October 1, 2007

Hello again.

I went with Fredi to an ENT at New York Hospital last week and the news was not as good as we wanted but not terrible either.

As it turns out the trach cannot be removed right now and we finally got a good explanation of why she continues to have so many secretions. He looked down her throat and in her nose (as ENT's will do) and saw that while her vocal chords are working well and flexing and closing while swallowing her larynx remains swollen from years of severe reflux caused by that rotten hiatal hernia. If you are unlucky enough to get one of these, have it repaired. As a result, her vocal chords can't close completely so what she swallows does not go down her esophagus, rather it continues to slip down her trachea. Therefore all the secretions coming out of her lungs are not lung secretions at all but rather mouth secretions that have run down into her lungs. For now, as long as her mouth creates saliva she will have these secretions. Because she cannot swallow effectively she still needs the trachea. So what do we do? He prescribed additional reflux medicine. He believes that she still has some acid creeping up and irritating the larynx. He wants to see her again in 6-8 weeks.

At the hospital she was given the tracheostomy because she couldn't swallow/handle her own secretions. Apparently, she still can't.

The good part is that since she isn't on a ventilator the cuff can be deflated. She can talk now as long as the hole in her trach is covered up. He also asked that the nursing home get her a cap for the trach that basically allows her to breathe in through it but directs exhaled air over the vocal chords so she will be able to speak more readily. I should be going to visit her today. I'll let you all know how she is doing.

Tracy