What a thoroughly hellish day!
The nurses/RCPs extubated around 9:50AM, this time with a more thorough plan in place for how they would support Leah through this difficult transition off the ventilator. Within two hours, the doctor was already starting to question whether she would get to the end of the day without being reintubated. At one point he essentially said he’d give her half an hour and see how it went. She got a treatment of racemic epinephrine first, and then was put on continuous albuterol for a while, but that didn’t help. The rec epi seemed to help last time and helped today, so they put her on three treatments, once each hour. The first two treatments went well, and between that and Mandy sitting Leah up, she started to calm down a bit.
The third treatment was a nightmare. Leah’s heart rate shot above 200 and she started freaking out in her silent frantic sort of way (she still can’t vocalize because of the vent – will probably be a few days). It was crazy. I’ve never seen anything like it. It was too much for her.
It took her a while to calm down but she finally did. Not long after that, Leah’s chest drainage tube fell out. Seriously? Seriously. The thing was sutured in. Not sure how it came out, but they did an x-ray to make sure there was no problem as a result, and decided not to reinsert. It was going to come out soon enough anyway.
The silver lining to the chest tube falling out is that it removed a major barrier to Mamas holding the baby, which I think is something she really needed. She and Mandy had a nice sweet time and it really calmed her down. The methadone probably helped too.
“Wait – did she just say METHADONE?”
Yeah – there’s been some speculation that on top of her labored breathing, which is the result of her tracheomalacia and its exacerbation by the breathing tube, Leah may also be agitated due to withdrawal from the many sedatives and pain killers they have been pumping into her to keep her calm throughout the surgery and intubation. The methadone will help ease her off of the other meds.
Now, pictures. Once again, don’t let her seeming alertness fool you; this is a still. What you don’t see is that she was panting and wheezing and heaving the whole day. You could see her little shoulders bobbing up and down from the effort. And then there were the horrible voiceless hacking coughs. I think this might have been the hardest day so far, aside from her day of birth. I would post video but I don’t think anyone wants to see it.
“Oh Mamas. This is not fun.”
Look at that hair! Just want to ruffle it a little more.
“MOMMY? IS IT REALLY YOU? I MISSED YOUR ARMS SO MUCH! YOU SMELL LIKE MILK!”
“Let me tell you ALLLLL about how much I missed your snuggly arms.”
“Mama – Mama, you’re getting this, right?”