Secretions

Logan saw the ENT doctor today. It was a follow up appointment since his tracheostomy was placed. I always look forward to meeting with Dr. S as I feel he is honest and only wants what is best for Logan. He is a man with a plan and he doesn't hesitate to tell you what's up. This isn't his first rodeo (thank god!).

We spent the majority of the appointment discussing Logan's ever overflowing gift of secretions. My kid probably makes more saliva than a bulldog. Now that the trach is healed and working so well for Logan, we must tackle the secretion issue.

His trach has a cuff. This means there is a balloon around the trach tube that we inflate with water. By doing this, we partially occlude the airway. Normally a cuffed trach is used for a client on a ventilator. Logan is not. The reason for his cuff, slow the passage of secretions into his lungs. This comes with a list of potential problems with irritation or erosion of the trachea being one of the worst.  So we watch it like a hawk and do not inflate the cuff completely.

Dr. S has asked that we deflate the cuff just during the day to see what happens with his secretions. If I understood correctly, he wants to see if the cuff was placing too much pressure on the trachea and then in turn, pushing the esophagus. This could have been occluding the esophagus preventing secretions from passing into the stomach and therefore spilling into the lungs.

I see this as possible but don't feel this will be our answer. I think we are dealing with a child with a movement disorder that produces an abundance of saliva because of the constant movements of his tongue and jaw. We then throw in some type of neuromuscular disorder that causes the inability to swallow properly and end up with lungs full of saliva.

We will give this non invasive attempt a try for a week or so. I am game as this is an easy experiment. I do worry that we are opening up the flood gates and now placing Logan at risk for aspiration pneumonia. Thankfully we have nurses to help us watch him like a hawk.

If this plan does not work, we will move to having some of Logan's salivary glands removed. This was originally planned last November but was scratched when we went straight to the trach instead. For now, we will watch closely and I will attempt to not be overwhelmed with worry... Too late but that's okay. If I didn't worry, we would have a problem. So ahead we go with the plan of attack and no looking back. Just another speed bump on the racetrack of Logan's life. Hang on tight!