Julie has changed so much over the last 6-8 hours. Obviously she was irritable this morning because she was in defense mode. She had one thing to worry about, breathing. When she was extubated, they also took out her swan line in her neck. The swan line is inside the larger Mack large gauge line. They administer meds through the Mack line and the swan line was used to measure pressures in the heart and the pulmonary artery. She was on 40% Oxygen and her sats were at 100. At around 1:30 they brought in her a device to help her measure her inspired volumes. Her goal is to do about 1000ml on inspiration and she immediately was able to do 500ml. The biggest news of the day is she was out of bed. She got up and as you can already see, took a walk around the SICU. She started with steps about the length of half her foot and took larger steps as she walked. It was so cool to see her ambition. The nurse told her she has never had a patient so active as Julie. She said "Your life is going to completely change. You deserve it, you have worked so hard so early." All the staff including her anesthesiologist are impressed with her progress. Any time they introduce something to her she says: "So what is the goal?" They were a little puzzled the first time she asked but realized quickly that she needs an expectation to work towards. The nursing student Michael who took care of her through the afternoon said "I can't believe the progress you made just from this morning."
Then the irony; They had to change her Mack line that had 2 ports for meds to one with 3 ports and in walks my fraternity brother Rich Dunn to do the procedure. Classic. He is just about to graduate here at the U med school. Despite kicking us out to have a completely sterile environment, he did a great job. He kept her calm as he stiched it to her neck and main the somewhat stressful situation for her tolerable. Thanks Rich.
Julie had to sit in a chair next to the bed for a while while they changed the bedding. They kept her out to create drainage and just sit up and breathe. She's been able to drink water and eat ice chips so that has been a relief for her. Because she was satting so high on 40% O2 (about 6 lpm) they dropped her to 25% O2 (about 1.5-2 lpm). She has a mask that she wears because the oxygen is humidified to make it more comfortable and help with the healing. She took the mask off to drink and her sats didn't change at all. She is satting anywhere from 98-100 on room air. She used to laugh and say there would be no way that she would wear a mask/canula if she didn't need it, but there is a psychological attachment to it. She did say that she likes the humidity though, so that could be part of it.
Thanks for the prayers and all the nice voicemails and messages. We are so grateful for the support. Stay tuned...