x-tubated

So it was a very long night...

I had hoped that it would be a long peaceful night since the plan while Caelan was intubated was to keep him sedated.  Well, Caelan has a very good memory when it comes to narcotics and having just been on a whack of them for a week, he was more than prepared to start back where he left off.  His infusions were set up at a minimal rate and they were hoping that with the addition of some nice sleepy time drugs they could keep him fairly settled.  If not, there were those boluses, or extras, that he could get once an hour.  I don't think once, all night, did we go that full hour without having to top him up with something.  By early this morning we were knocking him with everything we had to give him and then paging doctors for the okay to give him more.  At once point it took three times the prescribed bolus to keep him on the bed!  Remember that's in addition to a bunch of sleepy drugs too.  Caelan wanted that intubation tube out.  Nobody can say that boy is anything but committed to what he wants.  We managed to hold him off until 8 o'clock this morning.  I guess he'd overheard the plan for a "first thing in the morning" extubation.  We herded the team together and as easy as that the tube was out.

It was my hope that once the tube came out, Caelan would breathe a huge sigh of relief, say "wow, does that ever feel better" and we'd be on our way.

Unfortunately, it didn't quite go down like that.

He did have a huge sigh of relief.  He looked great.  He sounded FULL of gunk.  He was still pretty dopey, despite not having enough sedation to keep him completely settled, he was far from alert.  I spent the next couple of hours changing his position and trying to get him to cough some of that gunk out.  This entire time he had no difficulty breathing and showed no sign of distress.  Physiotherapy came by to do some chest therapy and we ended up suctioning out tons of gunk.  This however, did exhaust Caelan and resulted in some more laboured breathing.  Bring back the c-pap, the b-pap, the epi's...  ugh.

What does this all mean?  I don't know.

It could mean that he should go back into the operating room and they should remove a little bit more.  It could also simply mean that the surgical site is still slightly inflamed and needs some time to heal.  It could mean that we just have to wait for more of those sedatives to get out of his system.

Full of questions once again... or is it still?

That's where we're at headed into another weekend... again.