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Tracheal Stenosis Part 2

Monday, I had my pre-op appointment. That is when my nerves started getting anxious. Read the sequence of events that will be taking place. You will understand why.


The Anticipated Procedure Sequence:

  1. Induction of anesthesia and initial ventilation with the laryngeal mask device.
  2. Insertion and suspension of laryngoscope
  3. Passage of fiber optic bronchoscope with laser in channel through the laryngoscope. (Jamie here: the laryngoscope and the bronchoscope is the balloon devices that stretch out my trachea.)
  4. Thulium fiber laser ablation of the tracheal scar with 600 micron fiber at 10 watts and in continuously pulsed mode (this is the laser they will be using. I have no idea what a micron or what watts are, but there it is. )
  5. Switch back and forth between the laryngoscope and laryngeal mask as needed to maintain oxygenation. (This means that these two tools have to share the airway in some way. So while they are lasering I’m not breathing, so they have to stop give me oxygen and then go back to lasering the scar tissue. )
  6. When the laser treatment is completed, then remove the laryngoscope
  7. Insert rigid ventilating bronchoscope and apply to the laser area the 4 minute Mitomyacin-C chemo. Let it dry. (The ventilating bronchoscope has oxygen through the non-bendable device and I will be breathing through a straw. and the chemo takes 4 minutes to dry.)
  8. Plan to avoid tracheostomy if possible. The lowest level of stenosis is in a location that would not be accessible if a tracheostomy is in place. (My tracheal stenosis is right where the chest bone meets the throat. and it is a challenging place to get to. That is where the biggest and smallest part of my trachea is. The other is near my voice box. He does not want to have anything rubbing on it to stimulate more scar tissue developing after he lasers it off. The trach would do that.)


I’m reading this in the doctor’s office and I start feeling my heart beat faster. I thought, I got myself into a chaotic mess, didn’t I? But the truth is, this whole sequence of events from 7 years ago until now has been a chaotic mess of events. I’ve been through worse than this surgery. The only difference is I didn’t have the Mitomyacin-C chemo drug injected into the scar tissue. For the last couple of days I have been reminding myself that I am supported. God is holding my hand, no my whole body up as I with shaky legs get ready to walk the plank so to speak to face a procedure that is an experiment.

I will be going in at 8 AM Friday morning and I will be staying a couple of nights in the hospital. Everything is going smoothly. I will write part three while I am in the hospital or when I get home. It depends on how I am feeling. Keep breathing and smiling.

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