by True to his normal nature, AJ was “difficult” in the OR. (Nearly 9 hours in there!!) But thankfully this time the issues were anatomical and not about his stability.
They had to bring in urology to get his urine cath in. They had issues getting an appropriate graft of rib cartilage. And then had issues getting the graft to stay in place (usually Dr Jacobs is able to “rest” it on a ledge and the stent then holds it in place, but he ended up having to stitch AJs in place). All the while though, AJ remained stable – just seemed to be making sure everyone else had some work to do!
He did ultimately have two grafts placed that will hopefully heal in place and hold open his airway. Both were carved from cartilage that was removed from his rib. One is placed in the front and one in the back of his airway. The front graft that was placed is 18x9mm, the back graft is 9×4.5mm. The hope is that they will heal and the mucus membranes in his throat will grow over them to keep them in place, and his airway will function like a “normal” airway. There is risk that his body could absorb or reject them, among other outcomes that would hinder his recovery or cause the reconstruction to be considered as “failed”.
For now, there is a stent in the middle of them, holding them in place and keeping his airway open as they heal, kind of like a straw that sits in the middle of it all.
The goal for tonight will be to keep him comfortable while still promoting blood flow to his legs to prevent clots. He’s still pretty out of it, but it’s largely for comfort. He doesn’t have any restrictions on movement, but his world was pretty rocked today so it’ll hopefully be a quiet night. Dr Jacobs goal is to have him up and moving tomorrow.
We were told to expect to be inpatient at least until stent removal — originally the plan was to remove it on the 22nd, but now we are looking at the 28th at the earliest, and even that is up in the air. Aaron is here until the 24th at least, so we will be able to tag team for a while between now and then. Once we finally get discharged (and there’s no guarantee of when that will be) we will still have to remain local for at least 6 weeks for additional monitoring before we can even start thinking about heading home.
AJ got a new sign for his bed though — What used to say “Can’t be bagged from above” now says he can. That alone is a big step in the right direction.
I included the before and after pictures of what his airway looked like at his scope last week and after reconstruction today. It’s probably hard to understand what’s happening in the pictures for most, but if nothing else I wanted to make sure I had it documented and saved for reference!
The next few days and weeks will be incredibly important for the outlook of his recovery and to help us start to understand how his body will heal or utilize the grafts that were put in place. Dr Jacobs has concerns about AJs lower oxygen levels possibly hindering his healing, but he held up his end of the deal and made AJs airway “look good on the table” and now it’s up to AJ to heal.
Thank you to everyone for your thoughts, prayers, good vibes etc. Please keep them coming if you have them to spare, as we aren’t out of the woods yet.
