Downsizing and upsizing trachs

[Kaylie]

Hi,
We had a ENT appointment the other day ear check and so on, thru our visit we discussed another bronch as well as other issues so whatever needs to be done while sedated and in the operating room we could get done, blood work, tracheal ring,stenosis ears looked at ( because kaylies canals are extremely small it makes it difficult to see in her ears, especially when there is wax build up) She also needs that flap under her tongue cut, because we were told it can affect her ability for speech.So the plans is to see her airway status, if we have the right size trach for her needs, she has had the same size since she was trached.it may need upsized .remove any gramulomas, and just the works.My biggest concern is going up in trach size would seem to put us further away from decan, of course i understand if she needs it upsized, but i know that there are many opinions about this.Can anyone tell me about what your DR, have told you in regards to sizes of trachs and why ? is it because of the certain medical condition, the airway status, the size of the child? we have heard conflicting info.thanks

[T-bone]

Abigail has no airway issues at all. She needs her trach so that she can be ventilated, so my response will probbaly not help you at all, but I will give it anyway.
She has only ever been upsized and it is always after she has had a growth spurt. The leak around her trach gets to big for her to be ventilated properly.
Sorry, that wasn't much help.

Tess

[cariaad]

Alli kept a 3.0 NEO almost the entire time she was trached. She went to a PEDS for the length when we started havinh the trach "pop" out if she extended her neck. Then we went up to a 4.5 about 2 months before last decan to cap with and try to "stretch" the trachea some. Not sure if those are good descriptions of the reasons. Generally I believe the smallest trach that will work is the best. Deb

[sassyangel4u2nv]

We have been downsized in the trach size. The first time was because the nurse accidentally put in the wrong size trach. But I was told the reason they down size if for two different reasons. One... is because like Ericka's case they has a 5.0 peds in her and she should have been smaller. I guess the tissue or muscle around your trach connects to the trach area. And it thinks ohh here is this new thing lets stop working. Then the child or person will be with the trach for the rest of their life because the muscle function has been lost. Secondly they downsize to get the person ready for decann. So instead of having the surgery for closing of the stoma they stoma is smaller.. Of course this may be something totally different but that is what dr's told me a year ago.

[Mom2TwinsPlus1]

They have upped Emma FINALLY in the PICU this trip, she went from a 3.5 Neo to a 4.0 Ped, she has an ET tube in right now though due to leakage because she basically had no lung function on the left side a few days ago. Anyway They told me that she needed to be upsized because she had grown and the little one no longer fit correctly and she was leaking from it. Simple as that, she had grown. She weighted 4.5 lbs when she got her trach and is 31 lbs now (1 lb or so of that is hospital fluid!) so I would say she has grown for sure in size and probably trachea had grown as well.

[kimh]

We up sized when Matt was still inpatient, he had a big leak and was not venitalting properly, I am HOPING that when we see the ENT this we we can down size his trach in preparation for decann, Matty had no prevoius ariway issues, but after this week who knows.