Summary
What A Crazy day! I expected a chill day with the bronchoscopy in the afternoon and all would be well. However, the doctor called at 7am and said they were doing at 7:30am (GOOD). He found a large cyst in his air way, but needed to confirm that it was safe to simply remove before he attempted to removed it. The MRI was done at 11am and confirmed the cyst was 99% in the airway and could be removed (GOOD). They actually had a hard time re-intibating him and were very nervous about him pulling the tube out (NOT GOOD). To ensure his safety they gave him a paralytic and let the ventilator breath for him. To the nurses surprise, the doctor got him scheduled for surgery this afternoon and they got started around 4pm (EXCELLENT). It was originally expected to take 2 hours, but the doctor took his time (5.5 hours) to extract it and took great care in separating it from the vocal cords. In the end we are very relieved and glad to know what has been causing the problem and being to move to the next steps. He will be heavily sedated for a few days until he heals and the swelling has gone down and they will try and extibate him yet again. (for the 5th and hopefully final time)
I got the nurse to highlight what needs to be done before our kiddo comes home. I will try and walk through that tomorrow.
Timeline:
7:30 am - Rigid Bronchoscopy Micro-laryngoscopy performed, a mass was found above the vocal cords
- Found a “Huge Tumor or Cyst"
- Lower right side (above vocal cords)
- Re-intibated and had a hard time doing it
- Need an MRI to see all of what needed to be removed
- Attempting to get MRI today and surgery tomorrow (Saturday)
10:00 am - Update from Rianna RN -
- Completely paralyzed to prevent tube from coming out.
- Vecunium (aka “Vec”)
- Very very concerned about tube coming out and don’t believe it can be put back in if it comes out
- Found a Large Round Mass
- On the ventilator 100% for breathing.
- RR 30
- O2 Sats: 92%
- Waiting on x-ray to confirm location of tube and blood gas
- E.N.T.s want to make sure he stays intubated
- NOTE: had to run over and make sure the Respiratory Therapist didn’t pull out the tube
10:30 am - Update from Cortney the NP
- Q: Is it OK for him to be on the paralytic a long time?
- A: Yes - They have had babies on it for several weeks and months.
- Q: Is Skin to Skin liked at PHC? When can it be done?
- As long as this critical, no. A couple / few days after surgery . They LOVE LOVE LOVE skin to skin
- They removed the NG tube (Feeding Tube) - will remain on IV’s for nutrition
- She thought it would be a week before surgery … This turned out wrong… but was good for context
- The location is near the "epiglottis"
11:00 am - MRI was done. the mass is confirmed to be cyst, 99% is in the airway. a Strand does go down behind the side.
- Dr. Park - Showed a “Huge Cystic Mass"
- Hoping there is a liquid inside
- The term “Benign Lesion” was said
1:30 pm - Got the call that he was going to have surgery at 2:30
2:20 pm Consent given to Dr. Orb
- micro-laryngoscopy
- Is a tracheotomy an option? Yes, but not preferred and is a last resort. Would re-intubate and have several discussions before that was needed.
2:30 pm Arrived and found out that surgery was delayed because wanted to have some blood on hand for transfusion if needed.
3:00 pm Walked down to surgical unit and ended up in waiting room
5:20 pm - Call indicating still in progress and needed an other hour
6:30 pm - Update - another hour . . still waiting
Thanks for the continued thoughts and prayers. I know they are being answered!
Jason and Kristine
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