Trache - Tracheotomy - Placing an opening in the throat to permit air flow. A wonderful spot in our necks that God created to save lives.
Outer Cannular -The main trache tube. This is the tube placed in the opening. Once in place, an inner cannular is inserted into the outer cannular. The outer canular is changed out once each 6 months. The inner canular is changed out daily.
Stoma- The opening made in the throat for the outer cannular to be placed.
I am not sure of the correct spelling trache but I am going with 'trache'. It varies on the web. Regardless of the correct spelling, after this post we won't be worrying about it anymore. There is so much that has happened over the past few days after Rachael's night at SMH that I will do the best to update you as efficiently as possible as this is a busy day at Heartland.
Following the night at SMH, Rachael took 24 hours to regulate back to her curent norm. This lasted until Saturday evening.
Over the course of her healing, she has had what we call 'storms'. These storms are characterized by profuse sweating, muscle spasms and grinding of her teeth. These are very disturbing to watch but most likely are part of the healing of the brain to the extent that God wills. We are beginning to feel that they are related to comfort. Occasionally, when we have positioned her in bed or after a bath she seems to calm down. As with all things so far it is inconsistent.
Our mouths and nasal passages moisten the air we breathe. When a tracheostomy is performed and in use, the trache bypasses these God designed humidifiers and humidity needs to be supplied by machine, loosley attached to the trache. When we move Rachael around in a wheel chair, we need to remove the humidifyer that is attached to the trache and cap her trache so that she breathes through her mouth. Due to the level of recovery, the cap is not permenet as the gag and swallow reflex systems are not fully functional. Saliva pools if not swallowed and can cause a choking, vomiting or drooling. Capping is ok for a while if monitored but until Rachael attained a level of concsioness to swallow saliva and keep from 'aspirating' or not letting things enter her windpipe, she needs the trache.
On Saturday afternoon, Nancy took a break and I was by myself at Heartland for the day. Yes, that last sentence reads like a portent for the manifestation of Murphy's Law. About 2:00 in the afternoon on Saturday, I was preparing to plug the trache so that we could go for a stroll about the premises. Part of the process is to remove the humidifyer which has a strap that was mingled in another strap around her neck. So, I loosened the trache strap that holds the outer cannular in place so as to move the humidifyer up over her head. Part of daily trache care possibly involves loosening the trache straps to clean the area around the stoma so it is common to move these straps. Any slight movement of the outer cannular will cause a cough so you want to keep it still. When I loosend the trache strap, the outer cannular moved and Rachael made a terrific cough that popped the trache right out of the stoma! Yes, she 'popped the trache'. Nancy and I have had training in placing it back in which is no big deal. However, neither the nurses nor myself could find a new outer cannular. The one that popped out had been exposed to the air and clothing and in so doing, bacteria. Well, there was an aire of nervous perplexity pervading the room as our next step was sans protocol thus leaving us to improvise. With a few quick moments of prayer, and discussion we decided to call Dr. Simon, Rachael's wonderfully gifted doctor. Dr. Simon stated that she was going to remove the trache this week anyway so leave it out. LEAVE IT OUT! This is big to us. For her to be off the trache! First the vent, then the trache and now normal breathing of room air! Nancy had been very stressed as she knew that the trache was to be removed this week. Well, it popped out and moved up the schedule. Nancy and I had planned to spend at least the first night of the trache removal at Heartland so Saturday night we spent the night with Rachael in the most uncomfortable 'recliners' that without anitomical downward force, jeteson you from your reclined position , in more a launch than an inlcine. Good for rising quick to assist. I coded in Perl ( a most excellent programming language) and Nancy curled up for the night. It was Saturday night that Rachael began to 'storm' again unrelated to the trache as the trache in is much more uncomfortable. This lasted until Monday morning. She is now back to stability. No more trache!
Hanna's First Visit:
It was not until the trache was removed that we wanted Hanna to see her. With all the tubes and machines of her early stages of stabilization, it would have been too scary for Hanna. Now that Rachael was without the trache, the final step in appearance that would be apporpriate for Hanna to see, we felt it was time. Leaving the decision up to Hanna, we guided her down the hall. Mildred, one of the housekeepers here and a most thrilling sister in Christ, sort of danced Hanna to the doorway for her to get her first glimpse. Hanna was upset a bit so we let her return to the waiting room. Later, Nancy brought Rachael down to the waiting room in her wheelchair and Hanna got to spend a very sweet and emotional time with her sister. Realize that all of us in the family have been though this on a daily basis but Hanna has not seen Rachael since the night of the accident on January 1. Within a few minutes, Hanna turned pro! She was singing with Nancy and began talking to Rachael in a way so touching that I am not skilled enough to describe. She was amazing. She related stories to Rachael, 'remember whens' and the like. She told Rachael about staying over at Reggie and Sara Green's house the other night with her friend Faith and about her crocheting that she has started. It was non-stop. Hanna began to push the wheel chair around and has already started to assist in basic duties with cleaning Rachael and looks for other ways to help. Hanna Hinkle is an amazing young girl. Only nine years old and already denying the normal fears of such a time as this and digging in to help. She is so sweet when talking to her sister.
Rachael had a day of rehab work where they are working with her swallowing and relaxing her muscles. The folks here are great. She attended an exercise time here and laughed through it. Also, a lady came by with a Shih Tzu and we placed the dog in Rachael's lap. She felt the dog and busted out a huge smile.
We have much to rejoice in this day. No trache, Hanna's first visit and it looks like the storms have ceased. We thank our God our saviour and Lord Jesus Christ for all he has done up to this day and what he will do! The people that we have met, the Christians that we keep bumping into, the sick and stricken that we get to share with, this is all to the Glory of God and we so appreciate His presence in our lives. PLEASE continue in prayer. I often ask God to make this room holy ground and in the name of Jesus Christ, all minions of the enemy be pushed away.