Tuesday, April 19, 2011

Cautious Optimism

Surgery on Friday was a raging success. In terms of Roo waking up after anesthesia, coming home without having to be admitted to the hospital, and no Stridor-induced trips to the ER, things couldn't have gone any better. 

On the EoE front, the physical appearance of his esophagus was everything it ought to be - clean, bubble gum pink, free of white plaques and furrows, and best of all, remember those pesky little bumps and polyps that had us on edge for three months?  They are no more!  We're still waiting on the biopsy results which should be back some time this week but the physical evidence was encouraging.  Ultimately the biopsies will tell the full story but it's looking like the budesonide (aka Pulmicort) might be working for him.  I still don't quite believe it.  As we know, shoes tend to drop around here when we least expect it.  I'm not popping any corks until the official results are in, but there is a little ginger in my step that hasn't been there in some time. 

In addition to his regular upper endoscopy, Roo also underwent a bronchoscopy this time around.  In a strange twist of fate I almost forgot all about the scope results because I was sure that the budesonide wasn't working.  I was more focused on the bronchoscopy first because he'd never had one and second, because the Otolaryngologist or ear, nose, and throat specialist (yes, we've added yet another specialist to "The Team") warned us that Roo would likely need to be admitted to the hospital if he wasn't breathing well following the procedure.  The rationale was that he's already had lots of breathing issues - namely acute Croup and Stridor - following his regular scopes, and that a bronchoscopy would cause even more trauma to his airway thus increasing the croupy response.  Fortunately that didn't happen and now we think we now why.

As it turns out, Roo's airway is especially small.  He's obviously part Lilliputian to begin with and based on his actual stats of a whopping 24 pounds and 34 inches, the ENT said his airway is about 50% of the size he would expect it to be.  How this comes as a surprise I'm not sure.  I mean, his entire neck has the girth of a garden hose.  Regardless, the breathing tubes used during his previous procedures were much too large and essentially tore up his wind pipe...hence the coughing up of blood and tracheal spasms.  But seriously, is Roo the smallest 3-year-old they've ever seen in the Children's hospital?  I'm once again left wondering how this went unnoticed by the anesthesia team in a hospital devoted specifically to very sick children.

Well, enough of that because the reality is that no matter how we had to find it out, I'm thrilled that there's a reason for his bad reaction to anesthesia that doesn't involve another allergy or a tumor.  Things could be much worse.  And now they know what size tube to use.

So, just waiting for the phone to ring.  Not chiming any victory bells yet but the mallet's in my hand.

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