The Advetures of Jadon and Kalina

The Advetures of Jadon and Kalina

Saturday, March 23, 2013

Kalina’s MRI and Bronchoscopy

Kalina had a MRI and bronchoscopy yesterday.  I posted a few updates on Facebook but realized that not everyone has a Facebook account, and I did not explain why she had these done, which might be of interest to some people.

Explaining the MRI is relatively easy.  Kalina has kyphosis (curvature of the back).  Kyphosis is what can make you appear to have a “hump back”.  It is much more dangerous than scoliosis, as kyphosis can cause your back to curve so much, your spinal cord can be in danger.  That is why Jadon had his back fused and rods put in his back – to keep his kyphosis from getting any worse.  Kalina’s kyphosis has never been as bad as Jadon’s.  In fact, her degree of curvature has been decreasing.  We are thankful for that.  All her x-rays indicate everything looks fine but you only really check a spinal cord with an MRI.  So, just to make sure, she had an MRI yesterday.   The last one she had was a few years ago.  Her doctors don’t expect to find anything exciting, but felt it was better to do one just to make sure.
 
Kalina had a bronchoscopy last summer.  This is where one of her ENT doctors takes her to the OR and looks at her airway via a small camera inserted through her nose, mouth or trach.  Last summer, her doctor noticed some granulation tissue above her trach but below her vocal cords.  At that time, he was unable to remove it (usually via a laser).  The granulation did not seem to bother Kalina so we left it at that.  This past October Kalina woke one day and had great difficulty talking.  We took her to see one of her ENT doctors and we determined the granulation must have increased in size such that getting air around it to her vocal cords to talk was difficult.  We scheduled surgery to remove it for early December.  After about 2 weeks, Kalina’s voice had returned to its usual state.   At that point, we talked to some of her doctors and decided the risk of doing the surgery was not worth it, especially since the issue resolved on its own.  When we learned Kalina would need to have an MRI, we decided to revisit the issue, since she would already be under anesthesia.  The scope shows that the granulation is still there.  The pictures we got (yep, we get pictures of her airway) show that it is pretty big.  It blocks almost all of her airway when she is sleeping.  When pressure was applied to her airway, it blocks about 2/3 of it.  That would help explain why Kalina cannot sustain loud volumes for very long.  Kalina’s airway is still small and the tools available to remove the granulation are limited.  Again, her doctor did not feel like it was in her best interest to proceed with the removal.  There are more complicated, medical reasons that I will not get discuss now.  I’ll just leave it as we were happy with this decision.  We were told we may be able to revisit it as she gets older and grows allowing for more options for removal.  We were also told her lower airway looks a little better – it was not as floppy as last time.  Good news.  We are thankful that the granulation does not impact her breathing (since it is above her trach), just her speech. 

All in all, everything went well.  Kalina removed her own IV, precariously placed in her foot, moments after I met her in the PACU.  She really wanted to go home.  It took her a little while to stabilize her oxygen levels, partially because she kept getting upset and asking to leave.  Luckily, the nurses realized what was happening and let her go to the recovery room.  Once she was there, she perked up and we were discharged within 20 minutes.    

Kalina was a little groggy on the way home but requested a snack.  Later, she asked for French fries from The Rock for dinner.  We were glad she was feeling so well.  She had a restful night and has been having a great day. 

Thank you all for your continued prayers.   

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