Hey all, big milestone yesterday. Micah is extubated from the ET tube!!
This means a lot of good things…
- He doesn’t need to be heavily drugged and/or paralyzed.
- His heart is working well (his oxygen saturations are UPPER 90s or even 100%).
- His lungs are working well (even his left lung, if you can believe it).
- He’s strong enough to start breathing on his own.
Where we left off…
Since the surgery, the doctors and nurses (and us, whenever they ask for our input) are working hard to find the right level of medications for Micah. Since he’s mostly knocked out, we’ve gotten some restful nights at the RMH (the Donald Home, as Dylan says).
Wednesday, July 27, two extubation attempts.
When I came in the morning, Micah was moving a good amount. Mostly just his head, shaking right and left, like he’s emphatically saying “no.” The nurses were practically pinning him down so that he didn’t move too much. Obviously, being this is not a sustainable situation, the fellow came in and things just escalated from there. The attending decided that it could be a good opportunity to extubate. 9 times out of 10, extubating attempts are super tense for Micah. No exceptions today.
The first attempt was initiated because Micah was alert - which was good. The room was full with people and the respiratory therapist was at the stage just prior to pulling the tube. She was using a bag to see how much Micah was breathing on his own. At this point, Micah coughed a lot (which is good) but as they were suctioning him, they saw a lot of old blood come up. They weren’t entirely concerned by this - but as they realized how much liquid is still pushing on his lungs, they decided to cancel the attempt. Though we were unsuccessful, I was feeling motivated that Micah got all that junk out of him. They decided they wanted to attempt again later today.
On the second attempt, the timing of it was initiated more based on the doctors schedule. Micah was actually knocked out and tired from all his medications (which they gave between the first attempt and now). Go figure, the one time we don’t want him knocked out - he is. The team was really patient with Micah - but since he wasn’t awake enough, he wasn’t making much attempt to breath on his own and they couldn’t pull the tube.
Laura and Dylan were here at that point - so I was able to take a break from the hospital for a while. To be honest, I was surprised how discouraged I got from the two failed attempts. Thankfully Laura was able to take over and I was able to hang out with Dylan.
Thursday, July 28, Extubated!
Laura was with Micah in the morning and, being that all signs were good (drugs OK, lungs OK, etc.) they went into the extubation attempt right after rounding. It went really well! Laura described it saying:
“I was sitting there, texting you that they were about to extubate, and I looked up and everyone was already standing around. So I asked if this was really happening... and it was! They just pulled the tube right out! It was very calm and everything.”
Micah went to CPAP because they want to be able to push air pressure into his lungs, to combat against all the pressure against his lungs. In a way, it sounds like the doctors want to be overly cautious (given his previous couple weeks). He’s been doing really well so they started to wean down the pressures and settings. Soon enough he can be on a nasal cannula, like he was at home.
Here’s a little video to get an idea of how good he’s doing!
Friday, July 29, today
I got here this morning shortly after Micah woke up. He’s much more awake, alert, and interested in things. During rounds, the doctors decided to push for a lot of progress today - which is definitely exciting. They want to pull out his chest tubes (he started with three), wean his drugs (we’ll keep a close eye on him, don’t worry), pull out a line that’s going into his neck and keep weaning on the vent!
Here’s the sentence you all really wanted to read: he’s cleared for having water!
Here’s a video of Micah drinking some water...and even helping his stuffed animal have some too. How thoughtful :)
We're still working on our thank you letter to Dr. Frank Hanley (see the end of the last blog post). We have a list of over 100 friends and family. We're going to need to find a big card.
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