Tracheotomy

Alondra is still stable and doing well. I spoke with our ENT specialist this morning. He is discouraged that Alondra's undersized ventilator nasal tube hasn't begun to leak yet. She has a 3 and normally we would expect a 9 month old to use a 4 or 5. Air leakage would be an indication that the swelling in Alondra's wind pipe was subsiding and may mean that her natural airway would be large enough that she could go home with no further medical procedures. But since she's been on meds to reduce the swelling for nearly 3 days, and still no air leak, that indicates she may need a tracheotomy.

The plan now is to wean her from the anesthetic today. Then tomorrow morning, extubate (remove her from the ventilator). Then we'll see how she does. If all goes well and she has no trouble breathing on her own for several days, perhaps she can come home. If she has trouble, it's likely she'll be placed back on the vent and we'll get a tracheotomy scheduled.

The doctor believes the floppy airway issue is one that will correct itself over the next couple of years. The narrowing up higher in the airway however, he thinks will need to be corrected surgically. He indicated the best time for an airway reconstruction procedure is usually when a child is about 2 years old. But even if Alondra does need a trach now, she probably won't need one after her narrow airway is reconstructed.

So we're playing the waiting game today. Tomorrow we should know more.