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haikumama
04-25-2009, 12:52 AM
This is a message I never wanted to post. When my son was trached on 2/17/09 we were really, really hoping the trach would be out by now, or on the path to being out by now. But that doesn't look like the case.

I am having a hard time reconciling that the future is going to be just as hard or harder than things are right now. I mean, I hope they get better. They have to get better, right? But we've been told by numerous people that this is the easy part - the part where you don't know a lot about complications and illnesses and things like that. And to me, the thought that these past two month with the trach are the EASY months? Oh, man.

My son, Isaac, is 8 months old, 5 months adjusted. He was born at 28 weeks, 2 days. He weighed 2lbs 5oz. he was born early because my water broke at 20 weeks. I was on bedrest at home until 23wks 6days and then I was in the hospital for the duration of my pregnancy, trying to accumulate as much amniotic fluid as I could, stave off infection, and not go crazy from worry.

When he was born, we heard him cry, which was amazing. He was on the vent for 24 hours, the CPAP for two days, and then on the nasal cannula for quite a while. He came home from the NICU after 8 weeks, with no monitors or oxygen or anything. We were so grateful.

Then, in late January of this year, he began sounding really stridorous when he breathed. He was diagnosed with croup, and even hospitalized for a few days. But he always satted well, kept eating, kept smiling, etc.

They told us the stridor would end in a few days and he would be better.

Well, three weeks later, the stridor was worse. The retractions were worse, too. He was still eating fine, though, and the doctor would do spot checks on his o2 and it was always fine. So we went to see an ENT for a laryngoscopy. The ENT diagnosed laryngomalacia and said Ike would just have to outgrow it. It was nothing to worry about unless he ever turned blue. Thanks, doc.

Well, on Februrary 12th, Ike caught his first cold. Snot everywhere. He stopped eating and seemed to be getting dehydrated. We took him to the pediatrician early in the morning of 2/13 and when we were there, Ike's heartrate dipped, his sats went into the low 80s and the ped called 911 to get us to the hospital quickly.

We spent a lot of the day in the ER. They actually wanted to send us home at one point, but we said no. So we were admitted to the respiratory floor.

At about 10:30 that night, things started happening quickly. Even with a cannula and extra oxygen, his sats were dropping. The 16,000 14-year-old interns and residents kept trying racemic epinephrine and things like that, even when I told them it hadn't worked before. Finally, as Ike was getting worse and worse, an RT said, "We have to get this kid to the intermediate floor for some heliox."

By the time we were transferred up there, Ike was satting in the 50s. They were bagging him and it wasn't working. He was weakly crying and was a horrible blue/gray color. They rushed him in the bed, running, down the hall to the PICU. All I could do was chase after them, in my bare feet. They wouldn't let me in, so I waited in the too bright waiting room, completely freaking out.

When the doctor came out they told me they had intubated him but could only fit a coffee-straw sized tube in his throat. They didn't know why his airway was so constricted, but it was very, very critical. He was sedated, and paralyzed with medication.

After three terrifying days of heartrate drops and o2 drops, he was taken in for a bronch, to see what was going on with his airway. During the procedure, the doctor came out and told us he was going to have to do a trach. Ike's airway was too narrow to fit the tube back in. He also said because of inflammation from being sick and being intubated, he couldn't say why Ike's airway was so tiny. It had a 60% subglottic stenosis.

We were in the hospital for quite some time, but on March 9th, he came home.

Well, fast forward to last week. Ike had a second bronch so that we could finally get some answers. Yet his airway was still inflamed and red. The ENT said it could have to do with an infection Isaac had had the week before (with a lot of coughing involved), or it's most likely from reflux. He was unable to tell us much more, other than he thinks the stenosis is going to require surgical correction and that we should take him to Dr. Cotton for this.

So I have been in contact with Dr. Cotton's assistant to try to get the ball rolling. (We live in Austin, TX - not too close to Cincy.)

This all very overwhelming. We have two other children (Sam, almost 7, and Georgia, almost 3), as well as Ike. Our insurance only pays for four hours of nursing care a day and there is a nursing shortage so we only get a nurse maybe 4 days a week. My in-laws have been living with us to help out, but I'm sure you know how easy THAT is.

