June 6, 2008

Surgery Update

Okay, where do I start. Everything went well! There was a small bump in the road with the scope of Max's airway. We found out that he has subglottic stenosis which is a fancy term for a narrow airway. This explains why he had stridor (loud breathing) and was tugging when he took a breath. We were given three options: 1. leave it and see how he does, but they would not be able to continue with the catheter placement. The airway was so small that they couldn't intubate him. 2. Place a trach in his throat. This is ours and the doctor's last choice. 3. We choice to go with this one. They did what is called a cricoid split. A small incision was made in Max's throat and the cricoid cartilage was split to open up his airway. He was then intubated and will be for the next 10 days. After the 10 days is up they will sedate him once again and do another scope to see how things have healed. He will then be extubated in hopes that everything goes as planned. The "new" airway will heal around the tube and leave him with a bigger hole to breath from. There is a 90% success rate with this procedure, so we are saying 10x as many prayers and keeping our fingers crossed. This website will help describe what they did a little better, http://www.tracheostomy.com/resources/surgery/cricoid.htm

Other than this, everything went as planned. The scope of Max's bladder and urethra shows that the blockage that caused this whole mess is still there. They will remove this when they decide to break down his vesticostomy. We will not know the function of Max's bladder until this is done. The peritoneal dialysis (PD) catheter placement went as planned without any complications. They do not want to have to use this for at least a week so that it has time to heal.

Max was doing well when we left this evening. He is obviously heavily sedated and will be for the next 10 days when they remove the ventilator. They need him to move as little as possible for the sake of the vent tube. If he pulls this out we are in a whole new world of trouble. We are not allowed to hold him and they will keep him sedated with a morphine drip. We believe that this finding is a blessing in disguise. Of course we thought and hoped that they were going to find that everything was inflamed due to the reflux, but we will deal with this and hope and pray that the procedure is successful. The doctor mentioned that it is encouraging to know that it was his airway and not necessarily his lungs causing the breathing problems. "We can go in and widen an airway, we can't make a bad lung better." Don't get me wrong though, Max still has small lungs, but the small airway didn't help him out at all. We are staying positive and hoping that all of this will be behind us soon. We are anxiously waiting to check the respiratory complications off of our list of things to deal with before he gets to come home.

Keep those prayers coming :o)

Beth, Tim and Max

2 comments:

Rachael Schirano \\ Rachael Schirano Photography said...

i am so happy to hear that things went well with the surgery and although there was an unexpected find, at least it is something that they can treat. i want to tell you that i am just in awe of your incredibly positive outlook, i think it will carry both you and max through all of this. you are an amazing mama! i will keep praying for max!

Anonymous said...

I am glad the surgery went well and like teh prior poster said even though there was an unexpected fine it is something that can be treated and maybe answers some of your questions.
I will be thinking and praying for you guys extra hard these next 10 days.
Denise
aka Matilda&Leon