Extubation...Phew!

A bit of an eventful day, to say the least.


Judy actually came home last night since Jill was so heavily sedated that she really couldn't know whether or not Judy was there. Judy needed some good rest and she got it. "The best night of sleep in over a year."


Judy left for the hospital this morning before me. She soon called me to say that Jill had had a bit of a difficult night. Around 11:30 last night her doctor tried to install a PIC line up one of her veins to her chest. The PIC line delivers nutrition into the bloodstream. He had not real trouble getting the line in, but a second line met some resistance. The doctor tried for an hour and a half to get it in with no success. He thinks that the vein may have some scarring from her first hospital stay that wouldn't allow the vein to expand. So he gave up on that plan.



Shortly thereafter, each of her two IVs, one in her arm and the other in her foot, both failed. This may have been due to possible scarring in the veins. The doctor tried several times without success to re-install the IVs. Luckily, Jill's surgeon was making his rounds in the NICU at the same time (around 2:00-3:00 in the morning). He came up and decided to place the IV in one of her major arteries on her chest near her armpit. This isn't the ideal location, but accomplishes the same goal.


I got to the hospital around 11:00 am. Jill was sound asleep. Around noon, her sedatives were stopped with the hope of taking out her ventilator (extubation) to get her breathing on her own. At about 1:30 pm, the doctor, respiratory therapist, and two nurses pulled out the ventilator as Jill appeared to be breathing mostly on her own. After it was out, Jill would take a few breaths, but then suddenly stop. The doctor then placed the oxygen tubes in her nose along with a temporary mask. Her blood oxygen saturation levels, which should be in the upper 90s to 100, varied wildly. At one point she dropped to a 14 at which point the doctor said that her color was "dusky blue." I couldn't see the blue hue, but Judy did. Whenever Jill's breathing stopped, the doctor would squeeze a rubber bag to force air into her lungs. She must have returned to the upper 90s about 20-30 times, only to dip into the 50s and 60s several times. As you can imagine, Judy was horrified and had tears streaming from her face. I tried to remain as calm as possible and massaged Judy's shoulders to try my best to relax her. I may have finally loosened that darned knot…


The doctor at one point had become visually worried. Not good! He felt that putting her back on the ventilator could just result in the same sequence of events the next time her ventilator was removed. With the use of a stethoscope, we heard a gurgly sound within her lungs, which was likely fluid and sticky nasal drippings. He suctioned her nose, throat, and lungs several times. He was hoping for her to wake up enough that she would cough a few times. He eventually ordered the respiratory therapist to "thump her", which meant that she apply several hard pats on the back and sides with the hopes of loosening the stuff in her lungs. He would then suction the stuff and then repeat the procedure. After repeating a few times, her lungs sounded better, but he still wasn't convinced that it was going to work. At some point, however, Jill's breathing became more consistent and her oxygen saturation levels improved. This is when she began to turn a corner.


I'll take a break here to repeat what Judy said at this point. "That was the scariest hour and a half of my life!" While I agree that it was quite traumatic, I couldn't say the same was true for me. But it did rank up there with some other scary moments. I felt all along, well maybe not for the short time when she registered a 14, that she would either pull through it or at least get back on the ventilator for another shot on Saturday.


Well, under the close watch of her medical team and worried parents, Jill slowly began to improve. Every half hour or so, the "thumping" was repeated. Eventually, Jill was stable at close to 100 breathing on her own with the oxygen tube in her nose. She looked much more peaceful, yet swollen from the medications.


Judy is spending the night with Jill and I was just told that she has discovered that she can pull out the tube from her nose. So Judy and the nurse have to keep a close eye on Jill. Luckily, the blood oxygen saturation monitor beeps loudly whenever she dips below 90.


If everything goes well, Jill will hopefully be transferred out of the pediatric ICU into the children’s ward either tomorrow or Saturday. Until then, we have been asking and will continue to ask concerned family and friends to not visit Jill while in the ICU (due to potential illnesses, interruptions, and minimizing our stress). Unfortunately, some individuals didn’t heed our request and made it a bit more difficult and stressful for us when we had to turn them away. Please don’t be offended.


This recovery process is more difficult than either of us ever anticipated. Please hold up Jillian in your prayers and ask for continued healing for her. We fully expect her to return home and for her to not have to undergo any further surgeries. Our little girl is a fighter and God has been good to her and us.


Lastly, Katelyn has been doing amazingly well under the watch of our friend, Virginia. We are extremely thankful to her for her willingness to help watch Katelyn.