Seriously!?

Seriously!? As in Grey's Anatomy, "Seriously, you've got to be kidding me!" I think I mentioned before that the doctors said they've seen all the problems that Lawson has displayed, just not in the same child. Today we can add another unusual problem to the list.

Dr. Tanaka ordered a bronchoscopy, since his idea for the nitrogen washout (the combination of 100% oxygen and steroids) didn't work. A bronchoscopy involves running a tiny camera on a long tube down the breathing tube to look at the lungs and trachea. The procedure was done this afternoon just before I left for lunch. Apparently, they had to rent the machine, since they don't keep one around. I was in the room when they were getting everything set up. The machine was HUGE, like the size of a refridgerator! There were two screens and a bunch of knobs and dials. I met the Pulmonologist and his nurse and got a few questions answered while they were getting ready. I left before they began.

This afternoon, we met with the Pulmonologist, the Nurse Practioner, and Dr. Tanaka to discuss the results. So, to add to the laundry list of problems Lawson has either had since birth or has developed since then, we now have tracheomalacia. This is a congenital disorder of the trachea; instead of being rigid and round, it is soft and pliable and collapses during respiration. It is a completely seperate problem from all of the others so far, but helps to explain some of them. When he breathes in, the trachea opens fully to allow plenty of air in, but when he exhales it collapses and does not allow all of the air that he breathed in to escape. Although this is not the cause of the blebs, it explains why the ventilator settings have not been helping to treat them. Dr. Tanaka pointed out that they were treating the blebs under the assumption that the trachea was healthy, since there was no reason to believe otherwise. Thanks to the bronchoscopy, we now know otherwise and are moving forward with that knowledge in mind. The first part of the plan is to raise the PEEP pressure (positive end-expiratory pressure) on the jet ventilator. I'm not exactly sure what that means, but it was explained to us that it will 'hold the trachea open' by applying more pressure. They are planning to continue this over the weekend and re-evaluate again on Monday.

Here's my sweet boy one day away from one month old . . .
http://www.youtube.com/watch?v=nCpJHf0WSD4