Saturday, September 8, 2007

Failed extubation #5, but extubatable?

He tries, he really does. His lungs are pushing air through as they should and his heart maintains a steady rate, but his CO2 emissions shoot up, he retracts, sucking in his chest wall to get air through, in and out, which as you can imagine, isn't doing his healing ribcage much good, and after 45 minutes, they get a new endotrachial ("ET") tube ready, but...oh, wow, wait, he's not doing so bad after all, let's wait a few more minutes, he's crying, that's good, C'mon sweet love, mama loves you darling, stroking his hair, listening to the Drs laughing at his crie de chat, we haven't heard his voice for 8 weeks as the ET tube sits between his vocal chords preventing him forming sound, so the cries are bittersweet for us too, willing him on so badly, heart still beating steady, but mama, the look in his eyes, please help me, his lungs are collapsing, it's too much, no, let's call it, let's put it back in.

I'd like to say this is an awful one off, yet it's the 5th failed extubation in 8 weeks. 1. Upper airway obstruction, 2. upper airway obstruction (=throat surgery to remove obstruction), 3. heart failure (=cardio bypass surgery), 4. too early post surgery (=sprint), 5. upper airway obstruction.

Reuben is sedated as the respiratory therapist re-inserts a new ET tube. They look down into his throat. There's some airway obstruction, damn granulomas again!!!! lots of swelling. It's very red in there. There's some blood in his oral secretions.

He's extubatable. Lungs and heart are ready. Like his daddy, he's training has paid off. Two weeks of sprinting him, interval training, on and off continuous positive air pressure, the balloon effect, his lungs and heart have strengthened.

Weening him off the versed and fentanyl, sedation and painkillers. After 8 weeks of continuously dripped narcotics through his stomach Gtube, it's a difficult ween. The morphine is no match, but he has to get off them. He's often awake and alert, enjoying himself during the day and this is unusual for a baby under sedation.

Here he is today after he was sedated post the failed extubation.


MK said...

Again, we know that this seems to be the most frustrating part, hang in there. We bounced back and forth from trying to get Lucas awake enough to extubate, but kept comfortable enough with morphine. His chest really caved in off the vent but not as bad with just oxygen thru his nose (nasal canula), then weened him off the oxygen. Lucas also scared the nurses recovering in after a later surgery with his breathing; we almost had to convence them that that was kind of normal for him; though it is much better now since his last ml&b. Hopefully you'll see that beautiful face with no tape and tubes very soon!!!

ellen charge said...

wow at least hes trying

yp said...

Dear Catherine- another in a long thread of beautiful posts by you. Our hearts are with you - hoping for the very best and hoping for progress at the same time. Hoping for eveything and all things andstill holding everything we have with tender gratitude. So much love to you, Jason and Reuben always - stay exactly where you are, fully in the moment with your precious love - it's the only place that is real- oxo,y

Lisa said...

That's the thing about these kids, they only do things on their own schedule, when they are good and ready, no matter how much we want them to do things on our (or the doc's) schedule. Love to you all...

mobs said...

Its Mobs here, i am praying for you guys. I think with a name like Reuben Dodd he could play for Chelsea, Doddy we could stand on the Shed and watch him, if we could afford the tickets.

he has two of the best fighting his corner

Love Mobs XXX