With a trach, he breathes in and out of the hole in his throat... so no air, except for small leaks, ever comes out of his mouth. Which means, no sounds. The passy muir valve allows him to breathe in through his throat, but not out... it forces him to breathe out through his mouth. Which means, sound!
A big concern of the using the passy muir valve is CO2 retention... I swear, if I never hear those words again (CO2 retention) I would be okay. It's tough to breathe out of your mouth if you've never done it before, and if you're not exhaling fully, there's an even better chance for CO2 to build up then Samuel has already... just because he's Samuel :) But with all of his progress, the passy muir is becoming a part of our every day routine for about 30-60 minutes, 2-3 times per day. YEA!
Samuel is also getting more and more expressive each day... for example, yesterday he threw his first audible temper tantrum... and I loved every minute of it! Not only was he using his voice, but he was using it to show real, firm emotion. For the first time he really cared that I took his toy away (it was bed time, I wasn't just being mean!), and he was not happy about it. I sat there in complete awe as Samuel told me exactly how he felt... I wanted to freeze that moment in my memory. I actually thought about trying to take a picture of it, but I would have had to recreate the same scenario and that did feel mean - ha ha! Get this, when I tried to give him back the toy, he threw it down and pouted for at least another solid minute... go Samuel!
**Note to NICU and PICU friends - it's amazing, his real voice is so much different than his "vent voice"! I can't wait for you to hear it!**
Other tricks (otherwise know as skills) Samuel has learned: winking (it's awesome!), pointing, identifying his tongue and his hair when asked, playing peek-a-boo, smiling when asked, and clapping his hands. Clapping was the first one, and it's great for many reasons. It means he can express audible happiness even without the passy muir, and because he can purposely connect his hands midline, it means he has a great chance at sign language. Every day I think I'm maxed out on amazement... then tomorrow comes and I find out there is no such thing :)
Go figure, the first time he really clapped we were sitting in the doctors office waiting for our turn... luckily we were already in a room so only our nurse Stefanie saw my watery eyes. Sheesh!
Direct hit this time!
Too funny, what the camera doesn't show is that when he was first learning to clap, Samuel somehow ended up poking himself in the eye with his thumb at the tail end of his clap. By now we have it figured out, but the first days we ended up with quite a few teary, but happy, eyes :)