Anaesthesia

October 2015- Wyatt swallowed a piece of soap.  It was so fast and so unexpected, but as a a mother of three, I should have known better.  Of course my 2 year old wants to eat soap, because my last two children - ate soap.  It's so disgusting to think about that caustic material in your mouth as an adult - but children, hey, it smells nice, which means it must taste just as good!

 

What I thought was a little piece of soap turned into a significant slice of soap that Wyatt was able to slide into his 1mm opening.  This sliver ends up blocking his airway in the Recess room in CHEO and Wyatt is intubated on site.

 

As Wyatt's parents we've been approached about him having an elective tracheostomy done to him.  The tracheotomy, (I should try and be clear here, Wyatt had a procedure called a tracheostomy done to him, where they inserted a tracheotomy in him), would be considered a secondary airway.  So, if Wyatt puts something in his mouth; a piece of chicken, a pebble, a toy - we would have the option to remove the cap from his tracheotomy (trach), and he can then breath, and we are allowed to take our time to remove the debris, or take what we would consider a relaxed ride in the ambulance to CHEO to have it removed by ENT.

 

Sounds so simple now that I've written it down.

 

It took us 2.5 years to come to the decision of the trach, but it was well worth it. It came down to me saying "We can't just keep playing Russian Roulette with his life."  After Andrew had seen Wyatt go into respiratory arrest for the fourth time, in my mind, he had already decided on the trach anyway.  Once Wyatt's lungs were cleared out of the copious amount of soap sudz, ENT went in and inserted a trach into our beautiful baby boy.

 

So, considering the above - Wyatt is easier to intubate and life as we know it, has been simplified in a very good way.  Yes, a trach means more medical supplies, yes, a trach means additional medical problems (he is more susceptible to certain illnesses), but if you were to give me the choice between a bad bout pneumonia VS another chocking/apnic episode, hands down - I'd pick the pneumonia and I'm certain Wyatt would too.

 

August 2014 - Wyatt swallowed two little rocks and had to be brought into the OR for an emergency intubation.  I still remember the words of the Res Dr.:

 

"He's going to have to go to  the OR"

 

Me:

"You mean put under?"

 

Res. Dr.:

"Yes."

 

Me - I'm starting to lose my mind at this point:

"I don't think you understand how complicated and dangerous it is for him to go under... Is Dr. Corvo here?"

 

Res. Dr.:

"I don't know who Dr. Corvo is."

 

Me:

My brain explodes into a million pieces.

 

Needless to say, Dr. Corvo comes in (in my mind anyway) like a humingbird and I just started to bawl my eyes out. 

 

Dr. Corvo:

"Why is he allowed to be around small objects???"

 

Me:

 

"...."

 

Then Wyatt's ENT doctor comes in at some point, and I'm about to implode. I went from exploding to imploding - with absolute joy. I could not believe these two amazing women were both actually here. At the moment when I needed them the most.

 

Anyway, the removal of the two pebbles went quite smoothly, but according to Dr. Corvo and Dr. McCormick, it's always going to be risky. Wyatt is just an unknown in the medical community, so every time he has to go under two phrases always turn up (and you have to sign off to these as his parents):

 

1. Emergency, elective tracheostomy;

2. Possible death.

 

Wyatt is in good hands with Dr. Corvo, she is very good at her job, and takes it quite seriously.  She always provides worst case scenarios, but quite honestly, it's part of her job. Prepare for the worst, and hope for the best!

 

June 2014 - Wyatt is still followed by Anaesthesia, specifically, Dr. Corvo. She performed Wyatt's anesthesia during his Gtube/bronchioscopy/frontalis biopsy procedure (at 10 months of age). She administered minute amounts of anaesthesia, and was extremely cautious with him, Wyatt's pediatrician remarked she had never seen an anaesthesiologist be so cautious with a patient! 

 

Intubation and extubation were successful, and besides the swelling from hydrating, Wyatt came out of the operating room with flying colours! He spent one night in the PICU, and was promptly moved to his bed in 4 East, where he was eventually migrated onto Peptamen, a  'toddler formula'.

 

At the end of October 2014 Wyatt will receive his second round of anaesthesia, as his pediatrician wants to get an MRI of his brain done, so to have this, Wyatt must be anaesthesized.

 

2013 - Wyatt is followed by Anaesthesia because he should have had a g-tube operation ages ago, however he has a natural inclincation to "clamp" down on anything being inserted into his mouth; including fingers, toys, and tongue surpressors.  Anaesthesia is concerned that if he were in need to be, Wyatt would be at a high risk for an emergency trachiotomy. 

 

In the words of the anaesthesiologist;

 

"The risk does not outweigh the benefit. Wyatt is thriving with an NG tube."

 

We may be stuck with an NG tube until Wyatt is capable of eating on his own, and when that time comes - we may not need medical intervention at all for nourishment. However, after the recent Case Study in April 2014, Anaesthesia is more inclined to consider a g-tube procedure, as he has more of an opening than he did in August, 2013. The problem is, is that Wyatt needs to be well, that is, not admitted to CHEO, for at least 6 weeks. Something that he has not accomplished since before the day he required CPR.

 

Until then, Anaesthesia follows Wyatt's improvement, and we play the waiting game.

This image was taken 3 hours after Wyatt's visit with his Osteophath. We consider this 'wide' open for Wyatt.

What's Wrong With Wyatt?

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