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View Full Version : Accidental downsizing - now what?


Peyton's Parents
04-19-2009, 11:05 PM
During our weekly trach change tonight we couldn't get Peyton's 3.5 back in. There has been a little granulation tissue developing around her stoma so we figured that must be the reason. We went ahead and put our 3.0 in for the first time ever. Then, when I looked at the old trach we had just pulled out I realized we had accidentally put in a 3.0 last week. So she's been wearing it for a week now and we are thinking that is why we couldn't get the 3.5 in tonight. So now what do we do? We need to treat the granulation tissue but is it in our best interests not to upsize if she is tolerating the 3.0 without a problem? Her stand in ENT is several hours away (in between ENT's at the moment) so I'll call in the morning but wondered if anyone else had experiencing downsizing (either on purpose or accidentally).

Thanks!

drct1245
04-19-2009, 11:25 PM
We had downsized from a 4.5 to a 3.5 a few months before decan. Did you notice any working to breath, change in sats, or change in mood this past week? Usually secretions change when you upsize/downsized, so that would be normal. Since Ayden is a BPD baby, it didn't really phase him since we didn't have to worry about structural issues. Hopefully the ENT will just talk with you vs going in... if all checks out. (?)

Peyton's Parents
04-19-2009, 11:35 PM
Did you notice any working to breath, change in sats, or change in mood this past week? Usually secretions change when you upsize/downsized, so that would be normal.

There were a few things this week that were a little unusual. A few days she had more coughing than usual during the day but her night nurse has been sick with a cold so hard to say if that was related to the smaller trach or not. In addition she has been a little more gaggy then usual but because we just took her off reflux meds in the last week we attributed the gagging to that. Her sats have been fine and she doesn't seem to be working to breathe. We had thought she was more vocal this week than usual though.

drct1245
04-19-2009, 11:59 PM
Her sats have been fine and she doesn't seem to be working to breathe. We had thought she was more vocal this week than usual though.

That would be the benefit of the downsizing. :)

Now that you mention it, Ayden was a little more gaggy - my guess was the secretions would come up around the trach rather than through the trach.... and more coughing b/c of the change in secretions.

BTW... She gets cuter and cuter by the day! I realized I hadn't popped on her blog in a while and boy is she growing! :)