In true Erika fashion, she struck a deal with the doctor. They had anticipated her being on the ventilator for 24 hours after second placement and had no plans to do it before then. What they don’t know yet but I think are quickly learning, is how persuasive she is. Even without the ability to talk. While intubated and awake she had the ability to write on a dry erase board again just like she did yesterday. Today she wrote the normal first things you’d expect... “I love you”, “mom” and asked about her dog “Apollo” amongst other things. She communicated her own anxieties about her breathing and how she was doing and the nurses continued to reassure her that she was doing well. She then started writing to ask about time... “tube out”, “how long”. She then wrote “I seriously need this out” just in case anyone was questioning how badly she wanted that breathing tube out. That’s a long sentence! ????
They did a breathing test where the turn off the ventilator that was breathing for her and she breathes all on her own but still has the vent in place. (They did this yesterday prior to extubation as well). Her sats continued to look good while she was breathing all on her own. They drew labs to see how well her blood levels are which indicate how well she is breathing in O2 and off CO2 and those looked great as well. Then they brought the doctor in who told her he was very pleased with how well she’s done today and she wrote “I desperately need this out”. I think he was impressed because then the negotiations started. The deal she struck with the doctor was that if she has issues again, they will have to put a tube through her nose and into her stomach while she stays awake, without being sedated. She gave him a them thumbs up.
SO... they extubated her and she’s BREATHING on her own again!
They aren’t exactly sure what causes the problem last night, which is why they wanted to be very cautious today and moving forward. There was some discussion about her stomach contents from the food they had her eat yesterday, but they can’t be certain. Another reason they want to continue to cautious moving forward is because of this uncertainty. They did give her Benadryl last night due to her severe itching (lots of different medications can cause itching), but they don’t think this did it either. It’s likely a combination of factors and maybe simply that her body was working too hard and needed a little more time to adjust.
Right now she is concentrating hard on her breathing, pain management (which has been a bit of an issue again today), and managing her anxiety. She really wants to do well and is pretty hard on herself when she feels she isn’t doing something right despite continued reassurance from the team and all of us that she’s doing so well.
We are thankful for the positive leaps she’s taken today and hope for continued forward progress. There will likely be a few more bumps in the road, but hopefully none quite this big. A walk may be on her agenda for tomorrow! ??????????