KNOCK KNOCK. WHO'S THERE? SOFA.

Sofa who? So-fa, so good. Get it? That's 1 of Colby's favorite knock-knock jokes to tell with his communication device. I just couldn't resist using it.

Colby was EXTUBATED at 1:45 today and is doing awesome! I knew we were in good shape today because the same respiratory therapist who successfully extubated him 2 years ago was his RT today. I took that as a good sign. We had to decide whether to use a full face mask or a nasal mask. There are advantage and disadvantages to both. The full face will hold in pressures better. Colby still has so many oral secretions we were afraid the full face would not allow secretions to drain and he would choke on them. The nasal mask would allow his mouth to drain secretions, but we were afraid he would lose too much pressure support and would struggle. The doctor suggested 1 thing, the respiratory therapist the other. So after much deliberation, we went with upping his pressures on the bi-pap even more than originally planned and using a nasal mask with a chin strap. The transition from vent to bi-pap has been flawless so far. They have weaned his oxygen down from 45% to 25% already. He had his 1st cough treatment and breezed right through it. Sometimes they can be tricky because you have to take off the bi-pap mask to do the cough treatment, but he kicked butt. Actually the OT is over there stretching him out as I write this. This has been the easiest extubation this kid has ever had. WAY TO GO COLBY, MY GOODNESS YOU ROCK!! I've even heard a couple of faint noises already, sweet music to my ears! He still has a long way to go. His pressures are set at 28/10 with a backup rate of 22. That's a gigantic leap up from his home settings, 21/7 with a rate of 20. But like I said, he needs the extra support considering he's on a nasal mask.

Where do we go from here? Colby will stay in the PICU for an undetermined about of time. It all depends on his progress, which from here on out will be totally forward, right? He'll be on his bi-pap 24/7, coming off of it only for cough treatments. Then we'll slowly start weaning those pressures down. Then we'll try to start taking him off bi-pap for small breaks, usually 20 minutes to start, then gradually working up to more time off the bi-pap. They call this "windowing" taking windows of time off bi-pap. Once he's able to window for a while, maybe 30 minutes or so off, we'll go up to the TCC unit and from there, once he can window for an hour or so, we'll be talking about GOING HOME! My goal is to get us home by my b-day.

My friend Amber sent up her laptop so I'll be able to update over the weekend. Yay can't wait! Talk to you all soon. More good news to come I'm sure!!!!