Laryngotracheal Separation Surgery Day 1
We arrived in Cincinnati yesterday afternoon, and Nathaniel had Laryngotracheal Separation surgery today at Cincinnati Children's Hospital.
Rich and Nathaniel with Dr. Michael Rutter, Nathaniel's surgeon.
Laryngotracheal Separation is exactly like what it sounds like. The surgery separates the larynx from the trachea. The upper airway is sutured closed multiple times and in different ways including severing two neck muscles and using them as protective flaps over the closure. The trachea is brought directly out and sewn to the skin. The illustrations below show an airway first with a normal tracheostomy and then with a separation.
The surgeon was able to increase Nathaniel's airway tube from a 3.5mm width to a 5.5mm width. We have a critical few days ahead of us for initial healing; the goal will be for Nathaniel to rest as much as possible until we remove drains and stay stitches in a few days. Once the healing window is over, Nathaniel's new breathing stoma will be much more stable than it was in the past.
Nathaniel is resting comfortably in the Critical Airway Unit. He did not needed a ventilator post surgery and has been weaned off oxygen to room air. We are managing pain and nausea. When he wakes up, he signs 'all done,' 'help,' or 'Daddy.' Big tears roll down his cheeks from time to time; I suspect from pain and fear. Some big tears of fear have rolled down Rich and my cheeks too, but also from relief and joy. The surgeon shared a tragic story with us today about a little guy who had an airway accident just before his trip to Cincinnati for surgery. To God alone be the glory that Nathaniel's life has been sustained to get to this point today and that the operation went as the surgeon expected. We know we have been lifted up in prayer by many, both today and for the last two years, thank you. When we haven't known how or had the strength to pray ourselves; God has heard the prayers of others and delivered us.
We are dependent on continued prayer - now for healing. In addition to normal post-operative concerns, we are praying for no accidents that would dislodge the new tube or cause the sutures to be compromised in the next few days as Nathaniel's new stoma heals. We are praying that no saliva leaks develop where the upper airway was sealed closed. We are praying that Rich and I can balance being at the hospital and rotating back to the hotel to rest.
