The recovery plan

Let's see if I can remember all of the information from the past few days...

Ethan's procedure, a direct laryngoscopy and bronchoscopy, went very well. They tell us he tolerated it well and didn't even desat. The good news is that there didn't appear to be any malasia. What they found was inflammation, granulation and ulceration, basically scar tissue and damage to his wind pipe as a result of the ET tube. He needed the tube, but it is the damage from the tube that is causing him not to be able to get off the tube. Ironic indeed.

So, plan A is this:

1. A smaller tube - back to a 3.0. He came to the U with a 4.0 tube. This will decrease the pressure on the tissues that was causing the inflammation
   
2. More steroids to reduce the swelling
   
3. Medication for reflux. He's not really having a problem with reflux, but it's preventative. Can you imagine stomach acid on his already ouchie throat? :(
   
4. Sedation. As much as I hate it, it is necessary to keep him calm. When he thrashes around it causes the tube to hit the sides and causes more damage. I just imagine a bell...
   
5. Nutrition. They upped his feedings to breastmilk plus HMF 27. This will help to increase his healing powers.
   

All of this is designed to allow the swelling to go down and help heal the damaged areas. They will try to wean him off of the vent hopefully by the beginning of next week. ENT will be here then to do a flexible scope to look at his vocal chords. They are looking to make sure that there is no damage to the nerve from the pda surgery. Dr Klein said he didn't anticipate any long term problems with his voice, by the way.

If this does not work, then we may be looking at a surgical procedure that would, in effect, build a "cartilage bridge" in his throat to keep his airway open. If that did not work, then we may be looking at a tracheostomy; so here's praying that Plan A works.

As far as how long this would take, we've now been told that about 2 weeks will be needed for Plan A, but this could possibly turn to 6 weeks if things are not progressing quickly or if we need to move on to other measures.

In the meantime, we're figuring out how to reorganize our lives so that we can give Allison as much stability as possible and still be able to support Ethan. His room does overlook Kinnick Stadium, so we'll be able to watch the game on the JumboTron just outside his door on Saturday. (For those of you not familiar with the Hawkeyes, Kinnick is where they play. For those of who are Iowa State fans, football is the sport the Hawks beat you in this year!) I should mention that Lisa handed the computer over to me about three long-winded paragraphs ago so that Allison could have dinner. Sorry about that...