Thursday was a GREAT day. The sedatives from Tuesday night's MRI had finally worn off, and he was more active again, lower on his dopamine again, and breathing over the ventilator again. He was also urinating around his catheter, so they took that out. Another tube down! They took him off of his pain medication, because that was mostly for the chest tube which they removed Tuesday. Another medication out! He'd had no more seizure-like episodes, either. He was so much more responsive--I could tell how badly he wanted to scream when the respiratory therapist (who happens to be in our ward, cool, huh?) was sucking the secretions from his lungs. The ventilator screen flashed "high minute expiratory volume" and sounded an alarm, which was his only way of expressing himself with that tube in the way. He was reaching his free hand up (apparently he had been moving around so much before we arrived that he had messed up his IV and they had to remove it) and trying to pull on the tube in his mouth. He was effectively communicating that it was time for the tube to go.
During morning rounds, the residents, fellows, and doctors were discussing how they were planning on extubating, and the lead pediatrician asked the resident what they were waiting for. She suggested clamping the tube and giving him a trial without it, but the pediatrician said, "Look at him, he's ready, I say take it out now." So the respiratory therapist jumped right in and did it--right then!! Aaron and I were so happy that we got to be there for that moment of hearing his first cry. He was SO hoarse from the irritation of the tube, but it sounded like music to our ears to hear Dexter cry.
It was pretty intense watching him try to breathe right when the tube was removed. His respiratory rate was still fine, but his oxygen saturation kept going down and down to about 49%, so they were giving him blow-by oxygen and I stood there and prayed silently but mightily that he would just learn to breathe effectively so that they would not have to stick another tube down his poor little throat. The therapist assured me that it just takes them a while to get used to taking deep breaths on their own since the ventilator has been doing that for him, and gave him a nasal cannula (one of those little oxygen thingies up his nose) to give him a little boost during his transition. His oxygen saturation went back up and Dexter settled down. He looked so free and so much more content without the aggravation of the tube. Aaron and I were ecstatic!! He had been making baby steps of progress, but this felt like a leap--he can breathe on his own!! I hurried down to where my mom was waiting with Xander and Elodie to pick me up so I could get lunch and a nap before going back. When I told them the news, Xander started clapping right away and said, "Yaaaay!! Dexter can breathe!!" and Elodie joined in the clapping. It was so sweet! Xander really does seem to understand what's going on. And Elodie follows his lead. With that reaction, we all had to go back in the hospital so they could see their brother without a tube in his mouth. The nurse had flipped him over onto his stomach for the first time, so Xander and Elodie actually got to touch his back where there were no tubes or IVs. Eldoie love dit and kept asking in her sweetest voice, "Tan I touch baby Dexter's back adain?"
Thursday morning, when Aaron and I were praying together, he specifically prayed that Dexter's tube would be removed today. What a prayer of gratitude we said and felt this afternoon! I know the Lord hears us. Thank you all for your prayers and support in our behalf. We feel it and need it!