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More options than just tracheostomy

Posted Sep 11 2009 10:43pm
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My pulmonary specialist’s nurse called me today to check up on how things are doing. Better, but not totally out of the woods. The doctor does NOT recommend a tracheostomy be done at this time. This is a good thing in many ways but in some ways it is a disadvantage, the most obvious of the disadvantages is more limited airway clearance and management. There are a few others but that is the most obvious and most crucial. Right now airway clearance and management consist of Albuterol inhaler or nebulizer and a Cough Assist Machine (In-Exsufflator) they work pretty well, but for stuff that is well lodged down there or is right at my trachea and won’t move they don’t get the job done. Therefore the pulmonary nurse said we should still go to the ENT surgeon anyway to see what solutions he can develop for us.

Main goal in airway management and clearance is Preventing asthma / airway attacks and recurring infections.

The Tracheostomy has been deleted from the pending order area as it will be more than 6 months probably.

  • ENT (Ear Nose Throat) Surgeon for general respiratory evaluation & further care assessment (1:15 PM Monday)
  • Muscle Biopsy – See if there is a muscular dystrophy or other disease directly affecting the muscle such as progressive rhabdmyolysis. (Live – To be scheduled) (OP / IP at doctors discretion)<WAIT SCHEDULING>
  • Toxicology panels (drug & standard) – See if disease caused by toxic mutagenic agent (OP) <INACTIVE>[WAIT FOR BETTER INSURANCE]
  • Voiding Cystourethrogram / Urodynamics – CMG <WAIT SCHEDULING>
  • Cardiac Monitor <IN PROGRESS>

we are also waiting on a few other things to be ordered after the completion of these, the next order batch is. All of the below are considered dead until converted to live orders.

  • Spinal X-Ray Series <WAIT PENDING>
  • Pulmonary Functions Test (monitor respiratory status) <ORDERED OCT 2009>
  • Endoscopy (ulcer in stomach possibly) <Pending requisition>
  • Pacemaker / ICD <PENDING ORDER>
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