NICU Day #60 - Visit from the ENT Specialist

Saturday, June 19, 2010

We received a phone call at 7:22am to let us know that Timmy was once again going to be reintubated with a 3.0 tube size - two sizes smaller than he's had for the past month!  I figured that meant that Dr. Parry had been in.

A huge thank you to Miss Sara for everything she did yesterday.  She watched the kids from about 9:30 to 11:30 so that I could go see Timmy before we headed out to Safford for Lisa and Cindy's open house.

The few doctors who are there on the weekend were holding rounds when I got there.  I figured they had already rounded on Timmy, since it was already 9:45, so Dana handed my finally calm, peaceful boy into my arms and we blissfully snuggled in while I pelted Dana with all my questions.  We had just been through Dr. Parry coming in and what he had to say when Dr. Bedrick walked in and told me they were rounding on Timmy and asked if I would like to join in or just have them come in after they finish.  Considering all Timmy has been through and that it's not fun for him to get passed around a whole lot, I opted to skip the rounds this time and get caught up afterward.  (Regretting that now as I would like to have expressed my displeasure with the ventilation tubes, but that time will come!)

Dana read through Dr. Parry's report - he sent his scope down and found Timmy's trachea to be normal.  Sigh of relief.  Vocal cords a little red, but also normal and MOBILE!  (Huge sigh of relief.  I had worried all night that we had let Timmy's vocal cords become paralyzed from having a huge tube separating them for the past month!  Yes, it's been almost a month - 5/22 - since he had the 4.0 put in.  Since his record has been thinned, the details weren't there as to why but Dana had been wondering as well when that large tube was put in.  Apparently after the first or second extubation attempt had failed.)  I could hear Timmy making normal baby noises around the tube and they were music to my ears.  There were a few small areas of granulation tissue (basically, it's new tissue forming on top of a wound), one lower right lateral and another just below the epiglottis.  The epiglottis was also normal.  Dana told me that Dr. Parry also said that if anyone else says that Timmy needs a bigger tube to tell them no.  According to Dana, Dr. Parry also debated a little on whether or not to reintubate altogether but, with all Timmy has been through in such a short time, decided to give him a break and reintubate with the smaller 3.0 tube over the weekend to give him a little breathing assistance while he heals.  Timmy is also being given another short burst of steroids to help the healing process.  Dr. Parry will see Timmy again tomorrow (Monday) morning to reevaluate Timmy and hopefully extubate. 

Timmy was so peaceful and content in my arms yesterday it was a thrill to see him so comfortable after the night before.  I really do think that the 3.5 tube was just uncomfortable for him.  It was also amazing that, with the small tube, I could actually forget Timmy was intubated altogether!  Such a sweet feeling to see only my baby and not the tubes to which he's connected!  So cannot wait for him to not have a tube of any size in there!

But, at the same time, maybe I can.  Timmy will need to be intubated during the surgery for his reanastomisis.  I am not excited about that (the reconnection of his intestines, yes; the intubation, no).  So I asked Dana if she had heard anything more regarding the timeline for the surgery because, if it's really close, say this week, I think I would rather them just leave the tube in and not put him through another reintubation procedure.  She brought Dr. Bedrick in and he said that if the surgery is out a ways, it would be better to reintubate then and go ahead with the extubation tomorrow.  I agree.  I am beyond ready for Timmy to be freed from the ventilator.  But Dr. Bedrick did see my point and will call Dr. Cosantino tomorrow to see when she's planning the surgery.  Hopefully that will get it scheduled if it isn't already.  Kind of hoping it's this week and we can get Timmy's GI tract back together and him off the ventilator all in one whack.

One strange phenomenon that Timmy has been exhibiting for the past couple of weeks is random heartrate decels.  He will slowly drop into the 90s and then go back up into the 140s.  Not sure what's causing this and I'm hoping that having it written down will help me to remember to ask the doctors.

The relief I felt on hearing Timmy making noises and hearing that Dr. Parry debated on whether or not to even reintubate is beyond words.  I called James with the good news the minute I stepped out of the NICU.  Hoping this week is full of good news and we're finally seeing light at the end of this tunnel!