There were a few ups and downs in the last couple weeks, but no major changes.
On Tuesday the doctors decided to get Quintin back on a ventilator. He’s still fighting infections in his lungs, and the purpose of the vent was to help keep his lungs open so his body can clear the build up.
From Wednesday through Saturday afternoon he was moved back to the ICU (West Wing ICU this time). This was mainly because of the vent, and because for those few days he simply needed more care than was appropriate for the 3-4 patient-per-nurse ratio in TRACU. They did at least one broncoscopy, kept him on the ventilator, and decided Saturday he was ready to return to TRACU. On Sunday the respiratory therapist said she wasn’t getting much gunk out when she used the trach suction tube, and that’s great – it means the vent, antibiotics, and Quintin’s efforts combined got his lungs into better shape.
People have been asking recently what Q looks like right now. The number one question has been about his hair. Yes, they had to cut his hair, twice actually (because he had two separate brain surgeries). For the first surgery (in April) they shaved all his hair off. The second time (a month later) they only shaved part of his head, so after several weeks of growth time, it’s a little lopsided. The right side is long enough for bed head, the left is still pretty short. One of his nurses said that his hair growing this much means they’re feeding him well. As well as you can through a tube, I guess.
He has lost some weight and muscle tone, as happens when you’re in bed for this long. Thankfully he was in excellent shape going into this, and his joint mobility is still good. One of the hospital’s occupational therapists showed us how to do some of the range of motion exercises and that’s really nice – it’s a way we can actively help.
A lot has happened in the last week. To recap:
Quintin is still breathing on his own, with the trach collar providing warm, moist air.
On Saturday (his birthday) it was determined he was stable and improved enough to move out of the ICU and into the Trauma Care Unit (TRACU). The Northwest Film Center had sent Q an enormous bunch of balloons, and the whole family was there for the move, so we made quite the little parade from ICU to TRACU – all of us following two nurses wheeling Q in his bed, balloons bumping along the ceiling all the way to his new room.
On Thursday, a team of Physical Therapists in TRACU got Quintin transferred temporarily from his bed into a “chair” to help his lungs and to give his body a general change of position. I say “chair” because it’s really a throne-like version of the bed – completely padded and structured for support. His system handled the activity and new position well, and it sounds like they’ll be increasing the time he spends in the chair each day.
Because Quintin is doing well, it is likely he’ll be discharged from the hospital entirely sometime next week. The next step will be to an acute care facility (much like TRACU, but outside of the hospital). This is both exciting and scary for his family and me. When he made the move to TRACU, we’d seen real progress happening – most obviously that he no longer needed the ventilator. His doctors and nurses have been slowly checking off the criteria required to discharge him entirely, but the milestones aren’t things we can see. At the first discharge meeting Q’s parents and I had with the doctors and social workers this week, they explained what their skilled eyes were looking for: for example, it’s been over two weeks since his last surgery, and they don’t anticipate him needing another one. His heart rate, blood pressure, and other vital signs are trending in the right range. These aren’t obvious steps to those of us observing the process. We’d spent 40 days in the ICU and I think we were ready for another long stay in TRACU. Personally, I’d imagined that he would need to be awake before leaving the hospital, but clearly that’s not the case. So we’re working on readying ourselves for the step that Quintin’s already prepared for. Honestly, remember who we’re talking about here - we shouldn’t be at all surprised that he’s way out in front of us on this!
It’s wonderful that Quintin is making this progress, and enormous credit is due to the amazing team in the ICU. We’re all enormously grateful to everyone there. We have great help in TRACU, but miss our ICU friends very much.
P.S. Although Quintin is out of the ICU, please understand that visitors are still limited to family only and we will let you know when that changes.
Happy birthday to Quintin! As the Stirlings said, this guy really knows how to celebrate a birthday. And I’m not even being sarcastic here, there’s some really good news this week!
As Adrian said, he’s off the vent, which is an excellent step. The other big news is that Quintin had an EEG (a test that measures electrical activity in the brain). The results showed no seizures (which is truly wonderful news) and no “focal abnormalities”, that is, areas of inactivity in the brain. There is “diffuse slowing”, which basically means that all over his brain the signals travel slower than they would for you or me. This is completely expected for the state he’s currently in. Dr. Chen (the neurosurgeon) remains very optimistic, and so do we.
So raise a glass to Quintin today and let’s celebrate breathing!
Here are a few updates for today.
First, it's Quintin's birthday. Happy birthday Q!
Second, Quintin has been breathing on his own for the past 24 hours.
As you know, the nursing staff has been monitoring his ventilator breathing closely. They have been slowly lowering its settings, allowing him to do more and more of the work. Their goal has been to wean him towards independent breathing. Yesterday morning around 11 am, while still under close ICU supervision, they took him off the vent and let him breathe on his own. The air they are supplying him with is pre-warmed and pre-moistened and he is still breathing through his tracheotomy, so he is not quite breathing normal room air -- but wow, this is a huge step in the right direction!
If he continues to breathe well like this, we are expecting him to be moved from the ICU to the TRACU (Trauma Recovery and Acute Care Unit; pronounced "track-you") in the near future.
We'll keep you updated.
-Adrian
First, it's Quintin's birthday. Happy birthday Q!
Second, Quintin has been breathing on his own for the past 24 hours.
As you know, the nursing staff has been monitoring his ventilator breathing closely. They have been slowly lowering its settings, allowing him to do more and more of the work. Their goal has been to wean him towards independent breathing. Yesterday morning around 11 am, while still under close ICU supervision, they took him off the vent and let him breathe on his own. The air they are supplying him with is pre-warmed and pre-moistened and he is still breathing through his tracheotomy, so he is not quite breathing normal room air -- but wow, this is a huge step in the right direction!
If he continues to breathe well like this, we are expecting him to be moved from the ICU to the TRACU (Trauma Recovery and Acute Care Unit; pronounced "track-you") in the near future.
We'll keep you updated.
-Adrian
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