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.

Scope 5

Once again things didn't go according to plan.  I don't know why I keep setting expectations for these things anyway.  The EoE is still there.  There were clear visible signs in the photos and Super EoE Doc informed us he's very well versed in judging the photos and well, the EoE's still there and active.  Of course the official biopsy results will be back some time next week but it doesn't really matter. 

The polyp is still there but on a bright note, today's physician claimed it is not a polyp but rather a "bump", which is great since now there are more of them.  He claims they are associated with EoE and are further evidence that the allergy cells are still alive and thriving.  He took a sample of the biggest bump just to be sure. 

To add to the excitement, Roo is once again experiencing croup following the breathing tube and anesthesia.  He seems to have a reactive airway which means we got to spend a couple of extra hours in recovery while he coughed up blood, received nebulizer treatments, and got some steroids via IV.  We're keeping our fingers crossed that it helps prevent another ER visit tonight. 

We're crushed.  Had big hopes for this one.  He's off everything he was off when he got a clean scope over a year ago so we're back to square one.  We're still a step away from tube feedings but this is a dangerous path we're on.  I fear we're just really getting started.

Same day. Different hospital.

Sooooo...let's just say things didn't go exactly according to plan yesterday.  We started out well enough with Roo and I both surprisingly chipper to be up well before dawn.  He was a regular bundle of cotton candy and kisses, spotting city buses with a commuter's precision, singing endless verses of The Wheels on the Bus, practically bursting the seems of his blue stripey pj's and woolen winter hat with incomparable cuteness.  It wasn't until we neared the hospital 30 minutes away that he started to wane.

"I want my Kaloo." 

Oh crap.  Kaloo.  Imagine my horror at realizing mere moments from IV insertion, that I had forgotten Roo's beloved Kaloo bunny at home.  I mean, we don't go to the grocery store without Kaloo.  Surgery?  Are you kidding?

Somehow we made it through the procedure but it wasn't pretty.  He had a rougher time coming around from the anesthesia than I've grown accustomed to, and the fact that he was hacking like a seal and spewing bloody saliva afterward didn't help matters.  That hadn't happened before. 

The immediate results from the scope were mediocre at best.

Good news: the GI doc performing the scope did not see evidence of furrowing or white plaques that were spotted last time.
Bad news: There's a polyp in Roo's esophagus and he has no idea what it is.

Obviously we won't know anything definitive until the biopsies are back late next week.  Until then, we wait.

Having conquered the beast that is toddler surgery, Mufasa and I were all too happy to turn into bed early to face the polyp issue with clear heads in the morning.  Our sweet dreams were soured, salted, and stewed at 2:30 am when Roo awoke barking, sobbing, vomiting, and gasping for air.  I've experienced the Stridor of Croup a few times in this motherhood stint but this was different.  The kid couldn't catch his breath, his stomach was sucking in so far in with every breath I swear I was seeing his spine.  He was throwing up and choking.  Then his lips started getting a little blue.  Off to the ER.

Two breathing treatments, a second IV in 24 hours, plenty of steroids, more vomiting, 2 rectal temps, and 4 and a half hours later we came home.  He's bruised, coughing, exhausted, and covered in medical tape he won't let us peel off, but as usual, still smiling.  So hoping tonight is less eventful.