January 17, 2013

It's still early, but we had the bronchoscopy and amazingly they said his airway looks great. No problems. Which is wonderful, but leaves us to assume asthma is the culprit. They were looking for scar tissue from previous intubations or tracheomalaysia. They found neither, which will surprise a few doctors across the street. I got to go in with him wile they put him to sleep. They started by giving him some medication to make him loopy and then they surprised me again by having me help them hold him while they put the tube down his nose while he was still awake (but drugged). Again, I had to be a traitor. They needed to do this though to get a better look at his airway while he was breathing in and out on his own. The ENT did his part and then passed things over to the pulmonologist who did her part. The pulmonologist did multiple things including washed part of his airway with some sterile saline and took some a sample of the build up or film or something in his lower airway to make sure there is no infection. So even though today didn't fix things, we at least now know what it is not and what it probably is; where as before we were just guessing. Knowing this will help us to treat it better in the future. The pulmonologist changed his inhaled steroid from a low dose to a medium dose knowing now that this might all be asthma and wanting to get a leg up trying to prevent it in the future. We will give him two puffs of his inhaler twice a day every day and the idea is that this will work as a preventative for future episodes. She said it will take two to four weeks though for it to do its job as a preventative. So it wouldn't help prevent croup from coming on in a week, but hopefully that won't happen. Of course asthma doesn't cause croup, but you often see them together according to the doctors and the inhaled steroid will treat both. So even though we did not get any definitive answers, we know what it's not and that is important when you have a child that gets sedated as much as Clayton. These are all extremely important things for an anesthesiologist.
The bad news is that this procedure naturally irritates his airway a little, so the rest of the day will be spent being quite paranoid. He is going to sound like he is croupy all day and he will have a cough; all natural from the bronchoscopy. They will discharge us soon and we will probably go spend the day at the clinic across the street if we can just-in-case. That way he can play in the playroom when he wakes, but we will be surrounded by doctors and nurses. I'll let you know how it goes, for now I'm going to go back to staring at his oxygen stats and watching the rise and fall of his chest...