For one thing, we had been pretty much been guaranteed that Brian would be taken off the ventilator which was an exhilarating thought.
For another: My mom was already in the air, winging her way west to us.
I remember after I had Elliot, exhausted emotionally and reeling from an especially hard delivery, I would tell myself, Everything is going to be okay when Mom gets here. If I can just hold things together till she gets here, everything will be fine. And it was. She was as in love with our little newborn as we were, and she made breakfast, lunch and dinners, would bathe Elliot and dress him while whispering sweet nothings in his ears while I tackled the momentous task of simply showering.
It was different this time, I wanted her there, more for Elliot's sake and with that my peace of mind, knowing his Nana would be there with him, taking him on walks and reading books and doing baby sign. If there is anyone in this world I would defer Elliot's care to it would be her. But I felt okay emotionally, and wondered if I would collapse on her, even if I felt okay.
The night before we had a bit of trouble finding someone to stay with Brian. I wanted to make sure they didn't need to restrain him and I was willing to find people to stay over, however, we had a 2 hour window between 6 and 8am that was uncovered. Including the ventilator-which he SHOULD NOT pull out, he also had a central line- leading to the vein near his heart- another IV site, a foley catheter and neck collar. A determined patient can do a lot of damage in a short time! Brian's good friend Brandon came in "on his way" to work and sat with him.
I drove in to the hospital early, as Gwen and Lana had Elliot, wanting to be there when the Trauma Doctors rounded and, if possible, speak on Brian's behalf to convince them to extubate. I knew it would be a long hard day if he was again, awake, and wanting the tube out.
I made it in time, and Marisyl was there again, her bright smile and musical accent a welcome sight and sound. She explained that she had turned the ventilator down to "almost nothing" and showed me how to read the numbers- it could see how much of the breathing work Brian was doing by himself and how much of the time his lungs were "riding" the vent. It was so weird to think of my young, healthy husband's body getting "lazy" and not knowing how to breathe for itself. He was doing pretty well, but still not 100%. I talked to him, and told him about his injury as he kept touching the collar.
At first I thought he was tugging at it and after a few times of me saying (as I would to Elliot,) "No, no, Honey, don't pull on that" and him giving me the stink eye I realized he was trying to figure out why he was in a collar he was so familiar with. I explained his injuries as simply and gently as I could and told him how great he was doing and how happy we were to see his eyes. I read to him what I had been reading that morning, changing the adverbs to fit from me to him.
Always be full of the joy in the Lord. I say it again-rejoice! Let everyone see that you are considerate in all you do, remember- the Lord is coming soon! Don't worry about anything; instead pray about everything. Tell God what you need, and Thank Him for all He has done. Then, you will experience God's peace, which exceeds anything we can understand. His peace will guard your heart and mind as you live in Christ Jesus, and now, dearest one, one final thing. Fix your thoughts on what is true, and honorable and right and pure and lovely and admirable. Think about things that are excellent and worthy of praise... And this same God who takes care of me will supply all your needs from his glorious riches which have been given to us in CHRIST JESUS. Philippians 4:4-9,19
It made me teary to read "as you live in Christ Jesus" as I felt so keenly how close Brian had been to death. God wasn't done with him on earth, and we truly are living in Christ Jesus, how else can one live? In Him, we live and move and have our being.
One thing that I found interesting about being in a coma was that Brian definitely had "sleep" and "awake" times. There were periods of time where he was more responsive and would open his eyes readily and other times where it was almost impossible to rouse him.
Before I had been there an hour, the Respiratory Therapist came in to turn the vent down even more and measure his breathing and see how he would do before they actually extubated. The trauma docs came in shortly after and I was happy to see Cassandra Sappington, one of the PAs that I knew from before and Brian works with her husband. She said, "Oh! I do know you!" It made me feel better that even though Liz, who had been following us closely wasn't there it was Cassie who had an equally personal relationship with both of us.
