So far, we are still on track to probably decannulate Marissa in September. We just had an appointment with Dr. P today and we downsized her trach from a 3.0 Neo to a 2.5 Neo (the smallest trach made without going custom).
Tuesday, July 27, 2010
I emailed the doc a couple of weeks ago with my concerns that the squeak was still there and I didn't think it was due to swelling and irritation in her airway. I told her it was the same squeak that was there before her surgery and I just didn't think it was going to go away with time, at least not before decan season is over. I asked her, based on the fact that she is not in respiratory distress when she squeaks (no dropping of sats, no color change, no retractions or nostril flaring), if she thought Rissa's vocal cords are still not moving properly and how comfortable she is with decannulating anyway. I let her know that there was no way I want to decannulate if it is not safe or in Rissa's best interest. Here is a quote from her email response to me:
If the squeak is still present, I think we are looking at the possibility that, even though the graft opened her airway up some, it may not be open enough to prevent her vocal folds from meeting midline and creating the sound. There are positives and negatives to this. Negative, her cords are still not completely lateralized, however, the positive is, if her airway is stable, this may not matter and it decreases our risk of aspiration.
So, the squeak may not be a problem. Dr. P wants Marissa to have a sleep study and, if all goes well, we will see her in Denver sometime in September to yank that tube!!!
Posted by Alicia at 12:52:00 PM