A Rollercoaster Week: Day 3-5 – The Long Wait

Monday, November 5, 2007

The doctors decided to wait until Saturday (Day 6) to reattempt extubation. They hoped the 72 hours would allow any swelling to subside. To make that happen while the tube was still in place, they pumped her full of steroids to decrease swelling, which in turn caused her blood sugar to zoom up to 366 (steroids = Caro’s Halloween treat)! So, they also gave her insulin to counteract that – sometimes doing so too much, bringing her sugar levels down to the 40s. They also kept her on sedatives (Mommy and Daddy’s Halloween treat) to keep her from getting too upset about the tube.

This time, the ENT would attempt extubation using special sprays and scopes, to prevent any spasms and to see what was going on with her throat respectively. We really like her ENT and felt that he would do his utmost to keep her off of a trach. (He’d seen her prior to this hospitalization and knew that she had done just fine without a trach, a fact that most of the nurses and doctors here just couldn’t grasp).

The ENT did say that, if she couldn’t do well with this extubation, they would place a trach in the OR right then. So, to help prepare us just in case, he explained more about a trach and allayed some concerns.

He told us the following:
1) A trach is not permanent; it can be taken out when the doctors think she’s ready for it to go. Ninety percent of kids get their trachs out when they are three years old or 30lbs.
2) If a trach gets put in, it would be left in until a) swelling goes down (not long), b) all scheduled surgeries performed (by January), c) the winter (RSV season) is over, and d) her airway gets more structure and strength (???).
3) With a trach, she could still do everything she still does now – bottle feeds, physical therapy, tummy time, etc. Just no swimming.
4) A trach would not cause her to get sick with a cold or something more easily. It may get infected, but she could be given antibiotics for those infections.
5) Once the trach is removed, the scar left is very slight.
6) The trach comes with additional equipment (for suctioning and humidifying her airway).
7) With a trach in, performing her head surgery will be much safer, should we decide to go forward with that, because her airway will be more secure. Her recovery would also be faster (because it won’t be nearly as difficult to take her off the vent).

With that information, we spent a lot of time preparing our minds for either outcome on Saturday, and we began to pray for the outcome that would make her the strongest the fastest.

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