Noah was scheduled to have a broncoscopy, endoscopy, and an ECHO early Thursday morning. We had to be at Childrens by 6am to check in at Day Surgery. They got checked in and took vitals and such, then around 7:45am they took him back to the OR.

First, the pulmonary team did the broncoscopy. The went in through his nose and looked at his vocal cords to make sure they were functioning properly. Then they numbed the cords and pushed past them and into his trachea. Vocal cords look great and there was no inflammation. The trachea was not perfectly round like a "normal" trachea should be, but the good news is that it is improving and it no longer touches... it is just an oval shape. It does pulse, however, which means that his heart/vessels are still compressing his airways a bit, but nothing major as of now. He may later down the road need additional airway surgery to try to shift things around, but that all depends on how he grows. Then they went into his lungs through the bronchus. His left bronchus is still a tiny bit weak but that is also improving. They did find some fluid in his right lung that they washed out and sent to the labs to test. Other than that, the broncoscopy went without any hiccups.

Next, the GI team started the endoscopy. Again, they went through his nose and into his stomach. They did not have to intubate him for this procedure since he did so well with the broncoscopy. His esophagus looks great and there was no acid reflux damage noted so his reflux meds are doing their job. His fistula repair site is looking good... so no need for any dilation of the esophagus at this time. When they entered his stomach, they found a pancreatic rest, which is basically a pancreatic cell that has latched to his stomach wall and formed a nodule near the opening of his stomach. This may or may not be the cause of his sicklet vomiting, so they will be discussing another test/ultrasound in the future. Dr. Tipnis said he also wants to have a swallow study done soon since Noah is taking most of his formula by mouth.

After the endoscopy was done, the cardiology team came in to do the ECHO while he was still sleeping from the anesthesia. We do not have the results from the ECHO yet, so there is nothing to report from that at this time.

Noah came back to his recovery room about 9:30am and started waking up. We gave him about an hour before we tried a sippy cup but he threw it up right away. He threw up quite a few times and his O2 started dropping. We had to increase his O2 flow rate from a half liter to 3 liters. His heart rate was elevated and his breathing was fast. So they told us that they would be keeping him over night for observation. Up to West 5 we went. ::sigh:: Noah doesn't like to make things easy. BUT he did well over night and they sent us home around 9:45 the following morning. 27 hours... what should have been only 3 to 4 hours. Oh well. :)