Showing posts with label decannulation. Show all posts
Showing posts with label decannulation. Show all posts

Wednesday, January 27, 2010

Cause for my concern

(Continued from previous post)

At first, my husband and I were just thinking about the result of the bronchoscopy. Only later we realized that we weren't been informed of the actual procedure that took place. The doctor had said that his airway had healed but he did not tell us why they did not try decannulation.

When we first went to meet him in the outpatient ward he wasn't available. So, we finished the discharge procedures and went to the OP ward to meet him. There were a lot of patients and it was a really long wait. Vignesh has grown up a lot and it is really difficult to manage him when we are out. The more active and playful he is, the more suctioning he needs. At first, it was difficult to find a private place for suctioning and we were forced to do it in corridor. And, finally we met the doctor.

With so many patients waiting outside, we had time to speak to him for just a couple of minutes and this is what we learnt. They had inserted the broncoscope a little below the vocal chords. Things looked fine. They did not want to go further as it might irritate and cause swelling again. So, they just removed the tracheostomy tube but he was desaturating and so they put the tube back in. The entire procedure was carried out in about 15 minutes or lesser.

This just leaves us with a lot of questions. My son has been on trach for nearly a year now. So, removing the tube and expecting him to breathe on his own all of us sudden, looks unreasonable to me. From what I read on the tracheostomy forum, I understand that decan isn't handled as abruptly as this one. The doctors follow a series of steps before going for trial decannulation. First they try to downsize the tracheostomy tube and then they cap it for a few hours. Only later do they try removing the tube. And, this seems like the systematic and the best way to do it.

We are just worried that if we are to repeat my son's trial decannulation after 6 months, the same abrupt procedure might be followed. And, this might just keep continuing in a loop. I just feel like we are struck and I'm trying to find way to get out of this situation. We were told that there were just a couple of doctors who deal with pediatric tracheostomy in India. And, this was the only doctor to whom we were referred to. We don't know about any other doctor who deals with tracheostomy.

So, this is what I'm planning to do. It might sound too superficial. But, we are really running out out of options and the necessity is just forcing me to come up with all these crazy ideas. I'm just hoping this would work. So, this is the plan. I'm going to discuss with people in the trach forum to find what are the various procedures that are been followed in trial decan. I'm not sure how the system works abroad. But, I would anyway ask my aunt if she could get in touch with a ENT in this field and who could give us idea about trial decan.(She had helped me in getting assistance from a pediatric cardiologist to read my son's echo when they first did an incomplete diagnosis for my son here).

And with all these papers, I 'm planning to set up an appointment with the head of the PICU at the hospital in Chennai where we usually take Vignesh to. Her team is fully aware of Vignesh's medical history and her team takes special care when it comes to my son. We would discuss if the her team and the ENT at the hospital could try decan in the right way. As a matter of fact, this is the team that handled Vignesh's tracheostomy surgery last year. And, the ENT here has expertise with tracheostomy and short term decannulations. And, he also has complete knowledge of Vignesh's medical history.

I know all this sound too far fetched. There are hospital rules, doctor's egos and a whole other factors that are involved in getting this done. But, I'm just keeping my hopes up. We need loads of luck and prayers. Please keep us in your prayers.

Wednesday, March 18, 2009

Waiting for Wednessday

Wednesday is going be the big day. We've been waiting for it for more than a month and a half now. We're hoping for things to go on well. If everything works out in our favor, my son would be getting rid of his tracheostomy on Wednessday. Doctor would first be conducting a bronchoscopy to see if the swelling in the tracheal passage is gone before removing the tracheostomy tube.

True, that tracheostomy has helped my son in a lot of ways. When my son couldn't be extubated, tracheostomy seemed like a boon. Because, it put an end to a lot of things. An end to the pain that he was undergoing due to prolonged ventilation, an end to being sedated for more two weeks, an end to not being fed anything orally, an end to him being confined to bed when he should be enjoying his life without any problems to worry about like any other 7 month old.

But, it had its own disadvantages too. As long as the tube stayed, we would not be able to hear his voice (we terribly miss his cute babbles which we are hoping to enjoy from Wednessday). Also, he requires frequent suctioning - about once in 15 minutes to half hour when he is awake and about once every hour or two at nights. Its really tiring us. More than us, it is causing my son a lot of discomfort and he has started to cry and push us off when we try to suction. And most of all, although he has freedom of movement some extent, we can't let him roll to his tummy with the trach tube since he hasn't gained head control yet. Also, we are unable to take him out except for his hospital visits and short walks in the terrace because he needs frequent suctioning and it is difficult to carry the suction machine wherever we go.

So, an end to all these discomforts is just a day and a half away. I'm feeling like a school girl about to take my board exams. I'm sure it would soon be Wednessday afternoon and we would be eagerly waiting for the doctor to complete the procedure and give us the good news. Till then, I'm keeping my fingers crossed and being optimistic. Hopefully, next week I would be happily narrating about my son's successful decannulation in my next blog. Until then, good bye!