Friday, November 12, 2010

Update

Cayden visited his CF team this past week mostly for us to sign some paperwork before Cayden's upcoming bronchoscopy and endoscopy.  Cayden is doing really well--gaining weight and is super active.

Cayden has had a bronchoscopy before when he was only 5 days old.  With that, he was diagnosed with Tracheomalacia and Subglottic Stenosis.
The reason we are doing a bronch this time is because Cayden has been on antibiotics for 2 weeks of every month of life.  That is just too much.  The bigger problem is that the antibiotics do not seem to do the trick.  Cayden's symptoms go away for a couple of weeks and then return again full force.  All of Cayden's throat swabs have not cultured any abnormal growths so it is suspected that the bug is deeper into his lungs where a throat swab cannot get to.  Because Cayden is so young, he is not able to adequatly cough a suitable sputum sample that could tell us what is going on so that is where the bronch comes in. 

In a brochoscopy, Cayden's doctor will thread a bronchoscope through Cayden's mouth and down into the bronchial tubes.  From there, they look around to see if there are areas of inflammation or infection.  They also will flush the lung with saline and then suck some of it back up (called lavage).  This will be sent to the lab to be cultured.  Some of the lavage will also be used in a study going on through the university.  The study is looking at the live cells under a special microscope in young cystic fibrosis patients. Cayden will be put under during this procedure.

Here is a youtube video if you are interested:




Either before or after the bronchoscopy, and while he is still asleep, Cayden will have another procedure called an endoscopy.  In this procedure, Cayden's GI doctor will use an endoscope to look at Cayden's esophagus, stomach, and his duodenum.  The Doctor will also take small tissue biopsies of the esophagus, stomach and duodenum.  The GI specialist has added this exam on to the bronch because Cayden has had some trouble in the past with bacterial overgrowth and reflux so we feel that it will be a good opportunity to get another test done while Cayden is sleeping as to aviod Cayden being put under twice.

Here is an animation of an endoscopy being done:



While Cayders is out, they will also repeat some bloodwork that needs to be done fasting, which is great...I kind of feel like we are killing 3 birds with one stone!

Both procedures are pretty routine; however it is still hard to make the decision to do these things to Cayden.  There are risks, mainly the anesthesia but we believe that it will be the right thing to do and hopefully we can find out exactly which bug is in Cayden's lung (if any!) and then move forward!