Trach-free

I had this long, intense post written... when I accidentally deleted it. Yep, me - the person people turn to for computer help... I deleted the post and it auto-saved. Nice, huh? I just can't bring myself to re-write it. Perhaps you should be thankful that my other post was deleted... it was pretty long-winded (as I tend to be). But I wanted to break my blogging silence, at least for this one post. So where have I been? Enjoying life, of course. We've been living in the moment, and enjoying every bit of it.

The rumors are true that Norah was decannulated on June 4th. To say she's doing great would be an understatement. We're all adjusting to this new life. It's amazing what can happen in a year to such a strong-willed girl. She is strong, healthy, and enjoying her new trach-free life. We're all enjoying our new trach-free life. Norah is now in HD. She is more vibrant, active, vocal, mobile and just as sassy as ever.

The trach/vent mom in me will always be in there somewhere. But someday I'll forget the size and style of her trach. I'll forget her old vent settings. I'll forget the weight and juggle of equipment in my arms. I'm sure the first time I forget the oxygen tank (that is rarely, if ever used), Jeff, always the worrier, will be right behind me with it. And as we wean off of our private duty (night) nursing, I'm sure the trach/vent mom will be stirring within me, at the ready for any respiratory emergency.

Her medical journey is not over, but her rocky start is. She can finally breathe on her own. I can't even begin to express how thankful I am to all of you, to all of her caregivers, to technology, and to the love that has lifted her up and surrounded her since the moment she was born. Thank you for sharing in her journey... It isn't over yet.

Respite

Those close to me may be growing weary of hearing me complain about being exhausted. Jeff doesn't complain much, but I know he's just as tired as I am. How tired? Well, I'm far more tired than I ever was taking care of either of my kids when they were newborns. It's sort of like when you try to do a 18-hour road trip in one sitting. But not just one night. Maybe it's like doing a road trip like that every day for three weeks.

Norah has tons of gear that she needs with her at all times. I refuse to force her to live in her crib, so that means hauling everything from one floor to the next multiple times each day. We have three sets of split-level stairs, though I don't think Norah's been all the way downstairs. In the morning we go upstairs for her bath. Back downstairs for trach cares and getting dressed for the day. Further downstairs for playtime. Upstairs for her nap. Back downstairs for more playtime. Back upstairs after more trach cares and getting ready for bed. Rinse, repeat. Each time we move throughout the house, it takes 2-4 trips to get everything. Of course that all depends on how well my mind is operating, and if I've forgotten something. We've come up with a system for her medical gear, but that's not accounting for extra trips to grab non-essentials. Then in between there is much more stair climbing... Harper has become quite the helper, occasionally retrieving things for his exhausted parents.

I should add that Jeff has been amazing. When he gets home from work he makes dinner. He does the dishes. He takes care of all the things that I intend to do, but rarely have energy for. And when we don't have a nurse, he takes the night shift, telling me that it's more important that I'm able to take care of the kids the next day. I sure hit the jackpot when it came to Jeff. My friends want him to give lessons to their future husbands.

So we've been tired. Super tired. It was to the point that our bodies were hurting because of the exhaustion. So I called our nursing company, and scheduled the respite nursing hours that we qualify for based on Norah's technology dependence. Last night, Norah's nurse came at 9pm instead of 11pm. She was a new nurse with no ventilator experience, so took extra training. You better believe once we were done with training, we pretty much passed right out in bed. Hopefully they'll start coming most nights at 9pm. It made a huge difference. Don't get me wrong - I'm still super tired, but I now feel like I can function a bit better than before. I have a hard time asking for help, but when it comes to Norah, I've learned that I need to. It's not about me. It's about her.

My last post was quite the downer about our home nurses. I'm glad to say that things have been going quite well. That particular nurse and I had a brief but effective discussion the next night, and I felt much better about everything. All of the nurses have been friendly and willing to learn, which is the most important thing.

