Tues 10:31 pm. some bumps...more good.

This has been a most eventful  day. Emily is well and at the moment doing her inhalation therapy treatment, the one where we have to clear the room for an hour. Perhaps, a little perspective. From a distance I imagine that this transplantation has seemed a bit like a really good Hallmark Movie. You know all beautiful shots and smiling characters all around. Things have gone well, we are constantly thankful and humbled by what is being done here. But there is also a gritty and earthy side to all of this. The days are a fog in some ways. It has been typical for the last formal medical treatment to end at 1:00 am at the very earliest. Then at about 4:30 am is the first chest x-ray of the day, taken to be available for the surgical team making rounds between 6 and 8. First oral med is at 6, another batch at 9. Overlaying this is the constant to and fro of the nurses changing IV bags, taking vitals and after the horrible night when Emily's O2 levels plunged they make damn sure the telemintry devices are sending accurate info to the monitors in the nurses station. They never rest, the nurses, to work on a floor like this you had better be good and we are in awe of their care and devotion. We are profoundly grateful to them. But back to the night, just in case emily gets the idea of sleep the techs drop by every now and again to draw blood. The days don't quite settle and everything is a major production. need to pee ? It is a chore for Emily. It takes at least 15 minutes to align all the tubes and lines and collection devices. Then pee. Then reverse it all. Wanna walk? Same deal but add in more gear. All the while monitoring pain and protecting the incision. The incision which opened the way to new life. The path for those worn out lungs to leave and and the gift of the beautiful new ones to enter. Hook your thumbs in your armpits, imagine a smiley face connecting those two points, following a line just below the breasts but above the bottom of the rib cage. That is it, the big cut. The surgery team looks at this whenever they are in and check the tubes insertion points and output. Today the liked what they were seeing and promised and afternoon reevaluation. At around 10 the pain team entered, they are very thoughtful and kind. They recommended a bold move, discontinuing the meds going into the epidural block. Time to try to wean off but with a certainty of more pain. A necessary step. After an our or two some pain returned and then it came back with vengeance. Almost bringing her down on walk and back to bed, While there was a scramble to restart the  epidural and up the morphine. The pain eased but the morphine brought  a terrible wave of nauseau and retching. A really bad thing when you have been cut from side to side. After a too long of this an anti nasuseu med brought this under some control. At just that moment the surgeons, they also travel in packs of at least three, reappeared  with the big dog in the lead. This was a rare afternoon sighting of the transplant surgeon. A good but busy guy. After some serious talking and discussing they decided to pull two chest tubes . Wahoo! This was done a few minutes later and x rays a while later confirmed that at least for the moment all is well. A few hours later, sweet surprise , they came back for a third. This is an important step at a critical stage. Three years ago, when things got side ways , this was pivitol moment. Right now all is well and we just know it will remain so. Then it was off to x ray, Emily refused a ride and walked, they had to get special permission from the charge nurse, to allow this. While the tubes were pulled they asked Emily to hum to help seal the hole while it was stitched. 10 days ago if you had asked her to do this she would have had to shake her head no. Breathing was so hard that she had begun to pause between words. Today she let out such a long loud note that the surgeon started to laugh. Peg and I just teared up a bit. Emily grinned, as did the angels cause it was a sweet sweet sound that did not end in a racking fit of coughing. All you old RMS choir folks would ave approved.

Tomorrow, perhaps the 4th and final tube will be removed. We hold our breathe that all is good with the first three gone. Nice idea, Emily can now hold her breathe again. YES. So while not as smooth as that hallmark movie, today does get past the bumps and leave us all feeling good and optimistic. thanks for the support, keep it flowing........

Keith