Months ago, Brooke was told that when he got up to about six hours a day off the vent and could do that consistently for a number of days in a row, they’d downsize his trach from an 8 to a 6. He has worked, and worked, and worked at breathing off the vent, adding more minutes in small increments over impossibly long periods of time, but finally it has happened: the old 8 pulled out, the new 6 put in. This is a big and for the first time tangible step forward in vent-weaning, concrete evidence of real progress. Of course, there are more stages to go—the next one is downsizing from a 6 to a 4—and lots more effort before you can go 24/7 without the vent at all. Just the same this drop from an 8 to a 6 is a big deal, a long, long term intermediate goal finally met.
Of course, nobody told Brooke it would be harder with the 6. It’s like adding weights to your barbell, he says. So he’s back to building up hours off the vent: two hours 20 minutes this morning, an hour in the afternoon, another session starting right now, at 9:44 at night. I’m sitting at the foot of the bed, facing him, and I can see his abdomen moving with each breath. That’s new, and good. He’s listening to his favorite Music to Breathe By, slack key guitar. Earlier today he said he thought he could feel his diaphragm moving. In a sense it’s back to the drawing boards, building up the hours again; but in fact it’s a giant step ahead. Hooray.