Frustration should always be tempered with a healthy dose of perspective

Let's start with the good news, shall we?
Tiernan is off high flow and on to regular nasal canula.  He is on 60% O2 and his SATS are holding steady at 99-100%.  So amazing. 
He is feeling better overall today and he even WALKED (while pushing his wheelchair) all the way out of the unit and took the elevator (still on his feet) to the train.  Another PR!  Sweet!!!
And now for the bummer type news.
He had to have a visit from the friendly neighborhood ENT (ear, nose and throat).  His voice is still raspy and quiet, so they did a scope and found that, due to all the work Hanley did around the area, his left vocal cord is paralyzed for the time being.  His right cord is already compensating (moving over past midline to close against the left cord)  This may be something we need to continue seeing a specialist for after we get home.  Likely as not, he will not need a tube long term, or even after discharge.  We will know more tomorrow when we have a swallow study at 10.  The concern would be that he will aspirate while drinking. We have primarily been spoon feeding him his drinks because he had been coughing when trying through a straw.  But yesterday and this morning that had seemed better to me.  He was still coughing intermittently, but it is difficult to tell whether it is and aspirating cough or a residual vent/respiratory cough. The OT who came by did not feel he had any trouble with solid foods; only liquids. 
I am a bit frustrated by this complication, mostly because of the tube sticking around still.  But in the grand scheme of things, if this is the only complication he has following this massive surgery, then he is extremely fortunate. 
The only other notable happenings today have been trying to schedule his new meds.  It will be a little more complicated than before, due to the addition of the beta blocker, Propranolol.  This really shouldn't be given within 2-3 hours of the Enalapril.  The Propranolol is to be given 3 times daily and Enalapril is every 12 hours. So if we are trying to avoid middle of the night doses, then we will be giving meds at (in military/hospital time) 6:00, 10:00, 1300, 1800, and 2200 hours.  In addition, we will want to be more aware of his BP at home.  So we will be in search of a good child size cuff to calibrate to the hospital machines. 

In the category of Carrie's Mental Health, I got to have a nice visit with local-ish heart mom, Jennie and her super adorable Tyler.  They are LPCH veterans and, as always, I love getting an opportunity to talk with and commiserate with other moms who "just get it."  Thanks for making time to hang out, Jennie!

To close, I don't want to jinx anything so I won't come right out and say it, but the number 3 and a reference to the West have been heard on occasion today.  Most recently in combination with the word Wednesday.  I shall leave you to your own imagination as to what that all means.