Trach Surgery. Time to throw away the plan...

Tuesday I had surgery to put in a smaller trach. Well, I had a lot of problems with bleeding and something that was obstructing my airway, so the doctor decided the best thing would be to do a bronchoscopy, to take a look and see what was going. on. For this, the plan was to put me to sleep, do the procedure, and fix whatever was going on. I was quite nervous as waking up from the previous surgery was a less than stellar experience. After surgery, according to the plan, I would go to the PACU and after I woke up, I'd go home. Things didn't go exactly as planned. Instead of waking in the PACU as was planned, I woke up in the ICU. I don't honestly know what went on, but my doctor decided that he wanted me to stay in the hospital for observation. I guess he did a lot of manipulation of the trach while in surgery. There was also a lot of bleeding. He cauterized the blood vessels that were bleeding, however, he said it doesn't seem like I heal properly. Every time he went to cauterize the blood vessel, if he then touched it, it would start bleeding again. He is not exactly sure why this is occurring, but this is what is causing the bleeding and preventing the site from healing properly. He thinks it may be because of the prednisone, but I don't believe this theory. I doubt it for a few reasons: one, I've been on long-term prednisone before and not had this type of effects; two, I'm on only 10mg of prednisne, which isn't a really high dose; three, I had this bleeding problem before I started the prednisone. Before surgery he had me go for blood work. He tested my  PTT, which tests the time it takes for your blood to clot, hemoglobin, and hematorcrit. Interestingly, my PTT was normal. My hemoglobin and hematocrit were low. Having my hemoglobin and hematocrit to be low, was not surprising since I have been bleeding for over 3 weeks; however it was surprising to have my PTT to be normal; it would be expected that all this bleeding would be because my blood was not clotting. If this were true, my PTT would be low. The doctor also said that the obstruction was caused by severe inflammation.

With all the bleeding and everything else that occurred, he wanted to keep me overnight where I could be closely monitored and observed. I had a LOT of pain, more than the original trach surgery, which wasn't expected since no incisions had been made. The doctor explained that this was due to the fact that he did a lot of manipulation. I also wasn't able to swallow because of all the swelling. The first day was extremely hard because I was in such extreme pain and quite out of it. Today the pain was manageable and I was able to eat normally. I had a lot of bleeding the first day, he had used a special type of gauze around the trach site, which causes blood to clot. It seems to be helping since I am not coughing up as much blood, and when I clean the trach there is less blood in it.

The original plan was to stay over the weekend and be discharged today (Monday), but as I said before plans often get thrown out the window. I mentioned to the nurse that we were trying to get me into rehab, but had not been successful because of insurance. The discharge coordinator said that she didn't see a problem. I will be going to Fox Hill, a rehab facility, either tomorrow or Wednesday, depending on when they have a bed. I will get my IVIg tomorrow. I am somewhat hopeful, but I'll believe it when I see it. We'll see...