Last night Paul and I were surprised to hear them talking about extubating today. I guess with a positive bronchoscopy there is no need to keep Hana intubated. What concerns all of us (me, Paul and my parents) is their lack of a plan. The last two extubations obviously did not go well and afterward there was lots of talk of “next time we will do this”.
One time Hana failed extubation primarily because of upper airway the edema – which can be treated with steroids if you give them about 10 hours beforehand. But the attending physician on this weekend doesn’t believe she had upper airway edema which would be the opposite conclusion of the doctors who were present at that time including the one who had to reintubate her. This sounds shortsighted to me and it worries me that some precautions will not be taken. In general I refrain from saying anything negative on this blog about any of the medical professionals.
The second time Hana failed extubation she was going through intense withdrawal and she was having to deal with breathing with one lung and reduced cardiac output. This time her cardiac function will be supported by the Berlin Heart and she should have more use of her left lung. But she will still have to go through withdrawal and their “plan” to manage that hasn’t impressed me. I guess there aren’t too many good options especially since Hana has had to have such high doses of sedatives. So, we start to take away sedatives today to start the withdrawal and we (me, Paul and my parents) will have to be ready at bedside to console her. The nurse and NP and attending physician will just have to manage her sedation very carefully. Hopefully they are playing close attention. It has never been more obvious to me than now at how much personality plays a role in practicing medicine.
The plan is to extubate tomorrow as long as Hana’s chest X-ray in the morning looks okay and she is tolerating the ventilator changes. It will be a very busy few days where someone may need to be at Hana’s bedside around the clock. My dad even delayed leaving so that he could help. For the next several days we will be in all hands on deck mode.
Hana's Heart 
You would think that open heart surgery and having an external pump were the biggest challenges Hana faced. You would be only half right. The next 72 hours will be difficult as she withdraws from her cocktail of sedatives. I don’t want to be here to watch it again but I can’t not be here for it. I know everyone is praying for Hana but I ask you to shift your focus on her withdraw. The new miracle request is that it will be easier than the last two times. I’m praying for the best but prepared for the hell it might be.
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You’ll have me and 29 states (and two other countries) shifting our focus as you requested Grandpop!
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Make that 30 states! Just added Rhode Island!
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Prayers soaring in that direction. The practice of medicine is an art, and I hope the staff also take into consideration the experience, and wisdom of her parents.
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Sing Mary’s lullaby for baby Jesus “Silent Night”. It always works to soothe my kids. Prayers for all of you!
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Prayers for all of you.
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Sweet Hana and family, we are continuing to hope and we continue to pray. May Hana’s body be sustained by the gentle healing touch of the Father, and may he place his angels beside to comfort and hold Hana in the coming days. Asking the Lord to supernaturally ease the experience of withdrawal and that a successful extubation will be the result! Be of courage, and hope, and know that there are indeed praying for Hana!
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I do not know your family but am friends with Dean & Andi who have shared with me your story. I have a 7-month old daughter and I cannot imagine I would be able to be half as brave as you all have been. I don’t know Hana but I think about her very often. I will be sending positive thoughts for an easy withdrawal in the next few days, and warm thoughts of comfort to all those at her bedside. You are all amazing, in the true sense of the word. Warmest wishes, from the Lundy Family.
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Hoping it is an easier withdrawal this time. Hope they wean her slowly from the sedatives and painkillers. Keep her comfortable…I’m an RN, and that is what I would request for my loved ones. God bless Hana!
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