Page 45 of Grumpy

He’ll need to do evening jaw exercises and stretch session before going to sleep.

His sleep position is important. He should be on his right side to protect the prosthetic socket side from pillow pressure and keeps facial hardware off direct contact. Use the body pillow to support his back and to help keep him from rolling in his sleep. It might take him longer than it used to to settle, which is completely normal. Help adjust pillows, maybe the temperature in the room is too hot or cold for him but seems normal to you. It is okay to experiment so long as he doesn’t pull on a graft.

Medications

Pain Management:

Gabapentin 300mg - take 1 capsule by mouth three times daily (morning, afternoon, bedtime) for neuropathic pain. May cause drowsiness.

Ibuprofen 600mg - take 1 tablet by mouth every 6-8 hours as needed for pain. Take with food. Do not exceed 2400mg in 24 hours.

Acetaminophen 500mg - take 1-2 tablets by mouth every 6 hours as needed for breakthrough pain. Do not exceed 3000mg in 24 hours.

Skin/Wound Care Medications:

Mepitel One non-adherent dressing - apply to open or sensitive graft sites at each dressing change

Bacitracin zinc ointment - apply thin layer to any open areas twice daily

Eucerin Advanced Repair Lotion (fragrance-free) - apply liberally to all graft sites minimum 3 times daily and immediately after showering. Do not allow skin to dry out.

Hydrocortisone 1% cream - apply sparingly to graft sites as needed for itch relief, no more than twice daily

Prosthetic Eye/Socket Care:

Sodium chloride 0.9% (sterile saline) - use to clean prosthetic eye daily and socket as needed

Refresh Lacri-Lube ophthalmic ointment - apply small amount to socket at night before prosthetic removal or as needed for irritation and dryness

Refresh Optive lubricating eye drops - instill 1-2 drops in socket as needed throughout the day for dryness and irritation

GI/Bowel:

Docusate sodium (Colace) 100mg - take 1 capsule by mouth twice daily to prevent constipation. Increase fluid intake.

Omeprazole 20mg - take 1 capsule by mouth once daily before breakfast for GI protection while on NSAIDs

Mental Health/Sleep:

Sertraline (Zoloft) 50mg - take 1 tablet by mouth once daily in the morning for mood and sleep regulation. Do not stop abruptly.

Hydroxyzine (Vistaril) 25mg - take 1 capsule by mouth at bedtime as needed for sleep and anxiety. May cause significant drowsiness.

Nutritional:

Burn recovery high-calorie supplement - consume minimum 2 shakes daily in addition to regular meals. Target caloric intake 3,500-4,500 calories per day.

Multivitamin with zinc - take 1 tablet by mouth daily with food. Zinc supports wound healing.

Vitamin C 500mg - take 1 tablet by mouth twice daily. Supports collagen synthesis and graft healing.

Tessa: I know this is a lot. Please don’t hesitate to ask any questions. His stubborn ass isn’t going to let him ask for help, so it unfortunately is going to have to fall to you to watch for signs he doesn’t want seen. If I’m at work, I might not be able to answer you, but Bear is also available and I’ll get you his burn doctor information, too. Good luck, babes, and I’m so glad to hear the two of you are finally together.

CHAPTER 9

The warmth of sunlight across her face roused Kelly. She blinked, momentarily confused about where she was and why the sun would be touching her bed when her bedroom’s sole window shade should have been closed. Then she recalled the road trip.

The hotel Keys had reserved for them was nice. More expensive than anything Kelly would have reserved on her own, but not so high-end that she felt out of place daring to grace their lobby. Between the three of them, they had two connecting rooms, a king and a double queen. Each had a small kitchenette and a living room area. She understood it from Keys’ perspective. It would have been too crowded for the three adults to share a room, a waste of money to have reserved each of them their own room, and he likely didn’t want to make an assumption about Kelly and Grumpy sleeping in the same bed together. Keys had hedged his bets, and from her perspective, he’d made the right decision.