To say Nathan is awake does not mean he's sitting up in his bed and communicating with us. While they have drastically reduced the sedation Nathan is receiving, he is still mildly sedated. They are working slowly to reduce this and as they do he becomes more responsive and alert to what is going on around him. We do not know how much he understands of what is going on, or how much the sedations effect his vision or comprehension, we do know that he still is very tired and sleeps alot, but will wake up and acknowledge that you are there. At the same time Nathan is still intubated. For those who do not understand how this works I have provided a picture below. When a person is intubated a tube is placed in their mouth and down their throat. This tube is hooked up to a machine that provides oxygen to the individual.
A look at the pictures indicates that this is very uncomfortable. While Nathan has indicated he doesn't like the tube and would like it out he has been very good about not touching it or ripping it out. When a person is intubated the tube goes through the voice box and blocks off the throat so that air only goes through the tube. This means an intubated person cannot talk, although Nathan tries. We can only imagine the frustration he must have with it.
Three years ago Rob and I sat in a different ICU, during a different circumstance. While seeing Nathan sedated and intubated was okay I found yesterdays visit of him trying to communicate brought back a flood of memories. This is probably also because when I came to visit him the Physiotherapist was with him and I would say she was "torturing" him. She was trying to get him to spell a word by using a chart. It was very obvious that he was far to tired and exhausted, never mind that he had just had extra sedation for his dressing change and probably couldn't see straight and for sure not read the tiny letters she had on her chart. Nathan was moving his hand and trying to indication something but she just wouldn't give up. I wanted to tell her to leave him alone, but it wasn't my place to interfer. He seen me step into the room and then step back when I realized they were still working with him. He raised his head to look, but I have no idea if he could actually see me or knew who I was or just seen another figure come into the room. I guess the nurse had the same feeling as I because she told me Physios time was up and to go ahead in, and then when Physio still wouldn't stop she stepped in to tell her that he had just had extra sedation and was too tired. When Physio asked Nathan is he was tired he had no problem shaking his head yes then. I only spoke briefly to Nathan to say hi and tell him to close his eyes and rest because he looked so tired. He instantly lay back and rested.
I remember clearly those three weeks when James was intubated (with no sedation). At the time we cherished the moments we had with him. We talked to him and tried to communicated and did a pretty good job of it too. At the time my thoughts did not really focus on what he must be going through with the intubation tube. I'm sure it crossed my mind, but it was not until later that I wondered how much it hurt or how wise it was to have him awake through that. James did not want us to move him, hold him, cuddle him, or anything of that assort because it was so painful to be moved. After James passed away it has often bothered me that he was awaking during those weeks of intubation. I wondered how much pain he was in and desired to talk to someone who had been intubated and awake to know more. I'm not sure why, it's not like it can change anything, it's just to know I suppose.
It would appear that I may have my desire fulfilled, although I really wish it had not come in this way. Yet having this desire fulfilled means that Nathan will still be with us and if he can tell me what it was like, that means he'll no longer be intubated. I guess I have to look at the positive of it and remember that while it may be awful to go through, it is still a lifesaving device. What a blessing that these device are available and have been able to assist in saving Nathan's life.
We are so thankful for the medical equipment that is available and working so hard to keep Nathan alive and with us. As Nathan becomes more aware of his surrounding and what is going on the reality of what has happened in the past two weeks is going to start sinking in. We pray for Nathan and Aileen to receive the strength they need to go on each day again and we continue to pray for those who are caring for Nathan that God may bless their work also. We especially give thanks to God for all He has done and continues to do during this trying and difficult time.