Wednesday, March 12, 2014

3's a crowd

An ENT, Pulmanolgist, and GI doctor walk into an OR....that's how the joke starts. Preston got a 3 way scope today from three different docs. The GI left an impedance probe to measure any reflux he has, but did not note anything concerning in his scope of the GI tract. The Pulmanolgist noted the bronchial floppiness, and will stay on the case. He did a saline wash of the lungs and sucked out that part. They will culture it to be sure nothing out of the ordinary grows. He said that he moves air well enough that it should not be a concern but will monitor the case. Dr. Rutter, the ENT, noted that the airway shows growth and still needs to grow. He said the lower graft is the one causing more problems and the upper one looks great. This is opposite of what we originally thought. He is not surprised that he can move air around the trache but does not tolerate the passe muir valve. It has a lot of scar tissue to move around. 

The plan then is to return to cincy this summer for another scope. At that time the ENT will determine if he is a candidate for a single stage LTR, the same surgery from last summer, and remove the trache at the same time. The scope happens and then the surgery is 5-7 days later if Dr. Rutter likes what he sees. We would be here for another 4-6 weeks after the LTR, with P it is more likely 6. He is full of surprises. He would be in the ICU for a few days while he is intabated. He is scoped then servals times every 1-2 weeks post decannulation to be sure he looks good. Then that would be all she wrote. 



An ENT, Pulmanolgist, and GI doctor walk into an OR....that's how the joke starts. Preston got a 3 way scope today from three different docs. The GI left an impedance probe to measure any reflux he has, but did not note anything concerning in his scope of the GI tract. The Pulmanolgist noted the bronchial floppiness, and will stay on the case. He did a saline wash of the lungs and sucked out that part. They will culture it to be sure nothing out of the ordinary grows. He said that he moves air well enough that it should not be a concern but will monitor the case. Dr. Rutter, the ENT, noted that the airway shows growth and still needs to grow. He said the lower graft is the one causing more problems and the upper one looks great. This is opposite of what we originally thought. He is not surprised that he can move air around the trache but does not tolerate the passe muir valve. It has a lot of scar tissue to move around. 

The plan then is to return to cincy this summer for another scope. At that time the ENT will determine if he is a candidate for a single stage LTR, the same surgery from last summer, and remove the trache at the same time. The scope happens and then the surgery is 5-7 days later if Dr. Rutter likes what he sees. We would be here for another 4-6 weeks after the LTR, with P it is more likely 6. He is full of surprises. He would be in the ICU for a few days while he is intabated. He is scoped then servals times every 1-2 weeks post decannulation to be sure he looks good. Then that would be all she wrote. 
The weather here is crappy too, just like home. We have a FIES swallow study tomorrow and then home tomorrow. Can't wait to see Lorna and Reid, who is raising some hell transitioning to a toddler bed. Good thing they both are not transitioning. I have spring break next week which will be nice to rest and recoup. I will be able to knock some other stuff around the new house and hopefully sell an old one. He loves his Red Baron airplane too.

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