Hospital day 16

Eve all; it's time for ventilator 101 (breathing machine class). I need to take a few to explain how the ventilator works so you'll all understand where Mily is and where she's been from a respiratory standpoint (forgive me all you ICU junkies, this will bore you). When a patient needs a ventilator, there are several different settings depending on what a patient needs at a given time. Upon admission, Mily was put on a setting that did all the work for her. That's not to say she wasn't capable of doing any of the work - it was they just didn't want her to. She didn't need to do more than the vent was doing because it was meeting her needs. When she was roused or agitated, she breathed more than the vent was set for even from the beginning. Once she developed the PE, it wasn't a good idea for her to do more than the vent was doing; that's one of the reasons the sedation was increased - so she'd stop breathing more than the machine. Since the sedation is being weaned and her respiratory status seems more stable, they are now looking closely at what she's capable of on her own. She is being put on settings now (CPAP for the junkies), that make her work. The machine will only breathe for her if she goes apneic (doesn't breathe at all) for a set interval. She was on that minimal setting for more than 6 hours today; a really great step. That she remains on the vent means less than the settings she needs to be on. My point - they are trying to wean the vent, and she is moving toward that goal. However, in order for her airway to be considered safe enough for the tracheostomy to be closed up - she needs to be awake. Mily's blood pressure has become an issue again - it is being managed with meds. It's unclear whether the BP is higher because it's just higher or if it's related to anxiety/agitation because she's possibly becoming more aware. I use the word possibly, because we still aren't seeing the responses from her that we saw before. Honestly, that worries me; I can't lie to you. She IS still on sedation meds, so I am holding with the thought that she's still 'under the influence'. Kari is in Washington now and had a chat with the neurosurgeon tonite (THANKS KARI). They are changing some of her medications around knowing many of them will be needed longer term - meaning they'll be changed from intravenous to pill or liquid form. I've said it a jillion times now - keep up the BIG LOVE - don't lose heart for a second because it seems it's a snails' pace. If I've learned anything it's that God doesn't work according to OUR time frames; they are His own and we have to get over it. She works some, rests some and still loves us every second of the day - that's enough for me.
B