ChloeWatts.com

Friday, Jan 22, 2010

January 22nd, 2010 Posted in Daily News Post

Wow, what a day! I arrived at 8 AM as we were scheduled for an 8:30 trach change. Dr. Cuyler was on board to do the change and we were to have versaid on board to manage the pain and take the memory away. RT was also supposed to be standing by but I guess they didn’t receive their invitation.

When I walked in the room everyone had just risen … and from what they looked like … maybe it was from the dead. Dana told me it was nonstop action from 4 AM on, with suctioning, bells and whistles and anything else that could rouse them. Dana left to take care of herself for a few minutes and Chloe pointed to where Dana sleeps and put her hand over her eyes. I said, “Mama’s Done?” She nodded, yes.

By the time Dr. Indy… I mean… Dr. Cuyler showed up everyone was more awake to handle the procedure. The versaid was administered and Dr. C got ready. Dana called for suction to be on hand as I was reaching for the 10 French suction. I called for lubricant as Dr. C got the new trach out of the package and the nurse had it in her hand.

Versaid works fast so it was time to go. The pad for the trach came off first, followed by the trach ties. Then it was time to remove and replace. The trach has a cuff, a plastic ball that is inflated in the windpipe to keep Chloe from aspirating. That is sucked down for the two-way procedure. However, there is still a flange that makes changing one of these more difficult than just a smooth one.

With an extra tug on the old trach it was out. Chloe was starting to panic, the versaid wasn’t working as well as it could, and I watched as the stoma closed. Dr. C was on it like a bee on honey. He opened the hole with the very end of the trach and then, with a Big Push the new one was in place. He’s the master and it took the master to keep this change from being a repeat of the last one. The good part was that it looked like the silver nitrate had done its job the day before as there was no granuloma visible.

Before the new ties went in place I was suctioning her. The blood was impressive but one drop of blood can turn a gallon of water red. So the looks were worse than the amounts. However, it freaked Chloe out, even though we assured her this was normal at her stage of trach use. We cleaned her up and gave more pain meds. She was at a 10 pain level by now.

Dr. C did say this is a hard one. Go figure… it’s Chloe. He said we wouldn’t do another for a month. That was good news for all of us. The longer in-between these changes the better for all of us.

Later I was online looking for a trach I had heard of that has a cuff and no flange. I found it and past the word I’d like more information about it and to know if we could get it. Dr. C left a message that they have ordered them in the past. I put a note on the board for them to order some for our future. They cost $179 online. Wonder what we are paying for them????

Because Chloe had been through so much we had Speech come to the room to do the sensory tests to try and wake up the mouth and throat? She has new sensations each day so we are all very encouraged. She also gets to taste food during these tests.

Next was her teacher. She also came to the room. Her lessons are going much better now. It was a rough start but I like what I’m seeing now. Hopefully the insurance company will let her stay in rehab so that we don’t have to start all over again with new staff and new procedures. It will be the first time ever if they give us an extension past the 30-day limit per year they allow for rehab. One more month would be perfect! Chloe is making great strides with the system in place. If the insurance pulls us from the program we will have to go back to acute care and do most of the PT/OT ourselves.

Although she didn’t really want to, I convinced Chloe she should get in the chair so we could go to the art studio with Katie. She likes that so it was one of those times that persuasiveness was a necessity. She had a good time and Katie actually kept her an extra 20 minutes.

Back in the room Chloe had to stay in her chair, as we were to leave again in 30 minutes to go to OT/PT. Due to a bathroom break we were a little late getting downstairs but there was still plenty of time. She got set up, Dana suctioned her, and the games began. She used the BattleBall with weight on it today. It’s like a two-ended paddle and she hits a tossed beach ball repeatedly. It’s a good workout for her. Then she did some weight training and fought through the fatigue. Finally it was to the walker. She would walk about 15 feet and then throw a small basketball into a small basketball net. Then she would walk again. She wore out after the third walk and we were out of time.

Back to the room we were officially done for the day. She had her workout for sure. The suctioning was still colorful but Dr. Shih dropped by to say that this was normal and we’d probably see it all day. By nightfall it was pretty much gone and with a new trach pad now in place things looked much better.

Chloe is still addicted to the Food Network and watches it nonstop while in the room. She is also still sending receipts to everyone she can. I do believe she won’t stop eating once this trach goes away and she regains the ability to swallow.

I left the hospital as they were settling in for the night. I’ll be back in the afternoon, as I’m teaching tomorrow around noon. I’m hoping Dana gets someone to spell her for a few hours tomorrow before I arrive. She’s trying to do some errands and we both forgot I was teaching today. Days just turn to mush at this stage of the game.

All in all today was productive. We have decided to give her the knockout drug before the next trach. That seemed to work best. We also had a great RT today who is very invested in his profession and shows it with his due diligence. His name disappeared from my gray matter for now but we’ll be recognizing him at a later time.

Be well,
Ron