It has been an ironic blessing that my husband was laid off on January 30th, because he's been able to be at the hospital and at home to help out with everything and take control over finding us financial aid, and dealing with insurance.

And through all of it, Isaac is always smiling. He is so happy and loving and beautiful. But the trach seems to be causing more problems now. With his feeding, his O2 levels, his weight gain... I am so terrified that things are spiraling out of control. I want the trach out NOW. I want him to go to cinci and get fixed. I want aggressive doctors to treat the reflux instead of chase it. There are so many things that I want to control that I can't. Or that I seem to start being able to control, that get torn out of my hands.

I didn't want to have to join this group because I wanted this trach to just be a passing thing. But it seems like it's not and I need to stop denying that.

I would be grateful for some info on Cinci, if anyone has it. Where do you stay? What is the LTR process like? How long does the process last from contacting the assistant to getting up there?

I'm sure these seem like naive questions to you pros out there, and that I seem kind of like a jerk for resisting our "new normal" over here. But these questions are what's sustaining me now. I have to think we'll get this fixed sooner than later. But until then, I am going to need tips on keeping him healthy with two other kiddos in the house. And tips on controlling the reflux (he's on Prevacid and Reglan now, and has been for a while)... things like that.

I hope this message hasn't been too long or horrible. I look forward to getting advice and commiseration here.

thanks so much,
Kari

Kamilah's Mommy
04-25-2009, 02:02 AM
Hi Kari....just wanted to welcome you to the group...just know that your not alone and I am sure that none of us ever wanted to have to join this group...my daughter had a trach put in a few days ago and I sure didn't want her to have to get one but she had already stopped breathing twice at home and as you can imagine seeing your child turn blue in your arms and having to give your child CPR is perhaps the scariest thing you can possibly experience...sorry, I can't be of much help... I still don't know how it is to have a child at home with a trach...my little girl is still at the PICU from her last blue spell and in recovery from her trach surgery...we are lucky to have this support group...their are some very wise and experienced people within this group that can hopefully answer all of your questions...once again its nice to meet you sorry its not under the best of situations.....Prayers for you and your little one...

cherienz
04-25-2009, 06:44 AM
hi
We are not 'premmie' parents/laryngomylacia, but there are lots out there on this board. Our son was not trached until he was 1 year old.

Trache's are not anyone's wish, if our kids were healthy we would not need this board.!!! I hope your tests/results are better than expectation.

Keep asking, SOMEONE out there is bound to have a similar prob.
Regards Cherie

llwilliams8
04-25-2009, 09:54 AM
Hi Kari,

I know it is hard going through all of this. I'm in Texas as well (Midland). I also have 2 older kids so I know how hard it is to juggle everything. My daughter is trached and on a vent 24/7 and they think she will have to be like this for 4-5 years. I have a love/hate relationship with the vent. I try to look at the positives though--if it weren't for trachs then my daughter would not be with us right now. She has central apnea so she goes down and turns blue quite a lot so I have to be thankful for the trach. The trach does not bother me but it's this vent that I hate since it keeps us from going many places. I have come to terms about it all and think it MUST get better and if not then I will just have to take it one day at a time. I've stopped living for the future and just living in the moment. I'm going to embrace what I am dealing with now, hope it's not forever but not wish it was different anymore. I know, easier said than done. I still have my days of wishing it was different but seeing how happy my little girl is I know there is a reason we are going through this right now and trying to listen to what God wants me to see and learn through this. My daughter does not have the same issues so I can't help with any of those questions but I just wanted to let you know it does get better and we all understand where you are coming from. It's easy for us to want them to be "fixed"--I just think to myself--would I rather her be this way or not be with me at all? If given the option for her to be gone forever or be trached and on the vent forever I of course want her the way she is now. There is hope one day my daughter will be vent and trach free but in the meantime I will just cherish her the way she is!! Sending hugs your way and I will be praying you can get in to see Dr. Cotton asap.

