may well fall out on its own.  The shoulder area the doctor made sure to explore extensively, because any pockets of puss remaining could cause the area to become re-infected.  We will be removing packing slowly over the next week or two.

The reason for this slow packing removal is so the incision site won't close up before the underlying area has had a chance to complete draining and filling in/up.  Children heal so quickly that this will certainly happen if the packing is removed shortly after the procedure.  There has been research that shows the treatment of unpacking and repacking didn't add to the healing time or final outcome (and it annoyed the child to boot.)

Back to the ketamine.  I was told there were some interesting side effects but not to be concerned.  Basically, ketamine is a hallucinogenic that induces a dis-associative state so that the child won't feel pain and won't remember the event.  It worked exactly as advertised.  The side effects became apparent as he was waking up about thirty minutes later.

He was decidedly woozy and didn't have good control of his muscles initially but his eyes, wow.  He would open them so wide, suddenly, and stare fixedly at the ceiling or the wall or something somewhere or nowhere and you could tell he was looking at something, only there was nothing there.

The nurse would ask him if he was seeing Big Bird but he was too busy marveling at invisible colors or Elmos or who knows what to respond with anything other than his favorite word, "no."  It was so interesting to watch, but it was also a relief to see him come back to normal consciousness shortly later.

As we left, he wasn't able to walk or even sit without assistance because he didn't have full muscle control.  He tried to hold the foam football and Dr. Seuss book the nurse gave him from the "Prize Room," but he just couldn't manage it.  On the way to the car I fervently hoped I could find the key without having to put him down.  His trunk was swaying left and right and people were looking at me like I was carrying a drunk child.  I was never so glad to see the stability of the car seat and get him situated.

Then, it was "ChickenFries" all the way home.  He couldn't have any food or drink after dinner last night and he quite was hungry now that it was after eleven o'clock in the morning.  Once he'd eaten some nuggets, fries, apples and milk he was back to normal.  Now, he's busy and happy and not one bit sleepy as he should be this time of day.  And we were so hoping he'd take a long nap.

The Big Boy Update:  Lanced and Ketamine.  We went to the pediatric surgical ward at the hospital today to have his abscess drained.  It went very well and aside from a visibly bandage, you would have no idea anything happened to him. The Ketamine anesthesia (see above) was great for him and involved much less medication and time than full anesthesia. 

The Tiny Girl Chronicles:  Destructor.  Their play room turns up a mess each morning after they get up and play before breakfast.  I thought this was largely due to her older brother, but no, I saw what she was doing today.  She drive-by wrecks everything she can get a hold of, even if I've just cleaned it up from her wrecking it two minutes before.  I had a discussion with her about putting up the current toy before playing with the next toy much to her dismay and indignation.  My husband said he thought he remembered our son going through a phase like this a while back.  Just when I thought she was the sweet, innocent one of my two children, she turns out to be a troublemaker.  

Someone Once Said:  Let us all preserve our illusions; it lubricates social relations.