The decision

Carter will be getting a tracheostomy on Tuesday the 22nd around noon. It was one of the hardest/easiest decisions for us to make. Easy because it was very clear it needed to be done. Hard because it breaks my heart that he has to go through it and it is no small commitment on mine and Travis' part.
Carter will also have two other surgeries done at the same time. Both are pretty much required for him to have a trach. He will get a G-tube put in his stomach for his feeding and medications. The incision sight will be about the size of a straw. He will also get a Nissen which is basically a band that will go around his stomach that will keep him from spitting up and throwing up. This is necessary because if either were to get stuck in his trach he would have no way to breath. This Nissen incision will be in the middle of his tummy 3/4 the way from his chest to his belly button. I am not a fan of this one, but understand it is necessary especially with his crazy reflux. They might circumcise him at that point too. Might as well get it all over with at one time. The ENT will do the tracheotomy and a pediatric surgeon will do the other two. It should take them a total of 2-3 hours.
Some things we brought to the table when trying to decide what we should do were...
-carter improved on CPAP last time. He lasted 7 hours which was great for him, but not that great. He was also pumped full of steroids so we know those seven hours were a result of them and he couldn't have done it with out them.
- we have no idea how long Carter will have the trach, what kind of in home nursing care will be required, what he can and can't do, how this will effect him long term, and the commitment trav and I will make. We still don't know any of these answers. Only time will be able to answer them.
- developmentally he NEEDS to get out of there. He lays flat on his back all day long. He doesn't have much social interaction with people accept when we are there.
- we knew that if we were to keep giving him a shot at CPAP we would still end up getting a trach and as our doctor put it we would be wasting time.
- he needs to be home with his family and we need him home. It makes me so sad when I walk in his room and he is wide awake staring at the wall. Getting a trach in the words of our doctor will "expedite" him home. Babies thrive at home and do so much better.
- he has completely out grown the vent. They have switched it over to cpap mode which mean he is doing all the breathing on his own. The vent tube is just keeping his airway open and providing him the oxygen he needs. This is another clear indicator that it is completely an airway issue.

Obviously prayer was a huge part in our decision and gosh I can't even begin to think how I could make it through this without it. I think I have asked every nurse, doctor, respiratory therapist, you name it and they are all completely confidant we are doing the best thing for Carter. Sure I hate the fact that we won't be able hear his voice and go home without help, but I know that Carter will be so much happier and I can't wait to see his face with nothing on it.


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