Wednesday, November 17, 2010

Small Emergency

So... Luke didn't exactly pull his trach out...
For months, especially when his speaking valve (PMV) is on, we have been trying to keep Luke from pulling on his trach.  Sometimes he pulls at it frantically to try and get the PMV off.  Lately, he's just been pulling on it, and when the filter (called an HME - Heat/Moisture Exachanger) comes off, he likes to put it in his mouth and hold it between his teeth.  Makes him look like he's smoking a cigar.  It's difficult to relay to him the seriousness of the matter when you're cracking up at the way he looks with that thing in his mouth.  
This evening, I was drying my hair, with Luke sitting in his bouncy seat (yes, sometimes I can still keep him contained in it for short periods) since he was still sleepy from his nap. David was still at work, we were alone in the house.  When I turned off the hair dryer, I heard a strange whistling noise coming from Luke.  It wasn't the same whistling that he makes when his trach is out (during trach changes), nor was it the whistling he makes when his HME comes off or he needs suctioning.  I looked over and my heart leaped out of my chest.  I couldn't see his trach protruding from under his chin like I normally can.  I knelt down to look more closely.  He hadn't pulled his trach out, but he had pulled it apart.  He separated the trach in two from pulling on it so hard.  (See picture below).  
Normally we have trach ties on his back-up trach so it's ready to go in case of an emergency.  I dropped the ball on that this week.  The trach was where it was supposed to be, but without ties on it.  I rushed and set Luke on the floor of his room, tried to put one tie on the trach and just gave up.  Luke was starting to panic and turn a little gray.  Anyone want to guess who else was on the verge of panic??
I kept my cool. All I could think was "He's got 2 minutes without oxygen, and he's still breathing.  I've got time to do this."  I didn't take the time to swaddle him or put the other tie on (turns out I put the first one on backwards anyways).  Changed the trach without really even thinking about it, and got the ties on and fastened around Luke's neck.  We're both fine, although a little rattled.  Luke was pretty mad that we had to do trach care twice tonight, but I think he's over it.
I just wanted to share that I'm proud of myself for doing our first emergency trach change, by myself none the less.  Thanks for your prayers (and your cheers!).  

Anyway.  Just thought I'd share.

Above you can see a picture of Luke's broken trach. The pieces are completely separated. The right "tube" portion of the trach is the part that goes inside Luke's trachea. The perpendicular part is the part that lays against Luke's neck (or lack thereof). On the left side is the extension part of the trach that holds the opening away from his neck so we can access the opening. The opening portion is the part he separated (on the far left). You can even see the coiled wire popping out (I'm glad it didn't cut him!)!

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