Devin has had a significant increase in the pain in not only his right ankle/foot (which is expected post surgery) but also in his left foot. In fact the pain in his left foot has reached unbearable levels, well beyond the post op levels of the right foot. One of Devin's surgeons, Doctor Novak postulated that it could be due to the extensive nerve damage at least in part in the ankle region, possibly in the sciatic region as well. The severity of the pain that Devin has been experiencing is very difficult for someone to comprehend who has not had the opportunity to experience that type and degree of pain themselves, so they often think of his pain in terms of their own experiences with pain that leave them somewhat apathetic to his current condition... Having suffered severe pain myself (Broken neck, back, calcaneus, leg, foot, skull, and other traumatic injuries resulting in nerve damage, to name a few...) it is very difficult to be patient with apathetic care givers.
One of several types of pain that Devin has had aside from the more normal pain one would generally associate with a broken bone is what is referred to as Nociceptive pain which occurs when pain-sensitive nerve endings called nociceptors are activated or stimulated. The doctors in the pain management team were unable to bring Devin's pain into bearable levels resulting in several sleepless nights. After considerable and very consistent 'discussions' with the nurses, head of the nurses, surgeons and the entire pain management team we were finally able to convince them to try a procedure called a "nerve Block". Basically Nerve blocks are injections of anesthetic around the fibers of a nerve that prevent (or 'block') the pain messages relayed along the nerve from reaching the brain. They may be used to relieve pain in specific parts of the body for a short period; a common example of this type of nerve block is the lidocaine injections given by dentists before drilling or extracting a tooth. Some nerve blocks are injected in or near the spinal column to control pain that affects a larger area of the body; an example is the epidural injection given to women in labor. The doctors were at first adamant that they never preform the nerve block procedure prior to surgery for a variety of reasons, so Devin must be the first, at least in the history of Harborview. That procedure helped enough with Devin's pain that for the first night since his surgery on Tuesday, he was able to sleep pretty much through the night.
Below are a series of X-Rays taken during Devin's surgery. These X-Rays show the procedure done to his right ankle on Tuesday September 9: