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Case file: Surgical recovery

Case file: Surgical recovery

A healthy 45 year old pilot sustaining serious blast injuries while helping evacuate a burning hotel in Mexico.  An explosion caused extensive damage to his right arm and forearm. He endured two reconstructive surgeries in Mexico, and a skin graft surgery at Vancouver General Hospital one week before starting hyperbaric oxygen therapy, in total four weeks after the injury.

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Admission status:  sharp and burning pain at the injury site, with a tingling and burning sensation of the first to third phalange, and numbness in palm.
Medication was hydromorphone 3mg 2x/day, Tylenol and Ibuprofen 4x/day.
Pain rating was 8/10

Hyperbaric oxygen therapy:

A course of 21 hyperbaric oxygen sessions, 90 min at 2.0 ATA was delivered on a daily basis.

HBO 1: One week after skin graft surgery. On Hydromorphone, Tylenol 3, Ibuprofen, Advil.

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HBO 3: Increase in pain after session, burning sensation in radial nerve distribution on hand (thumb, index, middle finger)

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HBO 6: Able to shake hands with his right hand

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HBO 7: Pain varied from 4-6/10, and at times 8/10. It would still wake him up at night.

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HBO 8: Increased range of motion, able to bend and straighten out arm.

HBO 10: Pain was at 3/10, and range of motion was rated 4-5/10.  Along with hyperbaric oxygen therapy HBO, physiotherapy was also used to help aid the recovery.

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HBO 12: No change in pain score (still 3/10) but he was forgetting to take his pain medication. Range of motion had increased to 5-6/10, the numbness and tingling sensation 3/10, and strength was rated 4/10.

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HBO 14: Range of motion increased, able to touch nose with his hand for the first time.

HBO 15: Pain management medication completely stopped including Hydromorphone, Tylenol, and Ibuprofen. Numbness and tingling decreased to 2/10 at that session.

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HBO 19: Pain had decreased to 2/10, and by the 21st session, range of motion increased to the point where could touch his right wrist to his forehead.

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