Decisions, Decisions

So sorry for the late update today. We have spent many hours at Dad's bedside asking him a million yes or no questions. Not necessarily because we really care that much about the answers, but because it thrills us every time he obliges with a nod of his head (much to his dismay, in face we were rewarded with him rolling his eyes multiple times). Dad has had an extraordinary day yet again today. I hate to say that as if it has become routine, because the small progresses he is making daily take us farther away from my biggest fears and I am grateful for every tiny movement. His temperature was regulated much better today. As a result of this, he was not cooled as much by the machine and his shaking was much less intense. His heart rate was lower and the pressure inside his brain has remained under 10 for two days now (they would like it below 20).

Tomorrow will be a very big day for him. For days we have been discussing the options of placing a tracheostomy to assist in his breathing or allowing him an "extubation trial", in which the breathing tube would be removed and we would see if he could breathe on his own. After carefully discussing the risk factors with his respiratory therapists and neurologists, we have ultimately decided to go ahead with the tracheostomy. Dad has been intubated for 15 days now, which means he is most likely suffering from swelling in his throat, he also has a lung infection and is not fully awake. For these reasons we just do not feel comfortable with the trial. This decision means that along with a new breathing tube, the surgeons will be placing a feeding tube that goes right into his stomach. This will need to be in place for 6 weeks regardless of his progress. Because his intracranial pressure has remained stable without using the drain (it has been clamped for two days now), it will also be removed tomorrow. This means that for the first time in 16 days, my Dad will have absolutely no tubes or drains on his head or face. I for one am so excited to see his handsome face again! In other big news, an ultrasound of his legs today revealed that the clots in his right leg have extended and are now nearly as bad as the left. Because of this, they will begin treating him with anticoagulants once the drain is removed. I am nervous for this as thinning his blood increases his risk for another brain bleed, but I also know that his need for treatment is becoming an emergent situation. I can only pray that we do not cause him more damage.

Today he has been much more awake and alert. While this has brought lots of excitement to the family, it has also brought lots of frustration to my Dad. He is becoming more aware of the difficulty in moving his arms and legs and he seems so desperate to communicate. He kept pointing today and holding up fingers and we were just unable to understand what he is wanting. We are desperately hoping that he is able to talk once the ventilator is removed from his mouth.

Dad's progress has led to many decisions for my Mom. We are all praying that we are doing what is best for him but we know that he has an amazing team of doctors that are attempting to educate and help us along the way. Tomorrow will be a nerve wracking day but I am excited we are making progress toward rehab and recovery.