First trach change

Ellie had her trach changed today.  This was the first time her trach had been changed since the surgery last Friday.  From here forward her trach will be changed every 2 weeks.  This took place around 5am this morning and everything went well, very well.  As soon as the new trach went in, her ventalition was better.  The C02 reading was 37, so the vent was over-ventilating her.  For some reason, the trach was preventing the ventilator from operating properly.  The improvement was instantaneous!  We assume the trach itself was clogged with something, but we are not sure.  Today, Ellie is responding better to the ventilator than ever before.  We are obviously very happy about this but she is still paralyzed and we hate that.  The attending physician told me today that they plan to have a meeting tomorrow with the surgeons to find out what medicines should be reduced and when.  The attending's feeling is that the morphine and versed will be reduced first and then the vecuronium.  The attending is new to us this week and seems to be very intelligent and very nice, but he is no Dr. Greenberg.  We miss Dr. Greenberg so very much.  He is one amazing man!

The ventilator is a very complex device.  There are oxygen, pressure, volume, back pressure and a ton of other settings.  None of the settings were changed at the time of the trach change and her volume immediately improved.  So, the pressure stayed the same but the volume that Ellie's lung was receiving tripled.  This basically means there was some constriction in her trach or airway.  The respiratory therapist immediately changed the pressure (which reduced the volume) and allowed Ellie's breathing and oxygenation to be optimal with less pressure to her lung.  A huge fear is that the higher the pressure the more risk to Ellie's lung.  With her only having one lung, we cannot risk any damage to that lung. 

Ellie's oxygen requirement was 100% four weeks ago.  The oxygen we breathe out of the air is at 21%.  Today, Ellie's oxygen setting was 21%.  Praise God!!  This is a huge change!  The importance of the vent at this time is volume and pressure of air movement to her lung, not the need for the large amount of oxygen.  Our hope is that when she comes off the sedatives that she will continue to do as well as she is now. 

April and I are starting to get NICUitis.  Our life is obviously very difficult right now and at times everything seems very overwhelming.  Please pray that God would continue to give us strength and peace through this time. 

Please pray that Ellie will continue to do well when she comes off the sedatives!  Please continue praying for Riley, Olivia, Payton, Braxton and Jaxson.  These children need your prayers. 

God Bless,

Matt (Ellie's daddy)