Monday, June 29, 2009

Mikan's Bronchoscopy

Today we left my cousin's (thank you Darcey and Mike, we're sorry we showed up so late) house in Indy at 5:30 am for Mikan's 7:30 am surgery. Surgery went very well. However, the long term results are yet to be determined. Jenna and I anticipated there would be no removal of the tissue blocking the airway today. However, and to our pleasant surprise, the scope discovered that much of the blockage that was thought to have been caused by reflux had disappeared. Our doctor attributes this disappearance to the use of Prevacid for the last month or so. Good News.

While the blockage from the supposed reflux was gone, there was still scar/granulation tissue just above the tracheostomy opening in his airway. The surgeon was able to cauterize this relatively easily, without the use of a laser. He gave us some nice pictures of before and after airway cauterization.

Image One:
Airway blocked by scar and granulation tissue. You are looking down his trachea from above just below the voice box.

Image Two:
Airway opened up after the cauterization. If you look closely, you can see the top of the trach tube as it starts to go down towards his lungs.

This second picture looks very good. However, we are not out of the woods yet. As the second image looks much better than the first, it is still not ideal. The typical airway would be much smoother around the sides. Two known risks are still present: airway collapse, and having a strider (odd gasping like noise when breathing).

The plan forward is this:
1.) Wait for him to recover from surgery.
2.) Around July 4th, use Passy Muir Valve as much as possible.
If he tolerates Passy Muir valve, then the upper airway is in good shape. Mikan has a sleep study done and has the trach come out.
If he does not tolerate the Passy Muir Valve, then there are still issues with the upper airway and we adapt accordingly.

Even though Mikan was only going on 6 hours of sleep, he handled the day very well. We wish our state legislators could as good of a job as our ENT did today.

This picture goes out to all the non-artists out there. This is the picture our ENT drew for us before we went to the recovery room. Notice how he misplaces the location of the tracheostomy opening, scratches it out, then redraws it. He really do appreciate him taking the time to explain things to us.

Thank you for your thoughts and prayers, we are glad to be back in Northern Indiana.


Michelle and Sean said...

Well I'm glad to hear that it was a little better. Even though it wasn't the best still. I so hope he does well with the pm valve and is able to get the trach out. When Maggie uses the valve she still has stridor so it will be a while until she gets her trach out. Still to floppy back there.

We are praying for you and can't wait to hear how things go this weekend.

Maggie sends her hugs to Mikan. Take care all of you.

Hope said...

So happy it's done and he did well. Praying the PMV goes smoothly!! I don't think Ava will ever outgrow her stridor.

I'm thinking about you guys.

Jennifer said...

Always in my prayers. Glad you got to be with your doctor yesterday. Red :)

Alicia said...

Wow, that is great news! So glad the obstructions were taken care of. I will pray for the PMV trial to go well and for him to get that darn trach out sooner rather than later.

So happy for the good news!!

Jamie said...

i have to admit, i checked the blog probably 50 times on monday for updates. so, if you had a sudden "surge" in traffic, it was me.

i am glad to hear everything went so well. i had to chuckle at the drawing by the ent...i find similar works of art in the laundry sometimes. i always wonder the story behind them....