The surgery, recovery and self extubation......

So I mentioned that Grace was doing well after the surgery, and each day seems to be different. When she came back, it was around 10:30 pm and it was pretty hard to see her intubated, sedated, and bandaged again, she was also orange from all the betadine that they clean her with to keep her sterile. She stayed sedated the night mostly, she opened her eyes a bit but was very out of it. They got a blood gas and the RT's felt she might even be a little over ventilated. The next morning they made one change to the vent and said they were nervous to extubate too quickly given her history. They wanted to wean slowly. All day Thursday was spent trying to keep her from pulling her tube. IT was great though because you could watch her look at the tube and then grab it, she never really had much hand eye coordination before and now she does. She tolerated being intubated alot better than I thought she would. Yesterday she wasn't as eager to pull it, she behaved herself a little more. I held her yesterday and she kept moving her head and pushing with her feet, trying to get it out though. She finally got the MRI, it kept getting pushed back until around 10 pm! She only needed morphine and ativan, much better than her first one where she required general anesthesia! They did a sprint overnight and while she did good, she got tired and her gas was ok but not great. So they wanted to sprint her again a few times and a gas tomorrow morning. The sprint during the day went well and then after lunch I held her. While I was holding her she needed to be suctioned and she hates that, I hate it too. After she was suctioned she started vomitting and after that, she started moving her head like crazy and i was trying to stabilize it. All the while I was watching her tube and it was taped. then I realized that though the tape was all intact, the tube was moving in and out of the tape. I yelled for her nurse (Amy, one of our wonderful Primaries) and she came in and looked and said well she's not vocalizing and she wasn't desatting so we thought it was still in, she checked it out and turns out the end of the tube was just inside Grace's mouth. She extubated herself! They got some nasal cannulas and put her on 3 liters off the wall and she is fine! She did not want to wait for the surgeons to call it, she said she was ready! An hour later they got a gas and it was fantastic! So though I am obviously not happy she needs a shunt I am glad she has it now because she really seems to be doing better now.She is focusing her eyes on you now and she is trying to reach for things and she is bringing her hands to her face, doing so many things she wasnt! I pray this is the last thing we have to overcome before home. One of the things that is worrisome though is how her abdomen is going to respond to the extra fluid being shunted in, so pray that this all works as it should and she can finally be on the road to recovery.