When I wrote the post Thursday, we were under the assumption that Kai would be in the hospital for at least three more days, if not longer. ENT finally came and placed the new trach about four-thirty and then at six he was moved upstairs to the L-Pod. Our plan had been to get Zuri Friday morning, I would spend the day with her while J spent the day at with Kai. Then we would have Zuri spend the night with my mom while we did our 24 hour room in with Kai. Sunday would be spent mostly at home with Zuri (and going to church). Monday and Tuesday would be spent mostly at the hospital, and Zuri would spend that time with my mom. We were hoping for Kai to come home by Tuesday at least.
It didn't happen that way. Friday morning, as J was on his way to pick up Zuri, he called the hospital to see how Kai was doing. They said that he was doing great and that he could go home by noon. When J mentioned the 24 hour room-in, they said they thought we did that in the PICU. J said no, and they said if we really wanted to do it, we could, but they feel comfortable with us going home today. Of course we didn't argue with that! So, J got Zuri, and we all got ready to bring Kai home.
When we walked into Kai's room, the first thing we noticed was that his left eye was filled with pus and extremely swollen. His eye had been fine when we left for the night. Then we saw crusties around his g-tube site and his hair was all matted with goobers and sweat. It was so gross. In fact, unflappable Zuri (when it comes to stuff with Kai), took one look at Kai and got really scared. She wouldn't go near him or look at him for the longest time, and when she did, it was only because we were able to show her that Kai isn't "scary."
The first thing we did when we got Kai home? You guessed it, straight into the bath he went. He loved it. It was a lot harder and more awkward with the ventilator, and it definitely takes two people, but he was dirty on such a level that a sponge bath just would not cut it. Trach cares are also much more difficult, requiring two people. The custom trach is made out of a very flexible silicone, which makes threading the ties very awkward, and with the extra weight of the vent (not to mention the extra length of the trach and the long flexible neck) holding it in place while doing other stuff is very difficult. With the normal trach, we had gotten to the point where it was actually easier to do cares by ourselves. Hopefully we can get to that point with the custom trach.
We have our first "outing" with Kai on Tuesday, where we have appointments all day long. One of the appointments is for his eye, which is slightly less swollen, but still pussy and red. We have been doing what we can to help it, but I am really worried. There is a really thick pus that is right over his pupil and iris that occludes his vision. The nurses have no idea what happened to his eye. Hopefully we will get some answers on Tuesday.
The ventilator is heavy! It weighs a good thirty pounds, if not more. We have to figure out how to transport Kai now--especially as J will be working (he is taking Tuesday off to help with Kai and all the appointments) and I will be doing it all on my own. There isn't enough room in the stroller to set the vent (if we hang it from the side or hand rail it will tip over) especially with all the other stuff we have to take as well. The nice thing about the ventilator is that it produces a much more pleasant noise than the converter did (which we don't need anymore). The closest way to describe it is an ultrasound machine--minus the heartbeat sound. It could almost be an ocean sound as well. The alarm on it is extremely annoying, but meant to be so; even on the quietest settings, the alarm can be heard at the back of our condo with the doors closed. Another nice thing about having the ventilator is the extra care that Kai receives. He is placed in a higher bracket, which entitles him to better care. I know how awful that sounds, but the L-Pod is a perfect example. With just a trach Kai would never have gone up there (trust me, it is a NICE place to be). We are now guaranteed home night nursing and even given "respite" hours, where we can take a vacation and have the nurses watch Kai while we are gone. The care goes all the way to our home health care supplies. Instead of having to call up and order supplies each month, they have given us a sheet with the inventory of all the supplies and they will call us. We now have an RT (respiratory therapist) on call 24/7 and he will come to our home once a month to check not only on Kai, but also on the ventilator and change out the filters (ventilator rentals are $2,000 a month!). The hard thing about the ventilator, other than all the extra tubing and limited range of motion, is that Kai, whose sounds were virtually nonexistent before, can't be heard. I can no longer hear when he coughs or when he needs suctioning. Our "within eye sight" is even more true now in a big way, and in a smaller way it gives us a bit more freedom because now we have two alarms that blare at us if something is wrong: the ventilator and his pulse-oxygen monitor.
Kai, for his part, seems much more content since coming home. He has mostly just been sleeping, but during his awake periods he has been blowing bubbles and sucking on his fingers. He is also not going into his apnea/desat periods while sleeping anymore, so he is getting some really good rest. His eye doesn't seem to be bothering him too much, except he keeps turning his head more so he can see better. His bum is looking so much better! We have been using the cream from Germany and it has been wonderful. I can't remember if I mentioned it before, so if I have, bear with me, but we had the GI (gastrointestinal) doctor look at Kai. Their best thought was that he might have a carbohydrate absorption problem, and he might not be breaking down the sugars in the specialized formulas very well. The recommendation is for Kai to go on "normal" formula and he how he does. They took some of his stool to test. They ruled out harmful bacteria in his gut, but didn't have enough of the sample to tell about the carbohydrate issue. We had already switched formula's at the hospital when they told us they needed more, which voided the whole process because they needed the stool from the previous formula. They also have been giving him the bacteria from yogurt to help normalize him from the course of antibiotics. Yesterday was the first day we have seen some improvement in his stool (thicker and not so diarrhea-ish).
Zuri is also happy to be home. After greeting me on Friday, the first thing she did was to go to Kai's crib. She kept asking where he was and became excited to go pick him up from the hospital. It was the custest thing to see. She doesn't bother his equipment at all (except his oxygen tank, she loves to play with the chain on it). Other than her initial curiosity with a new machine, she hasn't paid any attention to the ventilator.
It is great to be home. The ventilator makes things a little more complicated, but it is so good to see Kai not struggling to breathe and turning blue all the time. We are still in adjustment mode, but it is so nice to be getting back to "normal."

Sleeping. In the picture it looks as though he has red-eye, but that is actually his swollen eye.

Awake. A better view of his eye as well. Amazingly enough, it has improved quite a bit. He can at least open his eye now, although the film of pus won't come off.
We would like to thank you all for your comments and support. It means more than we can say to have so many people rally around us during this trial in our lives. We feel the love and support and it is part of what has enabled us to get through these rough times. We have been blessed to have family and friends such as you. Thank you again from the bottom of our hearts.