Decannulation

Ok...so we get a call on Monday that says we have to go to APH on Thursday to get the trach out!  YAY!  We were told to be there about 2pm 1/27/2011.  Cyler loves the ride to Orlando and always gets soooo excited whenever he sees the big Mickey ears! We had some time to kill as the ENT was not there yet so we got to walk around the hospital a bit and Cyler had fun with Mickey and Pluto down in the lobby!

Finally, at about 6:30 in strolled the ENT.  This was it the big moment and we all thaught that we would allow Cyler to pull the trach out himself since that is one of his favorite things to do.  He wouldn't even touch it!  I couldn't believe it.  So I got to pull it out. Well Cyler screamed and screamed...the ENT was quite impressed. After about a minute daddy had gotten him calmed down.  Cyler then looked at me and pointed to his Mic-key button as if he was saying to take that one out also.  LOL!  It was sooo cute.  We let Cyler play with the trach tube for a little while before eventually throwing it in the garbage.

He did sooo well through the night.  Slept comfortably for the most part...untill the nurses needed vitals.  His numbers remained good throughout the night.  When Cyler woke up in the morning he did have quite a coughing fit but managed to get rid of his secretions...and that is what we want!  Yay! We are soo proud of him.  We were discharged home as promised right around 1pm.

Capped Sleep Study

Low and behold after my rant about how frustrated we are with Cyler's ENT office staff we get a call from them stating that there was a cancelation for a sleep study but we had to be there by 7pm.  We said ABSOLUTELY!  Otherwise we would have to wait until sometime in February.   We packed up and headed to Orlando, about an hour away.  We were about an hour early so we got to eat at Five Guys...mmmm!  First time there and will definatly go back.  Anyway, we were kindly at the sleep clinic.  We did have a few questions for the tech since this sleep study would be different from those in the past.  Cyler handled everything remarkebly well.  Didn't put up much of a fuss as she stuck over 25 electrodes to him in varius places.  He did however protest greatly when it came to a cannula that was to be placed under his nose to monitor his ETCO2.  He repeatedly pulled it off and all of the wires were pulled together so tightly that it was almost impossible to put it back in the correct position without totally disturbing everything.  When he finally fell asleep we tried several times to adjust this.  Everytime he would wake up crying.  I can understand why he was soo upset but the tech told us that this was actually one of the most important parts.  UGH!  Finally, she told us that if we could just hold it into position for a few minutes every half hour so that she could get a reading that would be ok.  Finally, Cyler got some good sleep.  He did soo well.  His sats stayed at about 98% all night and his ETCO2 remained within normal limits as well.   Respirations were unlabored and steady.  At 5am the tech came in and told us that we could remove all of those probes and get ready to leave.  She said Cyler did well and she didn't see anything that made her think that the cap needed to be taken off. Now all we have to do is wait for the results.

Frustration

We are getting very frustrated at Cyler's ENT's office staff.  We were told by the ENT two months ago that we could begin the downsize/capping process and that if we were ready sooner to give a call.  Well Cyler has been doing extremely well and about 3 weeks ago we gave the office a call to advise them that he is doing well and we are getting ready to put in the final downsized trach and that we don't have a back up.  I went further and asked what we need to do to get this process rolling.  She said well don't worry because she will order us a trach.  I explained several times that she can order anything that she wants but that doesn't mean the DME is going to get it to us.  Our insurance provides one trach per month and we are ordered to downsize every two weeks. She didn't get it, and yes the trach was ordered but of course we weren't going to get it because we weren't eligible yet.  We couldn't afford to purchase one as we had already made arrangements to purchase one 2 weeks prior.  Anyway, I also asked her at the same time how long Cyler needed to be capped before we can proceed to the next step.  She told me to start with 15 minutes and move up from there.  I asked again what length of time was required before moving on to the next step.  She repeated the whole start at 15 minute thing again, to which I told her that he has been capped all day.  I then gave up on that issue.  Over the following couple of days she came to the realization that we would not be eligible for the trach that she ordered until next month.  YAY, she got it.  She called again several days later to say that the ENT said February was ok!   For what?,  I asked and her answer was..."all the doctor said is that February is ok:"  UGH!!!!  She advised us to call her as soon as we get the OK from the cardiologist and she would set up a sleep study before Cyler's appointment with the ENT on Feb 2.  I called her on Monday and she said that she would set it up. Now it is Thursday and still NOTHING!!!!   I am sooo frustrated...every single time I speak with this woman she tells us that we can't rush this, like we don't know that.  We are not RUSHING anything we want answers...we want to know what we need to do to prepare Cyler and ourselves.  We want to know what to expect and all we are getting is a whole lot of nothing. 

Echocardiogram

Cyler had an echocardiogram yesterday because the cardiologist wanted to make sure that his heart was ok before we move forward with decannulation.  He required anesthesia becuase he is a wiggler.  That was more traumatic for us than it was for him...he actually did very well.  The echo took about an hour then we were discharged home.  In the evening the cardiologist called with some of the greatest news that we have ever heard. 
1. The VSD is closed.
2. Ventricles are more normal in size.
3. Pressures within the heart are completely normal-no pulmonary hypertension.
4. Cardiologist doesn't need to see him for 2 years.
5. Safe to decan from a cardiac standpoint.

YAY!!! we are sooo excited and yet petrified at the same time.