Since so many people have asked and the details are so vast, I thought I’d write out a full-length update on Mia’s health in chronological order. This is long, but it’s thorough and pretty interesting if you’re interested in that sort of thing…

The Beginning: The Flu and Ventilator
Mia got Type A Flu around February 16th. She was admitted to ICU on February 19th and she was incubated/put on a ventilator to assist with her breathing after not responding well to the by-pap machine on February 22nd.

(And by “not responding well to the by-pap” I mean “taking her mask off and throwing it at the nurse because she was agitated and hated it.” That’s our Mia. :))

Now, you and I get about 21% oxygen from the atmosphere. The pressure that our lungs and diaphragm extends to bring that air in is roughly 5 “Peep.”

Mia spent 19 days with a tube down her throat and most of that time was spent with a ventilator delivering 100% oxygen to her lungs at 15 peep – the highest settings the machine has.

She was breathing short, shallow breaths against the machine, so her lungs weren’t absorbing the oxygen as well as they should have and she was also out of synch with the ventilator. It was pushing a breath in while she was pushing out. The ventilator was supposed to help her rest, do the work for her, and allow her to fight off the flu and pneumonia… but she subconsciously fought it every step of the way.

The Middle: Pneumonia and Sedation
Because she was fighting against the machine so hard, and to help her chill out enough to allow the ventilator to do the work for her so she could fight the infection, Mia was heavily sedated from the get-go. This is why she didn’t know about Daddy… it’s probable she still doesn’t really know… we haven’t gone out of our way to bring it back up.

When she was on the by-pap, they gave her Morphine and Advan. When she was put on the Ventilator, it was Propofol (the drug that killed MJ). Then, when her breathing was so out of synch with the vent, they put her on a paralytic to completely paralyze her body so no muscle could fight against the machine – nothing, nada, not one movement.

Now, when you’re taken off of Propofol, you usually wake up pretty instantly. Mia… didn’t. Her eyes opened, she stared straight ahead, but she didn’t move. It looked like the lights were on (barely), and no one was home.

Those times she was taken off of all sedation were called “Sedation Vacations” (yes, I asked if I could get one, only the inverse… I was denied) and it was during one of those breaks that we told her about Daddy.

That was Wednesday night, March 5th.

At that point her doctor told us she wouldn’t survive a tracheotomy, that none of her metrics were moving in any direction let alone the right one, and that her major systems (like, kidneys) were starting to slowly fail.

Looking back, if we were going to ‘pull the plug,’ then that would have been the night to do it. Her doctor said that if she made it through the weekend with no movement in the right direction, then Monday, March 10th, we would discuss making that decision.

The Turn-around: Clearing Up and Getting a Trach
I swear that night I felt Daddy ask, jokingly of course, “This woman can’t even give me two weeks of peace in the after-life?”

And damn if she didn’t start turning around for the better on Thursday, March 6th.

The ventilator’s oxygen output was dropped to 70%…. then 60%…. then 50%. Then her peep level started getting adjusted down… her cultures came back that she was negative for the Flu, her kidneys picked back up, and she started maintaining her own heart-rate and blood pressure again.

On Wednesday, March 12th she was cleared for, and received, a tracheotomy.

For the first time in almost 20 days we were able to take her completely off of all sedation and see her entire face. And because she has a trach, there’s a line in her chest where nurses can pull out the gunk that you and I would normally cough up after a bad bought of pneumonia. Gross but awesome. Finally, she was heading in the right direction.

The Lights Are On…
The first two days after the trach, there wasn’t a whole lot going on in there. Again, we feared ‘lights are on and nobody’s home.’ Corey and I had such high hopes seeing her after surgery and while we saw tiny little flashes of possible recognition in her eyes… for the most part, nothing.

At that point her nurses were wondering, along with us, if she’d had a stroke… if she’d been deprived of oxygen too long (there was a point when the machine was working as hard as it could and her body just wasn’t responding),… had brain damage occured from possible oxygen deprivation… or had she just been on Propofol so long that it was stored in her fatty tissues and it will take weeks to work itself out….?

Basically, we were wondering if we’d made the right decision by keeping her alive via machines. We wondered what kind of body we were bringing Mia back to. We were afraid we went against her wishes. But the simple fact is, we won’t know the answers to any of those questions for a very, very long time. We went with the doctor’s advice and did the best we could.

Friday, March 14th – exactly one month since I’d last seen Mia and Daddy both totally normal, laughing, fun-loving as always – I left work and went straight to the hospital. I sat down next to her bed and bawled my effing eyes out. The only person who needed Daddy more than I did is this woman… she’s the only person who can understand the hole left in my heart and my life by his death… and she’s completely out of it.

Kiiiiiiiiiiiiiiiind-of….

I lifted my head off of her bed when her nurse came in and said “Oh hey! She nodded for me today! And shook her head! And she’s tracking with her eyes – watch, I’ll call her name from this side of the room and she’ll look over!”

And sure enough, she called Mia’s name, and Mia looked over. Then Mia looked at me and I saw it in her eyes – she recognized me. She opened and closed her mouth like she wanted to talk to me. And I started laughing and crying at the same time.

Saturday, March 15th to Today and Kindred
So last Friday, Mia looked at me and recognized me.

Last Saturday Cari and I showed up at the hospital and she was turning her head, blinking for us, responding to requests to open and close her mouth… she also accidentally squeezed my hand when she had a bad coughing fit, and even moved her legs a little.

I’m writing this on Wednesday, March 19th, one whole month after Mia came down with Type A Flu, and she is being moved from the Cape Canaveral Hospital’s ICU to a longer-term care hospital in Melbourne, FL that specializes in weaning patients off of ventilators, called Kindred.

She’s made a LOT of progress considering how ill she was, but to be clear: She still cannot speak or form words with her mouth for us to lip-read  – but she can respond to simple requests with a nod, head shake, or blink. She still has not moved a muscle, gripped a hand, or otherwise responded physically to any command – but she can move her muscles when coughing.

The Longterm Outlook
It’s a miracle that Mia is alive right now, but she has an enormous road ahead of her to recover. There is still no telling if she CAN recover. All we know right now are that the signs are promising, and she is making small improvements each day.

But to be clear, her future is very uncertain. She may never be able to relearn motor skills enough to live on her own again… she may never go home. But she also might surprise the hell out of us and be back in her house in six months. We just don’t know.

After her time at Kindred she will need to go to a longer-term rehab facility. We’re not sure if we’re going to be sending her to one in Pensacola to be nearer Cari, my stepsister and her daughter who has Power of Attorney, or if we will need to keep her nearby Merritt Island. That will all depend on how well she is to travel… we kinda hope she’ll be able to tell us if she even *wants* to travel.

As for the kids…
In the meantime, Cari, Corey, and I are splitting up the weeks at the house to take care of our parents very old dogs who are just as shocked as we are. Depending on how long Mia will be in rehab, we will need to find a foster home for them, which breaks our hearts and is a decision we’re putting off as long as possible.

We’ve taken care of Daddy’s will, honored his wishes to be cremated, and started the process to have him interred at the Florida Veteran’s Cemetery. We’ve gotten a probate attorney to help us sort through everything and we’ve started going back to work. Next, I’m going to start planning a memorial service for him and give folks enough notice to come from around the state.

I’m going back and forth between good-Daddy-days and bad-Daddy-days… which I’m sure I’ll continue to write about as I process. But what really breaks my heart is that, by the time Mia can really understand that Daddy died, my grieving process will be very far ahead of hers. I know what kind of pain and heartbreak she has in store. And whatever her recovery process may be… that heartbreak is awful, and I would give anything to save her from experiencing it too.