Jenna had another great night last night, she was what the nurses call a "rockstar". They decided to give her a bath and put her hair in pigtails, making them really tight and curly. So cute! During rounds this morning, they said that just wanted to let her rest, no major changes today and then possibly decide tomorrow for the plan of extubation. The attending doctor this week Dr. Johnson said that we had fought this battle twice already (extubation) and she wanted to "speak with the warriors" (other attendings, Dr. Lorts and Dr. Dent) about the plan, since they were here previously with her. They felt like she was holding a bit more fluid, so they gave her extra diuril to help pull some of that out, and boy did it help. They are still having to give her potassium, because every time she pees, she pees all of her potassium out, go figure. Her chest xray showed a little haziness, but looked good otherwise. They figured it was from the chest tube draining fluid. This is not going to come out for another day or so since she is still having fluid come out of it. So since Jenna was going to rest, Justin and I decided to take a break and go over to the RMH and do laundry and pick up. We were gone for most of the afternoon, but managed to make it back in time for rounds.
During rounds, Justin and I were thrown a curveball. They stated that they were planning for extubation tomorrow! They said that they felt Jenna was doing really well, they were able to lower her rate and peep pressure on the ventilator some and she tolerated. She is now breathing over the ventilator more which means she is doing it herself and not letting the machine do the work for her. Also, they said that they felt like there was no reason to keep the tube in any longer, because it increases her risk of infection. The plan is to extubate in the am and have the Bipap machine ready for her. Part of the issue previously when she was extubated was that one-they did not know about her diaphragm issue, so they were not prepared to immediately place her on bipap and two-her sedation was an issue, she was not quite awake enough when the tube was pulled so she had more issues. So, this time, she has been maintained very well with her sedation, happy for the most part, but anxious (this is due to her withdrawl issues). Also, she has now had her diaphragm surgery so her lung not expanding will not be an issue. They have also decided to keep the chest tube in until after the extubation, because it is keeping fluid from accumulating and also keeping her lung from collapsing from the fluid. So, this evening Jenna has been upset at times, but I try to calm her or Justin does. She is able to communicate with us by shaking her head yes and no, and sometimes points to what she wants. She tells us is she is hurting or wants to sleep or watch Dora. It is hard to watch when she is upset or hurting, because we cannot pick her up and she is scared. But I have leaned over on the bed more than once this evening as best as I can, to get to her. This has seemed to work for the most part. They have decided to turn her drips Morphine and Ativan down in half, then start her Propophol to keep her paralyzed for the night and then turn the drips off. They had to start this a little early because she became upset. So, these are going now and she seems to be in a happy place, just resting. So, in the morning the plan is to turn off the Propophol around 7:30a, and she should wake up quickly-10 or 15 minutes. Then they would like to wait close to an hour so that she is good and awake before pulling the tube, so that they give her the best chance. So, Justin and I are going to be here early in order to keep her calm until extubation.
We are both nervous, but hoping that she does well. At first, we were set back a little by the decision. But now after speaking with the doctors and discussing her progress, we feel that she is in a much better place this time around, then ever before. So, we are going to get plenty of rest this evening, since tomorrow is a big day. Please wish us luck and pray for babygirl lots. If we are successful, then we are one step closer to home. Let us hope and pray. Thanks to everyone for all of your support, we do not know what we would do without you. We will keep you posted as much as possible. Talk soon.
Love, Jenny, Justin and Jenna