Thursday, September 6, 2012

Cincinnati Part II


Speaking with a trach is not the easiest of activities to do. When I first learned about a tracheostomy and its function, I had to wrap my head around the fact that my son would not be using his nose and mouth to breath. His main source of airflow to his body is through a little tube called a trach.
Emmett has several factors that make it difficult to speak. 1. Emmett's vocal cords are paralyzed. In the image below show the trachea, vocal cords and the larynx. Properly functioning vocal cords should open and close when we breath, speak, drink, eat, cough and so forth.During a procedure performed at Cincinnati Children's Hospital, the Ears Nose and Throat Doctor discovered that Emmett has paramedian vocal cord paralysis, meaning his vocal cords are paralyzed in a half open position. This gives him a very narrow airway, which is dangerous and quiet voice. As parent's the voice is not the issue we are worried about, it is the narrow airway. It is not something that can be fixed on its own in Emmett's case and in the future will have to be surgically repaired.


image from cedars-sinai.edu
A Passy Muir Valve is a one way valve that is beneficial for those who have a tracheostomy.



Passy-Muir Valve, PMV007
The Parry Muir Valve (little blue valve) allows air to flow into the lungs but not out through the trach. In Emmett's situation he will have to learn how to push air past his trach and up past his vocal cords. This will create positive pressure that will encourage proper swallowing techniques, help to prevent aspiration and have a little bit of a louder voice.



image from ceu.passy-muir.com
Preventing aspiration is a big key in helping to prevent future damage to Emmett's lungs. 

Emmett will be returning to Cincinnati Children's Hospital in a few weeks for a second round of scopes. After much thought, research and praying and praying and praying and pondering and praying, Michael and I have decided to have the reconstructive esophageal surgery performed at Cincinnati Children's Hospital. The surgeon who we met and worked with their, specializes in esophageal reconstruction and is the director of an esophageal center in Cincinnati. The surgery that Emmett needs is extremely complicated and is a last resort for his esophagus. We know Emmett will conquer this next battle with the help of our Heavenly Father by our side. Surgery has not been scheduled yet, we believe after this next set of scopes, we will have a better timeline of when surgery will happen. Deep breathes, deep breathes.

Go Emmett, Go!



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