Friday, February 11, 2005

More mixed blessings

Today was a good day. Really.

There were some not-so-perfect moments but overall it was an excellent day. As Jen would say, 'You have to redefine your notion of success...'

Bad news first:
Mom failed extubation today. It was a valiant effort, but it just wasn't time. The problem wasn't that she couldn't breathe, but more that she couldn't cough. The broken ribs are just making it too hard for her to get a really excellent cough going and so the goo was backing up right away. Because neither the ribs or the goo is going to change any time soon, this means that the time has come to proceed to tracheostomy. We had a nice chat with Dr. Sievers today and that is on deck for tomorrow. The good thing is that it is a much easier procedure in some ways in humans than animals (for the vets reading along) and can be done at the bedside with minimal muss or fuss. It does require general anesthesia, but that can be short-acting in type. After the tracheostomy, they would put Mom back on CPAP (assisted ventilation) for a while and then would see if she can transition to a 'trach collar.' This would blow moist air past the tube and allow her to breathe on her own.

In this way, we sort of get the best of all worlds:
Mom gets to get the tube out of her mouth, the tape off her face and she will be able to close her mouth. This will be a Godsend for being able to heal the nasty woundage in her mouth from having it open so long. In addition, she can then speak and tell us if her neck is okay which will allow them to remove the collar. This will decrease itchiness and achiness. A huge bonus will be the ability to decrease the level of restraints- enormous for comfort and morale. So- we are disappointed yet excited about how this could help things.

Good news:
Mom has improved tenfold over the last day or two. Today the swelling in her left arm is almost gone- just a bit of heat and swelling still burbling in her elbow, some blisters on her forearm and between her fingers. The swelling in her right arm is stable and more lines were removed on that side today. The swelling in Mom's face and legs is also moderately improved and the bruises continue to leach away.
More importantly, MOM is coming back. She is awake a much greater percentage of the day and generally interactive. She was single-mindedly pulling her hands toward her face and we finally figured out that she wasn't going after her ET tube but wanted to feel her swanky new haircut, scratch her head, and clean her eye. She also managed to slip her arm around Roland to hug him close (a challenge for Roland to accommodate without suffocating her). She has started sharing her interests in her gifts and enjoys holding her sunshine toy (thanks Nicole). Roland gave it to her and showed her that it squeaks and asked her to throw it to Glenn. Mom threw it toward her feet and smiled. Such a precious gift for us to see a glimmer of her humor.

The doctors were so kind today. Dr. Sievers really took time with us to chat before the extubation and again after she failed. He and I had a really good talk, and he is definitely getting inured to my hugs (actually quite a good hugger when he puts his mind to it)! Dr. Brown also took time out when he saw me to remind me that this isn't a step back per se. Even when he recognized that I was okay with things, he really stayed to chat a minute and reinforce our progress. Superkind.

I am going to attach a few pictures for you of our world. Also, tomorrow is the parade and perhaps there will then be pictures of dancing dragons.

With love from an ox in the year of the rooster-



Blogger Nicole said...

Hey there family afar, I am about to leave for a short weekend in Steamboat- while Mike learns how not to kill himself driving at ridiculous speeds on ice, I will be escaping into fictions unimaginable under the blankets of some unknown bed and breakfast. I look forward to the time away. However, I will be without my computer so you will be hearing from me by phone- sorry to be so annoying. It is hard to be away from you guys right now- I think of you often. I am glad that Pam was able to appreciate the sun. Only the mother of a veterinarian would be so lucky to receive a squeak toy as her very first comfort. You have to admit it, the thing is pretty darn cheery, eh? I am sooo happy to hear that she is able to interact so much now. As scary as the trach is in concept, it will truly be a blessing to have those tubes out and give her a chance to be herself again while she convalesces. Just think of how scary it is for our clients to agree to have a feeding tube placed- and yet all the benefits that are derived from them. I am with you all the time- just a phone call away. Love, Nicole

11:02 PM  
Blogger Vanessa said...

Hello everyone, I am so very pleased and encouraged to read about Pam's progress. It really is a miracle. I think of all of you many times throughout the day and anxiously await the next update. I'll be sending more cards soon. Please give Roland an extra hug from me.

Love and peace,

7:55 AM  
Blogger Lanena Moore said...

I'm really getting the hang of this computer now. This is great that Pam had a very good day. I'm sure she will feel so much better without all the "stuff" on her face. She probably has things she wants to communicate. Jacqui, you are doing such a fantastic job. Thank you for keeping us informed. Please give Roland a big hug for me. Tom & I are praying for you all.
Lanena Moore

5:28 PM  

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