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View Full Version : Thoughts appreciated - reschedule bronch or no?


lovemy3
05-18-2012, 08:37 AM
I am sure this is going to sound like a crazy rant b/c quite honestly I feel crazy right now.

Jackson is scheduled to go to CHOP for a routine bronch on Monday. The only extra thing they will do is remove a granuloma up above his trach so we can try to start using the PMV.

We wanted it last fall, they said no, based on his extreme secretions they didn't think it was safe. This March at his airway appointment they said yes, it's time, lets do a bronch, get it out, and give him the PMV. Scheduled an OR slot for April and had to cancel because he woke up the morning of with the stomach flu. Rescheduled to Monday.

Last weekend he had a cold and it's gotten better each day, he isn't coughing as much and he sounds pretty good, no fever, BUT in the mornings he has thick green snot coming out of his nose. He is happy, playing fine, but it's that green color that has me concerned.

This morning CHOP calls and there is an emergency reconstruction that has to take place Monday and Dr. Javia (our surgeon) has to be on the team. They say we can either reschedule into June or use a different surgeon.

So my husband and I talk and decide to go forward with a different surgeon. We aren't talking about decann anytime soon, it's a standard bronch, we just want that granuloma out. Obviously we will talk before Jackson goes back to ensure we are on the same page and he will have Dr. Javia's notes/images from previous bronchs. It's not like we chose Dr. Javia, he was assigned to us in the beginning of our stay.

I mention this to our primary nurse this morning and she says "Well I think it just needs to be canceled in general and I have thought it all week. He has nasal congestion". And I just kinda lost it and burst out crying and selfishly said "I don't want to reschedule again, the mental and physical work that goes into admitting him & watching him go through this is too much, I can't do it again". She says "It's not about you, it's him Melissa". That's a whole other rant that I will keep to myself but everyone can imagine how I felt about it.

So help me please...is everything adding up to the fact that I should reschedule? I don't care so much about a different surgeon, it's a new set of eyes on him with new ideas maybe. But I don't want to get so caught up in my own agenda that I discount that green mucus we are seeing in the morning. And my annoyance at that nurse.

I feel like if we wait until he is perfect we will wait forever. It's a bronch, we aren't anywhere near decann, and I am so very desperate for him to start using that speaking valve and to hear his little voice again. But b/c it's just a bronch, am I putting him at risk by putting him under when he has some congestion?

Thoughts appreciated....

tbhartman
05-18-2012, 08:43 AM
can you get him into the Ped, or at least call today? see what they say... when in doubt, i get my Peds opinion... As long as his lungs aren't congested you'll probably be fine.

lovemy3
05-18-2012, 08:59 AM
Our ped won't touch him, he was upfront about that from the beginning. Shots, standard checkups, etc he is fine with but anything regarding his lungs or a sickness he sends us to pulmonary. Which is two hours away.

And I was thinking the same about his lungs, they are not 100% yet but much better than a few days ago. We are doing CPT constantly and Albuteral around the clock too.

kadiera
05-18-2012, 09:42 AM
I'd call ENT and ask their opinion. They may tell you to ask pulm, but that's better than getting there and having them say no, green snot is right out, and then having to reschedule completely with no warning.

Ainsley's Mom
05-18-2012, 11:19 AM
I have been in similar shoes more times than I care to remember. I really think green snot requires rescheduling. Going under anesthesia is hard on the body and the stress could make him sicker. If he does have a granuloma removed you don't want him to be sick and start coughing, because it could start bleeding, or the surgical site could get infected if he already has bacteria in his airway, which is sounds like is possible based on the green snot. Sorry to tell you this. I know how badly you just want it done and over with. :hug:

Cillian's Mom
05-18-2012, 11:36 AM
We were recently in a similar situation. Cilly was to have a bronch in March but was sick at the time (cold symptoms). We called and spoke to ENT and they recommended that we reschedule. We had to wait until this month to get it done but i am glad we waited for the same reasons Susan mentioned.

MelissaRyan210
05-18-2012, 01:10 PM
I am sorry, I know how stressful this can be.

But I really thinking that waiting is best thing to do... :(

Putting a kid under when they arent at top shape can lead to pneumonia and worse. Its hard on our little ones...

Chin up Momma! It wont be too much longer and you have (I am SURE) been through worse.

SammyJo
05-18-2012, 01:54 PM
So sorry, but I'm with other others. We have also been in this situation and I know it feels like there will always be something that will postpone it. I think its better to be safe and Susan made really good points. Sorry again, we all have been there!

lovemy3
05-18-2012, 03:15 PM
Thanks for all the responses...I knew I would get the right answers here.

Talked to ENT and they want us to wait it out over the weekend and make a last minute call. Since he has no fever and it's only colored mucus in the morning they think he has a shot at being fine. As a backup they already penciled us in for June.

Thanks again!

Ainsley's Mom
05-18-2012, 03:42 PM
Thanks for all the responses...I knew I would get the right answers here.

Talked to ENT and they want us to wait it out over the weekend and make a last minute call. Since he has no fever and it's only colored mucus in the morning they think he has a shot at being fine. As a backup they already penciled us in for June.

Thanks again!

Oh, right, it's Friday so he might get better. Why does that always happen?!! We have had so many Monday procedures when Ainsley was questionable on Friday and you never knew which direction things would go over the weekend. I'm glad he's only got the green in the am. He might be able to kick it by Monday. Good luck!

Sweet Harrison's mommy
05-18-2012, 08:44 PM
It sounds like you've got a good plan now! I think if I were you, I would worry about whether or not his lungs are clear. The colored snot, without being accompanied by fever and other symptoms, wouldn't terribly concern me, but junky lungs would.

I TOTALLY get the "feeling like you'll wait forever if you wait for him to be well" thing....Harrison always seem to be getting over or starting up some sort of minor cold. I do think I would wait for healthy and clear lungs, though.

Hoping that he has a good weekend and feels ready for the procedure next week!!! Let's get that boy using his PMV:)

principe
05-19-2012, 05:30 AM
The bronch being done by a different surgeon is no problem. As long as they are in the same hospital they look up the notes themselves. They just don't do the bronch just like that. They look at previous procedures, notes, etc and do a follow up bronch. The issue here is the congestion and I read they told you to rescheduled because of it. Makes sense. I know it gets stressful. Once I broke down crying at the pediatric clinic for whatever reason. Just wait till he's better and thinks would come along.