OK, so here's the update on Marissa's ENT appointment today.
Here are the answers to the questions I asked in the last post:
1. There will be one of three types of surgical procedures that Marissa will have. Arytenoidectomy; Posterior Cricoid Split with Rib Graft; and Posterior Laryngotracheoplasty with Rib Graft, all of which I briefly described in this post. We won't know which surgery will be done until Dr. P has a chance to scope Marissa. She wants to scope her in the Spring and she will make the decision then.
2. Dr. P can do the surgery so we will stay local, which is great.
3. Unfortunately, the surgery will most likely change Marissa's voice, making it quieter and somewhat hoarse.
4. Unfortunately, the surgery will also increase her risk of aspiration.
5. The procedure will be a double stage, meaning that Marissa's trach won't be removed until after she has healed from the surgery.
Now, on to the subject of a timeline. Dr. P seemed a little hesitant when I mentioned possibly having this done next Spring/Summer. She likes to do these kinds of things when kids are between the ages of three and five. Marissa will turn three in March. Dr. P said it is not necessarily about age but more about size. The bigger, the better. So, Dr. P will be making the decision about whether Marissa is ready for the surgery when she does the scope. She also mentioned that, with the rib graft surgeries, the bigger she is, the more likely it can be done endoscopically rather than it being an open surgery. This, of course, would be the best case scenario. So, she may have the surgery and her trach removed by next summer, or she may not. We won't know for several months. We obviously want to do whatever is best for Marissa, so we are leaving it in the hands Dr. P and, more importantly, in the Hands of the Great Physician.
We are still letting all this information sink in. I am sure I will follow up shortly with a post lamenting the fact that neither choice for the next step feels like a good one. It's what I do. I have to process information for a while, let it sink all the way in and then gripe about it.
So stay tuned.