Thursday, March 1, 2018

Post-Op Day 8, Trach Change Day

Hi! Well, today was a better day than yesterday, for both Harlie and me.

They were able to get some fluid off her, so she seemed a little less puffy.



My friend Sally came again today to hang out, which was great.

Last night (Wednesday) my brother, Bruce, came to visit. Forgot to get pictures, darn it! He took me out to dinner, and then took me back to the RMH. Before we left the hospital, I met the night nurse and she saw that I was working on a puzzle. She said she loves puzzles too, and would call her roommate (who works at the hospital, too) and ask her to bring me one to work on when she came to work in the morning. And she did...


And our friend, Mike, surprised me this afternoon.


And Dr. Preciado came to do her trach change.




That went fine. They were able to put in a longer trach without any problem. He explained that he made a vertical incision for her new trach site and that incision has gotten longer. In other words, the stoma (hole) has opened too much. This probably made it easier for the trach to come out the other day. And the trach was cuffed at the time. 

The cuff is a balloon on the cannula, that when inflated, fills the gap between the trach tube and trachea. It is very hard to ventilate a patient when there is air escaping around the trach and not going into the lungs. 

So, I'm guessing the opening got pretty big. 

Anyway, the stoma is not healing great. So, they are going to do "wet to dry" dressing changes in that area. Basically, they are going to pack saline soaked gauze into the exposed hole around the trach to promote healing. 

He also said that based on how it looks today, she needs more time to heal with the ET tube in her nose as a back up airway, and as a stent. So, instead of Tuesday, they are shooting for Friday, March 9th, which will be Post-Op Day 16! He also said that they might do everything bedside instead of taking her to the OR. Transporting her to the OR will not be easy given everything that will have to travel with her. So, he's going to have to think over what they gain/lose by being in the OR vs. bedside. 

They are going to do their best to keep her comfortable on the lowest doses of sedation/paralytics possible. They are hoping that she can be kept more sedated vs. paralyzed. So, the plan for today was to cut her paralytics in half and see how she does. This is a delicate balance. I think in simplest terms, sedation keeps her asleep and the paralytics are a muscle relaxer that prevents her from being able to move. And to make things more complicated, the doses have to increase as she gets used to them. 

Not moving for 16 days will be very hard on her body. In Boston, she was on paralytics for 8 days, and it took a toll on her. She was so weak for a long time after. But, her moving her head and neck before her airway can heal is not an option. So, they have to do the best they can at balancing everything until then. 

My friend, Lindsay, came up to visit today, too. 


We hung out for a couple of hours, and then the three of us went out to dinner. 


I felt a little less sad today than yesterday. I guess I was probably more scared yesterday than anything else.  It seems that we are one misstep from devastation, and that's just really hard. And watching her nurses work their butts off taking care of her everyday is hard, too.

But, Sally, Mike and Lindsay all did a great job keeping me distracted today. And Tom will come up tomorrow after work, so that's good. 

Well, it is late and I need to get some sleep. Thank you all for your continued love and support.

Much love,
Christy xoxo

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