Post surgery cast issues and dehydration

Kayli has had a challenging week post surgery.  Once home, she was crying and  her heart rate was more than 200 bpm a couple of times.  Her right cast was very high up her thigh, and was causing pain.  Both casts caused skin breakdown within 24 hours.  The second night after surgery (apprx 24 hours after surgery), I took Kayli in to the ER to have the surgical team cut down her cast.  Once home, Kayli showed signs of relief, but her heart rate remained high.  We gave her Tylenol but her h/r continued to rise.  We started giving her more water than usual and we noticed that she was smiling more!  Friday, we gave her double the amount of free (filtered) water.  She continues to smile and is in great spirits, and her heart rate is slowly decreasing towards her normal range.  After looking at her feeding formation, I realized that her concentration was short of water.  The Dietitian agrees that her water intake was likely too low, then add on the stress of surgery and lack of fluids for 12+ hours...Kayli was dehydrated.  We are watching her closely and monitoring her Keytones and Blood sugar.  The first couple of days home from surgery, her Ketones were very high.  The Dietitian thinks it was because she was using her own body fat (Ketones) for energy since she was not getting what she needed externally.  

Tonight, Kayli is resting comfortably in her Tumble Forms seat, sitting in her therapy room, watching Mickey Mouse and Veggie Tales movies! <3  She has been smiling, and turns her head to check out the newly cleaned therapy room! 

Because Kayli's casts were hurting her, and because the casts are positioned awkwardly, I had not been putting Kayli on her potty.  She has not been stooling though, so I placed her on her potty, Friday.  She did not go.  Yesterday I put her back on and she voided (peed) and stooled (pooped)!  I put her on again a couple of hours later, and she stooled again! :D  This is a good sign of hydration, and constipation relief! 

It is good to see a resolution to the higher heart rates, and constipation.  Her heart rate is still higher than normal, but I am told it could take a couple of days until we see her h/r come down to her normal rates.  

<3