JWorthington
04-25-2009, 10:46 AM
Hi Kari, and welcome. I know this is a club you prefer not to have to join, but you will find a wealth of support and advice here. someone has always been there, done that IYSWIM. Like you, we thought the trach would bea short term thing, we were told 4-6 weeks while the swelling in Sam's airway went down following surgery. Here we are 4 and a half years later, still with a trach. I admit to having a sort of love-hate relationship with the trach, it is good to see your child breathing easily (Sam had a horrible stridor too), but I hate having to plan trips out like military manouevres so we don't forget anything. My advice to you is to try not to think of the future, just take one day at a time and try and enjoy your little one. It is hard, but, yes, it does get easier to cope with. Hope you get to cinci soon:hug:

Julie x

saywhatyouwill
04-25-2009, 01:39 PM
hello (yes, me again).

all the scary stuff will eventually fade into a memory you think about only every so often.

emily's subglottic stenosis is over 85% and she'll get her tube out :-)
to be honest i'm not completely clear on when different doctors decide to go in and operate. the surgery can be done on small babies, anyway, although it seems that they wait until 18 months - 2 years.

hope you get some answers soon.

Barb
04-25-2009, 03:25 PM
Hi, Kari. I am in Austin as well. My son's trach journey was several years ago, but I would be happy to help you navigate the Austin specialists that I know. PM me.
-Barb

Ann
04-25-2009, 07:47 PM
I didn't want to have to join this group because I wanted this trach to just be a passing thing. . . .

I'm sure these seem like naive questions to you pros out there, and that I seem kind of like a jerk for resisting our "new normal" over here.
Kari

It took me two years before I joined, so I completely understand the resistance to being here. I'm ten years into this and I'm still resisting ... every day. It took a lot of strength for you to post at all and I hope you can get some answers and reassurance from the people on this board.

Dr. Cotton and his team are great, hopefully you can get in to see him soon and get a plan in place.

Best of luck and welcome.

Vicki Rocha
04-25-2009, 08:41 PM
Hello and welcome! My little guy is also named Isaac:) My son was born at 26 weeks and your story sounds so much like my own..Those were the scariest times for us, watching Isaac retract and turn shades of blue..I was so scared of the trach, but it has turned out to be the best thing for him..We are scheduled for Isaac's reconstructive surgery on May 1st in Cincy with Dr. Cotton..The process happened very quickly and easy for us..I called the office and got an appointment for a broch scheduled for the following week..Right after the bronch, i sat with Dr. Cotton and his team and they explained what they found and answered all my questions, they were great!They also said Isaac could have his surgery that same month, I was acutally shocked that It was happening so fast..I ended up having to cancel that time because Isaac had RSV, but It was very easy to reschedule...I hope this info helped a little and I hope you get into see Dr Cotton soon:)

haikumama
04-25-2009, 09:47 PM
Thanks so much for the kind words, everyone. I am going to try to sort through my thoughts and post some questions to the main pediatric tracheostomy board, I think.

It is very encouraging to hear that it was easy and quick to get things scheduled with Dr. Cotton!

thanks again,
Kari

alizesmom
04-25-2009, 10:21 PM
Just saying welcome and hoping you get the information you need. I pray your trach experience is short lived and your son sports a naked neck. Me, mine are trached for life and it certainly is a love/hate thing. Karen

KJKK8437
04-26-2009, 07:46 AM
You know, I didn't join this group until a few short weeks before they tried to decan my son Alex a year ago. Like others have said, I didn't want to think of us as one of "those families". This trach was just a "thing" we had to live through.

Well, we failed that decan and ended up with an LTR in Children's National Medical Center in Washington DC this past February. The families on this Board got me through that year, the adjustment, and finally the LTP. They can help get you through this, too. Sadly, a lot of families on this Board share your feeling of disappointment.

Did they mention if the malacia was still there? I sure hope not. I hope your problems are not complex but are as "simple" (for lack of a better term) as stenosis that can be surgically repaired.

