The Plan

We took Elijah to see one of our favorite doctors in the world today, Dr. K (pulmonologist). We shared our airway-croup-intubation-extubation-heart-surgery concerns with him and showed him the photos that were taken of Elijah's irritated airway a week ago. Dr. K had a thought about something he'd read about a while back, and got on the phone with E's ENT doctor to chat about it. In theory, if steroids are administered directly onto the surface of the airway, this could help it to not become inflamed. But. This is not an approved procedure, so it is not recommended. Steroids aren't meant to be absorbed by the tissue in the airway. He wanted to read more about it, but thought it probably wouldn't be something we could do.

As I knew he would, though, he did want to come up with some sort of plan. So. Here is our let's-make-sure-Elijah-can-breathe-after-surgery plan as of now:

1. Give Elijah Pulmicort nebs 2x/day for the entire week leading up to surgery.

2. Dr. K wants to chat ahead of time with the anesthesiologist and intensivist assigned to take care of Elijah during and after surgery, and obviously his surgeon (Dr. M) as well. Since administering steroids onto the airway probably won't be a possibility, they will instead spray Pulmicort directly onto the airway.

3. A dose of steroids will be given to E immediately before extubation.

4. Racemic epi nebs will be on hand at extubation.

Dr. K let us know that the severity of Elijah's croup, and especially the fact that he gets it so severely post-extubation, makes him a very rare case. Plans like this usually don't need to be formed. I hate that we are having to form this plan, but I'm glad we have it.

We did learn today that we can request a specific anesthesiologist for this next surgery. We have never ever had a bad one, or even just a good one. They have all been nothing less than excellent. BUT! There is one that we love a little more than the rest. Dr. A, our beloved Dr. A. I hope he is free to care for our boy on June 10th.

On a much lighter note...

Elijah has his first modeling job! :) His physical therapist called me last week because she thought he would be a great model for a brochure that is being created for a new PT/OT/speech clinic that is opening up in our area. We all know what a great, happy smile/face he has, and he's a pretty cooperative kid (most of the time). She said that all of the therapists swoon over him after he leaves the clinic each week. She has OTs and speech therapists approaching her and saying, "Are you SURE Elijah doesn't need other therapies?" :)

I noticed this same thing when I walked into school with him the other day. As we walked down the hall, everyone would turn and say, "HI ELIJAH!" "Hey Elijah, how are you today??" "Good morning, Elijah! It's good to see you today!" I said, "Wow, sweetie, you have a lot of friends." Elijah said, "Yeah."

Now if only he would accept his cute, chubby, snuggly brother Sammy as his friend. :(