Sorry about lack of photos lately... but if you are on the web version of my blog, you can see my latest Instagram photos to the right. If you have Instagram, you can follow me @mama_nauna.

PTSD

I've heard multiple parents of medically fragile children talk about PTSD (Post-Traumatic Stress Disorder). It's something I've learned a bit about over the last two years. I take anti-depressants and have lived with the chronic nightmares, but every now and then, PTSD rears its ugly head at unexpected times. I don't mind if this long post goes unread, I simply need to get out my thoughts and emotions.

Let me start by saying that private duty nursing (PDN) has been a huge help. Aside from some scheduling issues, we have been able to get (a little) more sleep, and pass off a few duties to Norah's nurses. Norah is pretty stable at night. She only needs monitoring, suctioning, humidifier refills, and assessing throughout the night. To that, we've added some cleaning items, a couple feedings, a respiratory treatment if she wakes before the end of the shift, and the like, to the nurses' duties. It is important that Norah gets plenty of rest at night. We give her more ventilator support at night than in the day. Every little activity during her waking hours are a workout, so we need her to conserve her energy as much as possible. After all, growing is a key part in her overcoming her respiratory issues.

So last night, we had a new nurse. I trained her but had the nagging feeling that I was forgetting something. Also, she had very few questions. (Yes, I am now going to put a written document together detailing Norah's needs so I don't forget anything in the future.) I fell asleep around 1230 or so, but woke at about 330 to the sound of Norah's labored breathing in the monitor. It was the "sound" of her crying. I went downstairs to find that our new nurse had just completed trach cares (cleaning the stoma/hole and neck, changing the trach ties, and placing a new drain sponge). What I neglected to tell the nurse, was that we simply let Norah sleep through the night. She's always been a great sleeper. She may wake a couple of times if she needs to be suctioned, but will otherwise snooze sweetly. We need her to.

She commented that Norah didn't seem to like trach care. Norah was sobbing. As I comforted her, I kindly said that she hated trach cares in the hospital, but since coming home, Norah doesn't mind when I do it. Jeff has said many times in these last weeks that he is amazed when watching me do Norah's trach cares. She looks up at me with trust in her eyes. If she cringes at all, I talk to her sweetly, or sing to her gently. She seldom cries when I do her cares.

So Norah was traumatized, taking in short gasping breaths. I was traumatized. I had found my girl beyond upset, and the nurse stepping away with the medical supplies. Something about it stabbed my heart. Then I realized what it was. You see, I don't blame the nurse. She was only doing her job to the best of her knowledge, training, and skill. After all, it had been my responsibility to tell her that I did the twice daily trach cares during Norah's waking hours. The distress that I felt was a culmination of all of the times that we've had scares with Norah. It was every time she turned blue. It was when she died for nine minutes. It was every ambulance ride. It was the middle-of-the-night phone calls from charge nurses, telling Jeff and I that we needed to come in. It was her inability to vocalize her fears and pain. It was helplessness while watching her struggle. It was every painful procedure she endured while we did what we could to soothe her. It was sheer exhaustion caused by two years of stressing about my daughter's life. It was PTSD. (I could link many more old posts, but you get the point.)

The nurse was quite well-intentioned when she verbally confirmed that we were new to private duty nursing. When I said that we were, she stated that when Norah gets "better" about trach cares, that it will help give us acuity points. For each item requiring the nurse's attention, Norah gets a certain number of points. These points are what help qualify her for the Medicaid waiver. It allows Norah to have medicaid due to her technology dependence instead of her family's financial status. There is no way I will put Norah through that in the middle of the night - even if it means that we had to give up nursing and Medicaid altogether. This isn't about relinquishing control. Norah needs security, confidence, and sleep much more than she needs those other things.

I like to think that we are very easy-going about Norah's cares. We aren't neurotic about specific things at specific times, or about nurses doing certain things a certain way. We've learned the hard way that the few "rules" that we have must be documented and outlined. Who would have thought that letting her have a good night's sleep was one of them?