Wednesday, November 20, 2013

Never Dull

Ginny is a very articulate 3 year old.  Today I was reminded of a conversation we had nearly a year ago, a variant of which lasted a couple weeks.  We had attended a reunion of the 4/23 Infantry Recon Platoon at Ft. Benning, Georgia, which was also the place where I took my Airborne training when I was in the Army. Ginny was very impressed with the aircraft mock-ups and loved to talk about them.  She had asked Rachel about why we jumped out of airplanes.  Rachel's answer was something like "Daddy and his friends would jump out of airplanes to go fight the bad men...."  Something like that.  I didn't hear it, but the conversations that followed went something like this: 

Ginny: Daddy, when I get bigger I want to jump out of airplanes.
Daddy: Ok, Ginny.  When you turn 18, I promise we will jump out of an airplane together.

A few days later...
Ginny: Daddy, when I get bigger I want you to teach me how to fight.
Daddy: Ok, Ginny, when you get bigger I will teach you how to fight.  But more importantly, I will teach you to fight when it's appropriate.
Ginny: Ok Daddy. 

A few days after that...
Ginny: Daddy, when I get bigger I want you to teach me how to fight when it's appropriate.
Daddy: ?

Today I told Ginny that I wouldn't need to teach her how to fight.  She already knows.  Today's plan was to wean Ginny off the nitric oxide (done), to get her breathing mostly on her own with only a little support from the vent (done), and to get her meds adjusted and ready for extubation in the morning (done, sort of).  Extubation was supposed to happen just before shift change at 7 a.m.  

As the stuff in her lungs continues to break up, she starts going into coughing fits.  There were a couple in the morning that we suctioned away the junk without incident.  After lunch, stuff got real.  She went into a coughing fit that required multiple passes of the suction tube.  This was accompanied by wild thrashing and a considerable amount of vomit, sprayed all over my arm.  It also required that I hold her down by her forehead while our awesome nurse Tiffany (only one of the awesome nurses we've had - including Pam and Laci and Tony and Renee) ran the suction tube down her ET tube.  Her face was red as a beet, mouth wide open in a silent scream, and tears running down her face.  It was heartbreaking. 

This happened a second time, shortly before dinner, only this time it was Tiffany, me, and Rachel holding her down while our respiratory therapist, Jesse (a dude about 5'10, 250 pounds with legs hanging out of his arm sockets) ran the suction catheter down her ET tube.  At least this time we were able to catch the contents of her stomach with the other suction tube.  After we got Ginny settled down, I heard Jesse say to Tiffany "Damn.  That kid is strong." Told you...

The third episode happened just about an hour ago with me, Rachel, and Pam handling Ginny while Sarah our RT handled the suction.  The green vomit added a nice touch this time.  My mother watched and then helped us get Ginny cleaned up while she gave us all the stink-eye for putting her through that. Then we gave her methadone and she went to sleep.  Mom's comment: "Parenting isn't for cowards." That's when I realized where Ginny gets all that fight.  Rita Horn.  If you're a member of my family, you know exactly what I mean.  If you're not, I can only say that Rita was my grandmother on my mom's side, and simultaneously the sweetest and the toughest woman on the planet, from 1922 - 1997. 

In all the commotion, it looked like Ginny's ET tube had moved slightly.  She was breathing will through the vent - it was only providing 5 breaths a minute, and 45% oxygen.  Saturations were in the low-mid 90's.  All on track.  So, rather than try to re-tape the tube (which no doubt would include a fresh batch of vomit) only to have it removed in the morning, the docs have decided to discontinue her feeds now and extubate in about two hours, provided she stays stable for those two hours.  It's looking good so far, so maybe by morning I'll get to hear my little girl's voice again.  

AS I finished typing this post, Rachel ran into the Ronald McDonald Family Room to get me.  I went into Ginny's room and we removed her ET tube.  Ginny is off the ventilator and doing great.  She's on oxygen support through the nasal cannula.  Maybe we can get some sleep tonight...  

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