While we were at CNMC, our surgeon performed an LTP on a 3 month old little boy with acquired subglottic stenosis. The child was born in St. Louis and now lives in California. He was successfully sent home without a trach, although it was a risky surgery and he might someday still have to get one for "a short time" (whatever that means, right?) Now, I need to mention that stenosis was (so far as I understand) the only airway problem. There were no other health issues, and that played a big factor in the family's and doctor's decision to operate at such a young age. In many other cases, it is not so simple, like Claire mentioned, and the doctors will ask you to wait until the child is a little bit older. I sure, sure hope that you don't have to wait. With all my heart, I hope for this for you. :hug:

faywrayy
04-26-2009, 10:38 AM
Hi and welcome. I resisted joining the board as well, but finally did and am so grateful for it. I truly got and still get support commiseration and information here.

My daughter's story is different, but I want to tell you that she was diagnosed with a grade 2 subglottic stenosis (50-75% blockage) at 5 mos old. We looked towards an LTP which her ENT (Ian Jacobs at CHOP) said he'd do between 18 and 24mos of age. She grew and thrived with the trach while we waited for her surgery date to come. She was scheduled for the LTP in Philadelphia on July 3rd of last year. In the OR, they bronched her once again and discovered her stenosis had downgraded and she no longer needed the repair. She was downsized, capped and decannulated the next morning. She's had no issues since. Her health was good other than the stenosis (which was aquired -- she was initially trached for upper airway obstruction). I remember wondering why we needed to wait so long for the repair, but I'm thankful now that we did. If we'd gone ahead even 6mos sooner, she'd have likely needed the repair and would have faced a complicated road towards decannulation. A non surgical decann was such a blessing and she's done great since. Her stoma was surgically closed this past Friday.

I have those same pics of Kate's airway. I can show you how hers opened up over the course of 14mos. PM if you'd like to look!

Niff
04-26-2009, 06:34 PM
As of February 2nd, our daughter's airway was 90% occluded by a subglottic hemangioma. When she was trached back in December for a large cyst in her airway, I thought for sure she'd be decanned in a couple days and everything would be fine. She went from being on a nasal cannula to vent dependent and it took us months to get her off the vent.

Big :hug:s to you. We're all here for you and never be afraid to say what you feel. :)

Ainsley's Mom
04-26-2009, 10:32 PM
Welcome to the boards. I'm sure it will be invaluable to you as you try to come to terms with the change in your family's life. I think many of us lurked on the forum before we got the courage to post. I've been a member for about 2 years now. I fully expected it would be a short time. Ainsley was born with stridor and they were never able to determine a cause so I thought she would be extubated since they couldn't find a problem. The intubation caused pollups which turned into swelling so she was trached. I really thought once the intubation tube was gone the swelling would go away and out the trach would come. It hasn't gone that way. I think you'll find there are few of us here on the trach who were excited about the trach, even though we knew our children would breath easier. The sooner you can accept your situation and live day to day in case things don't happen as quickly as you'd like. And if the trach does come out right away that's a bonus. That's not to say you shouldn't pursue surgical treatment. We would if that was an option. I also have 2 other children so I know the demands you face. As for staying well. When Ainsley came home from the hospital we adopted a few policies.
1)everyone washes their hands immediately when they come into the house
2) no shoes on in the house
3) if you're sick stay away (visitors especially, but I'd also keep the kids away from Ainsley if they were sick)
4) I didn't take Ainsley out unless I needed to, to limit germ exposure esp. in cold/flu season
5) I keep hand sanitizer in the car and the kids and I use it when we return to the car after shopping, after school pick up, errand running etc. I also keep one in the diaper bag baby bottle pocket for easy access everwhere we take Ainsley.

With a kid in Kindergarten and one in Preschool we got our share of colds and Ainsley got them a few times. One time she caught RSV and had to be hospitalized. But that was the only time for illness and she's never had pneumonia. But I think her underlying lung health is very good so in part it is luck.

We also went to see Dr. Cotton (a year ago) and we live in Seattle. It was a LONG way to go. I still hope that one day he will be able to help Ainsley. I say go if you can make it work.

Best of luck to you as you work through these things.

Isaac'sMomandDad
05-01-2009, 03:44 PM
Just wanted to say hi as we have an Isaac as well! He was trached at 11 days old and I sooooo wanted it to come out 'soon' at like six months. Well ,turned out to be 18 months, but now coming up on a year trach free he is doing wonderful. Just take it a day at a time.

Lara