Wednesday was a momentous day: the trach tube would be removed today. Meghan was both looking forward to this and dreading it. So she was understandably nervous when Michael, the respiratory therapist, and Dr. Connor came into her room.

“Today’s the day, Meghan! Are you ready for this tube to come out?” She nodded.

Michael was wheeling in a cart with airway supplies. He saw her gaze rest on it. “Don’t worry about this, Meghan. This is only for people who don’t play nicely with me, and you’re not one of them.” He opened a drawer, removing a nasal cannula, which he hooked up to oxygen. He went ahead and put the cannula in her nose, adjusting the tubing so it sat comfortably snug, putting it behind her head instead of under her chin.

“We’re giving you some supplemental oxygen for the rest of the day, just to be sure that you’re staying well-oxygenated while your body adjusts to breathing through your mouth and nose. I’m going to lay you flat in the bed now,” Dr. Cooper informed her. He operated the bed controls until she was lying flat. “Okay, Meghan, I’m going to deflate the balloon on the trach tube, and then I’ll pull it out. I’ll cover it with some gauze and tape that in place. I’ll warn you – you’ll probably feel short of breath for a few minutes, but shouldn’t feel a lot of pain. We’ll be right here with you until you’re breathing easy again.”

Meghan nodded.

Dr. Cooper pulled on a pair of gloves and nodded at Michael. Meghan could see out of the corner of her eye that he was also gloved and held an Ambu bag, just in case. She took in a deep breath and let it out, trying to calm the butterflies.

“Here we go.” Dr. Cooper deflated the balloon at the end of the trach tube. He undid the cloth tape holding the tube in place around her neck. “Deep breath, Meghan.” She breathed in, and then as she started to breathe out, he pulled the tube out of her throat. He quickly placed sterile gauze over the hole in her throat and taped it in place.

Michael reached out a hand and helped Meghan sit upright in the bed, supporting her as she gasped her first few breaths through her mouth. “You’re doing great. Deep breaths, that’s it. Slow your breathing down. Good girl. Slow breaths.”

Dr. Cooper adjusted the bed so that the back was elevated again. Michael helped her to ease back, letting the bed support her.

Meghan’s respiratory rate finally calmed down. Michael, who had been keeping a close eye on her pulse ox, glanced back up again at the numbers. “You’re doing well. Your pulse ox is leveling off at 98% on 2 liters. I’ll keep you on oxygen until this evening, and we’ll see how you’re doing. Need anything else, doc?”

Dr. Cooper shook his head. “Nope, I think she’s doing well. Thanks, Michael.”

Michael nodded, stripped off his gloves, and packed up his supplies before heading out with his cart.

Dr. Cooper pulled over the rolling stool and sat next to Meghan’s bed. “Meghan, it’ll probably take a couple of weeks before the hole from the trach completely heals. We’ll keep it covered with sterile gauze and tape until it’s all healed up. The nurses will be changing the dressing daily until you’re dismissed from the hospital, and then you’ll need to keep that up until everything is healed.”

Meghan nodded.

“When you cough or want to speak, you’ll need to occlude the hole by putting a finger over it. Right now, the air is going to want to exit your tracheostomy. By occluding it, the air is forced to travel up through your vocal cords so you can talk. Until everything heals, your voice may sound kind of raspy, but it’ll normalize.”

Meghan hesitatingly touched the bandages, then pressed gently over the gauze, covering the hole with her finger. “Like this?” she asked. Her voice was indeed raspy, but she was also glad to be able to speak again.

Dr. Cooper nodded. “Just like that.” He smiled, then sobered. “Also, Meghan, I wanted to apologize. I wasn’t aware that you had an allergy to penicillins, and thus prescribed a medication that sent you to the ICU. I feel absolutely horrible about it. I’m so sorry.”

Meghan waved away the apology. Finger over her stoma, she replied, “Not your fault. I didn’t know I had a penicillin allergy either. We both found that out the hard way.”

Dr. Cooper smiled. “I appreciate that. I’ll check on you tomorrow,” he said, standing and shaking her hand. He turned and left the room.

Meghan closed her eyes and leaned back in the bed, pushing the buttons to lower the head of the bed some. She was glad to have the trach tube out but felt like she’d run a marathon in the process. She was asleep a few minutes later.

**********

Dr. Brant knocked on Meghan’s door later that afternoon. As he entered, he noticed right away that she wasn’t in her bed, but rather was sitting up in the recliner! “Well, this is good! How does it feel to be sitting in the chair rather than lying in bed?”

Meghan covered her stoma. “Feels good. Physical therapy was in and got me up in the chair half an hour ago.”

“And you’re talking! You’re making progress, Meghan.” He was smiling as he pulled over the rolling stool and sat down.

“Yes, slowly but surely. I want to get out of here!” She smiled.

“You have had a rough time of it, to be sure,” he said. “But I wanted to peek in on you, see how you were doing. And I wanted to chat about your fracture.”

“Oh?” Meghan wasn’t sure she wanted to hear more bad news.

Rick wanted to kick himself at the look on her face. “No bad news, I promise!” he said hastily. “Friday marks four weeks with the cast, six weeks since we repaired the fracture. I’ll put in orders for x-rays to be done tomorrow, and as long as things have healed up as they should, we’ll remove the cast Friday. I’ll be setting you up with orders for physical therapy to work with your leg and get it strong again.”

“That sounds wonderful to me. I’m ready for this heavy, itchy thing to be off.”

Rick chuckled. “I’m sure you are! One less medical device hindering your movements is always a good thing.”

Meghan nodded vigorously.

The door opened, and Kelsey and Mitch entered. “You’re in a chair!” Kelsey exclaimed, delighted.

“It’s a nice change of location,” Meghan replied.

“And they removed the trach,” Mitch noticed, pleased.

Meghan tried to say something, then remembered to cover the stoma. “Yes, although this is going to take a little getting used to.”

Mitch and Rick shook hands. “I was telling her that I should be able to remove her cast on Friday, pending x-rays, of course.”

“That’ll be good. I know that getting that big splint off and going to this molded one has been nice.” Kelsey hugged her sister, then found a seat to sit in nearby.

They chatted for a while before Rick excused himself to go back to work. Meghan was quickly fading and called for assistance to return to bed. The nursing assistant helped her maneuver from the chair back to bed, saw that she was comfortable, and left.

“I think we’ll head out and let you rest,” Mitch said. “Need us to bring you anything?”

Meghan yawned. “My knitting would be great to have. And Mitch?”

“Yes?”

“Maybe a cup of coffee next time you come? A small one?”

Mitch smiled. “Now I know you’re starting to feel better. I’d be happy to bring you coffee. Get some rest, and we’ll see you later.”