Houston Methodist – Day 15: Subcutaneous Emphysema

Anya sprung another leak in her lungs this morning due to the high pressure of the ventilator pumping air into her lungs.  I don’t know if it was another mistake on their part or what, but all I know is that when I went to see Anya this morning, her face and neck were so swollen with air that she looked like she was stung by a thousand bees.  Yeah, it was pretty rough seeing her like that.

The doctor told me that he went to check on her at 6:00am and she looked fine.  Two and a half hours later, he checked again and she was noticeably swollen.  Why didn’t the nurse alert the doctor sooner?  No clue.  Another careless mistake that, in my opinion, could’ve been avoided.

Anyways, she was alert and awake for most of today.  Probably more alive than she has been since Saturday, mainly because the ventilator was breathing for her.  The doctor assured me that she did not have another collapsed lung (pneumothorax).

It’s just that the small hole in her lungs started leaking air again due to the high pressure of the ventilator, so the air is escaping her body in the path of least resistance, which is through her skin.  This is called subcutaneous emphysema.  It’s rarely a cause for concern but since Anya’s lung function is already compromised, they’re keeping a close eye on it.  If the hole closes by itself, which it should, then most of the excess air will be gone in 4-5 days.  They’ve also lowered the pressure on the ventilator to hopefully prevent this from happening again.

Tomorrow, they are going to put a tracheostomy tube in her at 9am.  This procedure will allow them to take out the ventilator tube and ventilate her through the trache tube.  They can also close the trache hole and allow her to breathe on her own, when she is able to.  Right now, the ventilator tube is just hanging out of her mouth and down her trachea, which is good for emergency purposes, but it can lead to other problems with her mouth open at all times.  With the tracheostomy tube, the surgeon will surgically implant a tube below her throat and directly into her trachea, so that her wind pipe will be accessible through another hole instead of her mouth.

Hopefully, by next week some time, she will be back to “normal” and maybe even breathing on her own again.  She will most likely still need the ventilator at times, but hopefully, she will not need to solely rely on it to breathe.  Baby steps.

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