The build-up

Emma has been great the last 2 days on her sedation meds.  There are a few other symptoms that are side effects of being prone, on a ventilator, etc., but keeping her still is the biggest accomplishment (in my opinion, I guess).

Dr. Troup came by today and said that it was fine with him to extubate today (Tuesday) or tomorrow.  After he said that, the attending PICU doctor decided to go ahead and change the sedation meds to propofol to allow her to start waking up.  We have been watching for movement all day, but she didn't budge.  Since Troup was ok with extubating, that also meant he was ok to flip her on her back.  So Emma has been on her back since around 2ish this afternoon, and her swelling has already gone down some.  I hope it will go down A LOT before they extubate so that she can open her eyes as wide as possible.  As of this morning, both eyes were almost swollen completely shut.

At about 8:00 this evening, the attending PICU doctor wanted to drop her propofol dosage in HALF to get her moving some.  That lasted for about 30 minutes, and then it was every man for himself.  Russell and I both had to grab an arm, she was moving her tongue around trying to figure out what was in her mouth, and she opened her eyes a couple times.  They bumped her steady propofol drip back up to 75% of what it originally was and then gave her a bolus (a quick hit).  About 10 minutes later, she was back asleep again.  I, of course, was a stressball for about 10 minutes...Russell was grinning from ear to ear.  He is so excited to start this process of waking her up that I think he secretly wished they would just go ahead and do it now.  He also knows that he is Daddy's girl and that he is the only one she will want when she awakens.  I am 100% ok with that - no jealousy here, just joy that he can provide her with that much happiness.  He just said to me, with a huge smile, "I think she'll do great tomorrow.  I'll be right there to snatch her up," as he motioned with a big bear hug.  I do love this man.

18 minutes after that bolus, she started squirming again, so they gave her another one.  She can have them every 10 minutes.  The goal here is to determine how much of the steady propofol drip she needs to be on to be still enough, but also how much to give her so that when it stops, she'll wake up quickly.

Here's a picture of Emma now that she's on her back.  Her face is very swollen, and her bangs have gone mohawk/bouffant on her.  To get an idea of how swollen she is, I'm including a normal Emma picture.  I can't wait to see how her face looks in the morning after being on her back for about 15 hours.

And here's Emma's home away from home:

I hesitated to put a picture of Emma all swollen and tubes everywhere (and you can't even see the central IV, the blood pressure cuff, or the oxygen monitor), so I asked Russell.  I said, "Do you think it's too graphic?"  His reply?  "No, it's real."

Good response, my love.  But you need to be glad I didn't ask him that question over the last few days or you might have gotten a good glimpse of some incisions.