Once again, Tori and I went to the hotel last night because Cannon was to be sedated all night. We usually leave just before midnight, walk to the Marriot, and come back by 5:something. We had a big debate about whether to go to the hotel last night; Cannon had been alert quite a bit and sedation had been removed so we knew it was likely he'd be awake at points through the night. Before surgery, we'd promised Cannon we would be next to him at all times since his major fear was being alone. We discussed this with Tracy (on-duty nurse for the night) and asked her to do her best to keep him as sedated as doctors orders would allow. This would allow Tori and I to get some rest and be ready for a long day today. We had a long day planned: remove the atrial line in the heart to monitor pressures, the center chest tube, and the breathing tube, then start drinking very small amount of fluids. It was an aggressive plan that we supported 100%, but we knew it'd be a long day! So on our arrival this morning, our first question was "Did he sleep all the way through the night?" He didn't. And he didn't like that we weren't there. But, grandpa said when he was in ICU he didn't remember anything, and I think Cannon was so doped last night he won't either.
Despite the incident of waking last night, everything else was great when we arrived. He'd endured a pressure trial through the night with no problems (the ventilator is put into test mode and Cannon is in charge of breathing on his own). And during that trial, his body's gasses were great... he was processing oxygen correctly. At around 7, the team of doctors did their normal round and heard about the details for Cannon's test results. Their decision was to proceed with removal of the atrial line this morning.
This is a good thing, but there's risk involved. The line is a sensor that goes straight through the skin, through the wall of the heart, and into the atria (it was put in during surgery). The line is put in in such a way that it's removed by a little tugging, but Cannon doesn't have to be opened up. However, when it's pulled out the heart could bleed into the chest cavity. Not a huge deal since there's drain lines leading out of his chest, the blood can escape the cavity and not put pressure on the heart. And if the heart does leak they have blood at the bedside in case they have to do a transfusion. If it's REAL bad bleeding, they also have an OR in reserve in case they need to open him back up to sew the hole closed. Because of the risk involved, Tori and I were asked to leave. Of course, we put these situations in God's hands, and God delivered as usual. After 30 minutes they called us back up... the atrial line was removed, there'd been no appreciable bleeding, the central drain line was removed from his belly, and the right & left drain lines were disconnected from the collection machine and fitted with small collection bulbs (this allows him to be mobile while still having chest tubes).
For this procedure, they'd given him a heavy painkiller and a narcotic for sedation. This would keep him calm during the procedure (I picked up during a doctor round that Cannon was still alert enough to beat on the bed during the procedure, glad we weren't there for that). So after the atrial line was removed, we were back at the beside and Cannon was dead to the world. Just so happened that there was a procedure that had to be done on the baby next to us, and since his bed was close to the door, we wouldn't be able to leave during the procedure. Further, our nurse was needed for that baby's procedure and couldn't begin to wake Cannon up for the extubation (removing the breathing tube). So we got locked in next to Cannon, who they kept on the sedative to keep him asleep while the other baby was worked on.
Once that was complete, we needed to get the breathing tube out (extubation). The sedatives were stopped (about 10:30) and Cannon started waking up over the next hour and a half. He would wake up every few minutes and mouth what he needed (water, get rid of this tube, untie my hands, etc...). As he became more alert, I warned him that what we were about to do would hurt, wouldn't be fun, would feel weird, would be very scary, and he had to be awake. He handled the news OK, but didn't want to go through it. At 12, he took a serious turn toward consciousness... he began beating the bed and struggling against his restraints, crying without making a sound. It was clear he was in pain all over and couldn't stay calm. We were warned this would happen and this was the point at which we'd extubate. Performed a couple quick tests (pull my finger, lift your head) to make sure he was sober and would be able to handle breathing on his own. He was. The respiratory therapist disconnected the ventilator, pulled the tape off Cannon's face, pulled the tube on the count of 3 and my son could now make noises! Greaaaat.
The first 5 minutes without the tube was TOUGH. Cannon was scared to death, with a severe "What's happening to me?!" look in his eyes. He needed to cough but couldn't, and needed to breath but couldn't because he was plugged with mucous. The respiratory therapist had removed a bunch of mucous before removing the tube, but a lot remained. As a daddy, I was concerned about the stress on a newly rebuilt heart. I watched his heartrate shoot up to 140+ from 100 and blood pressure got high as well. Like rebuilding a motor and immediately taking it to the racetrack for full-speed runs. It works, or it don't. Cannon's heart did fine. After much crying, this time with sound, a couple of muted screams, he finally just wore himself out and fell asleep. He finally got the idea that the moving was causing the pain, and sitting still helped. He's still full of needles, tubes, wires, all covered in tape that pulls against your skin when you move.
So the tube's out, and the next challenge is to get him to last 4 hours without anything to drink. Knowing that he was dying of thirst before the tube came out, we knew this would be a tough four hours. Nothing a little prayer couldn't solve. Once he calmed down, he fell asleep. He would wake periodically and watch TV, then fall back asleep. The next thing we knew, four hours had passed and he never asked for a drink! He got an X-ray, they saw no issues, and allowed him to take in fluids for the first time. His throat hadn't seen moisture since Friday, so he really enjoyed that first drink. He was rationed to 1 oz per hour. Tori warned him that was all he'd get, so he decided to drink half and save the rest for later. He's 6. I'm 36. He's tougher than I am. Sad.
Through the afternoon, he progressively became more agitated, to the point at 7 PM when we got a new nurse, she immediately decided to give morphine. He wasn't in great pain, he just kept saying he was uncomfortable. I wonder why. You've got a 8-inch scar on your chest, 3 wires coming out through your skin, 2 quarter-inch tubes coming out of your belly, more tubes in not-so-comfy places, stickers grabbing your skin all over, and your innards have all been handled, and you're a pincushion for needles. Where's the discomfort in that? Once the morphine kicked in, weeeee weeeeere allllllll goooooooooddd!!! Now it was all about "I want to see Aspen" or "I have to poop like for 80 days", and so on.
We didn't discuss surgery much, but I asked him how long he'd been in the hospital. He said he didn't know. I asked him if he remembered waking up this morning. He didn't. I asked him when his surgery was. He said yesterday. Surgery was Friday, today is Monday... SUCCESS! He remembers nothing of the worst parts of this journey. He'll just have to read about it one day.
After a few hours it's about 9 PM and the morphine is wearing off. I've been working on this particular post on/off for most of the afternoon, between trips up to see Cannon. I'm about to head back up, and I hope he's close to another shot of morphine! That's a blast to watch ;-)
No comments:
Post a Comment