Brian woke up when he was hollered at a few times, grudgingly going through the trial of tests normal to an assessment: "Open your eyes, Look to the Left, Look to the right, Squeeze my fingers, Push up on my hands with your feet, Can you give me a thumbs up?"
They were worried with how drowsy he still was, and I was glad Andy had sedated him so he could rest the night before. Cassie asked him if he'd like the tube out and he nodded as well as held up his one finger "yes" signal. She expressed her concern about the depth of his breathing which was in the 600s on the vent, saying they might have to come back later in the afternoon after he'd have a chance to wake up more.
At that news, I saw a look of steely determination cross Brian's face and I saw him gathered every ounce of strength in his weakened body. On his next breath, the numbers shot up to over twice that to a 1300.
Cassie and Dr. Dulabon laughed and they agreed they would extubate, since the patient was so determined.
It was a little disturbing and a little gross to watch the extubation, but I wanted to be there as they checked his airway and pulled the long tube from his lungs and... out! He coughed and coughed which was "good" and he continued to all day, spitting out the mucus that had collected on the tube for four days.
It was so awesome to see his beautiful face without the tube tugging on his bottom lip and the straps further distorting his already swollen cheeks. I was concerned about his lips being chapped since he's a little of a chap stick guy in regular life, not to mention in the dry hospital with his mouth being held open for days.
My mom and our friend Renee, who had picked her up from the airport, came straight there while I was back with Brian. It was so wonderful to hug her and look in her eyes and I think she was glad to see I really was okay and be able to "talk" to Brian and say hello. She was so sweet to him and he was really happy to see her, in his sleepy way.
That evening, I expressed my desire to shave Brian's hair and get him all cleaned up. The cervical collar and pads had been on since Saturday and were covered in blood and sweat and spit, and I hadn't had a chance to give him a real bath. He gave me everything I would need and said he'd try to get the hair shaved before morning. I cleaned him up, even brushing his teeth and trying my hardest to get the blood out of his bangs. Carmelle came by after work and came back to see us. While she was there she offered to help the night nurse, Jack, to maintain C-Spine precautions while I changed the sheets and while he could get to the back of Brian's hair and switch out the collar pads. He thought that was a novel idea while we were all there, so that's what we did.
I winced as the hair came off, knowing how Brian had loved his hair longer, and remembering how I had planned to leave it when it was half shaved, thinking he'd like a say in it got shaved or not, and that he might get a kick out of the punk rocker look. But this, this had to go. there was about a two inch wide swath of hair around his whole head that had been trapped under the C-collar or missed by the OR barbers. There was a shaved circle where the first surgery had been preformed and then as the incision went at a right angle toward the neck another patch of hair was gone. It was like a very bad marriage of mohawk and monk.
And to my surprise- and contrary to Brian's earlier explanations about his oddly shaped head- he looked so HANDSOME! With his high cheekbones and the C-Collar holding his head up high he reminded me of a regal Egyptian.
His voice when he tried to talk was barely above a whisper, having a bit of a sore throat from the tube and over all weakness, but he did talk and some of it was his normal, witty remarks and it made us all giddy with delight to hear.
Here's a list of Day Five Highlights I wrote in Brian's guestbook.
1. EXTUBATED!!
2.Waking up... slowly.
3. Spending more quality time with you
4. My mom came!
5. You sat up on the edge of the bed with Occupational Therapy!!
6.You are "figuring out" what happened though I wonder if you remember what I say.
7.You nod and shake your head "no"
8.You said, "weeeeellll" (a famous Brianism from before) after I asked if suctioning felt better
9.You mocked Carmelle saying, "Oh My" In a very derisive tone
10.you gave me quite an eyebrow raise when I asked if you knew I was your wife. In my mind, I could hear your voice saying, "Dear...!"
11.Clean DeRoyal, bath, teeth brushed, sheets changed and
12. HEAD SHAVED
13. Jesus has given me so much peace
14.I am so happy to serve you
15.I am longing for you to call me dear or
16. STOP GIVING ME THE STINK EYE!
... He has done exceeding abundantly above anything we can think or ask. xoxo
