March 11, 2013

A year since the 1st time we talked about Tracheostomy

   A year ago March 13th was the first time I had ever thought about having a child with a Tracheotomy  I remember it like it was yesterday, its hard to believe it already been a year. Hannah had just been intubated for the second or third time in a month and a half, I was sitting in her room in the NICU with my family preservation worker when the doctor came in. Hannah had just been intubated and we were discussing why she needed to be intubated(high co2) and that they couldn't figure out why she was failing the thrive on Bipap.. after all she was just on low flow for 6 months. The doctor told me that they couldn't keep intubating her for high co2, excavating her to bipap and having her co2 go up and need to intubate her a week later. The doctor said that they would do a bronchoscopy and try lung steroids.. I ask what makes a child qualify for a tracheostomy.. and I still regret those words coming out of my mouth. After I asked about a Trach that was the plan. They said they would try everything they could not to trach her but for the month leading up to her trach that's all there was talk about.
   They did a (not very in-depth) bronchoscopy and said they didn't see one of her vocal cords move but that they weren't considered and they didn't see anything reason why she couldn't breath on her own. They tried steroids and she did amazing on them. She was even off oxygen on Bipap and seemed like normal Hannah again, had energy to do things. But once they stopped the steroids her breathing started to get worse. By this point all the doctors had come in and told me she needed a Trach. I managed to only cry a hand full of times during her hospital stay and this was on of those times. It just wasn't fair.. How could she go from breathing so well on low flow to this.. so much would change with a trach and so much she wouldnt be able to do..
   They did another bronchoscopy, this time it said that they found that her left lung had Bronchomalacia and her left vocal cord was paralysis. Not the kind of news you like to hear.. but at least it was only one lung, and one vocal cord.

   Bonchomalacia is the walls of the bronchial tubes, the main stem bronchus collapses while exhaling. 

 








Vocal cords effect breathing because they open while you inhale, close to keep the air in your lungs and open to exhale. Hannahs stays open so air seeps out around the vocal cords making it extra hard for her to breath with Bonchomalacia. 

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