February 28th

An interesting day again. The button that replaced the trach in Jodi’s throat did not stay in place. It appears that it began to come out almost as soon as it was put in. As a result, the hole in Jodi’s throat has begun to close. By tomorrow AM, it will be fully closed. Jodi was given the decision to either have another whole trach put in or to not have a trach at all. The answer seems obvious but it is not. If she chose to take her chances with no trach and she continued to throw up and aspirate, she could end up being put back onto a ventilator and put back into ICU. Jodi chose not to have a new trach. It has been a hard day for her due to that decision. She has not had as much nausea because I asked the Doctors to introduce only the basic meds into her feeding tube and nothing more. Tomorrow they will only give her extremely small tube feedings so that we can be sure that her stomach is ready for food and she will not get sick again thus minimizing the chances of throwing up.
She has had nothing but IV fluids for seven days now.

Her brain is having to be retrained as far as taking care of all her secretions. For three months now, she has coughed up those secretions only as far as her trach. Now she is trying to bypass that trach area and cough them into where the secretions can be suctioned out of her mouth (she still cannot swallow). That may not sound like much but it means that Jodi feels a lot of inability to breath during coughing and she panics. When she panics, she does not cough as effectively and she forgets to suction early enough causing her to choke even more and once again, there is the risk of aspiration. She also has to remember to sit up (from her lying down position) in a way that gravity can help her. she doesn’t have a lot of strength to pull herself into that position in time to be successful while she is concentrating on everything else that she has to do to accomplish the management of the secretions.

In spite of all of this, she managed to perform a lot of her therapy goals. They are mostly done on the edge of her bed because she needs to regain her strength but she is participating none the less. She walked down the hall with her walker and did quite well.

She has told the Dr. that no matter what, she is going home on March 7th. They are a little hesitant but she is determined to do all she can to be doing well enough to do so. Please pray hard for her to begin to control her secretions and have no more nausea.

Connie