The Good, The Bad and The Ugly

Hi Everyone,

It has been a busy week here at the Drostens. Three main things going on, called the good, the bad and the ugly for no good reason. (Except for getting you all in the mood with a fantastic soundtrack) So what's been up?

The good, we had an appointment in Rotterdam at the Sophia,and we have scheduled Noah's operation the remove the blockage in his throat. The bad, we have had to postpone the moving from Monday to Thursday. Too much is not finished, especially due to having to redo the stairs and the floor taking longer then expected. The ugly, Noah was rushed to the hospital last Wednesday, because he had enormous trouble breathing. Luckily it all turned out to be okay, we found out he had a too small canule (breathing tube) since friday, and the effort of breathing through that had gotten too much. He quickly recovered after changing the canule and a few night on his breathing machine to give his overworked breathing muscles a break.

So for more details.
The Good: Noah's operation is scheduled for June 8, and he will have to stay in hospital for three weeks afterwards. The whole healing process will take around 4 months, after which he will be closely monitored for another two months.
The plan is to create an opening in his throat, while preserving the vocal cords. After surgery a balloon or plug (stent in dutch medical language) will be put in his throat to keep the newly created windpipe open. He will not be able to breathe past that so he will keep his canule for the time. The plug (for a lack of a better word) will also prevent scar tissue from growing inward and reducing or even closing his airway.
This plug will be very much in the way, so it is expected that Noah will not eat, and have some discomfort (medical language for pain) from it, especially in the beginning. The plug/stent will have to be swapped every three weeks, which is a full blown operation performed under general anaesthetic. Noah will stay in hospital until the first change, if all goes well he can go home and come back every third week for the next stent change.
It will take about 4 months for his throat to heal completely, so it will be a lot of trips back and forth to the hospital for us. Noah seems to be looking forward to traveling, He is sitting here with a 'get on with it Dad!' expression already!


Once he has healed , the doctors can asses the quality of his new airway. It is possible that it will still be too narrow, or too soft (it will be difficult for Noah to keep his airway open if it is too soft). The best case scenario is that his airway will be wide and firm enough, because it would be difficult for the doctors too operate again - this is a one shot deal.
His vocal cords will also be checked, but there is even less the doctors can do about them. They hope no scar tissue will form on them (limiting movement and thus range of sound), but as Noah has never used them, the muscles and and nerves are an unknown factor. We have some indications that his reflexes work (coughing, etc) but whether he will be able to make sounds, or even speak? We'll have to wait. So 5 more weeks, and then 4 months of waiting.


The Bad: Moving has been postponed a few days, as the builder has had too much delays this last week. All though they had an alternative entrance to get into the house, they couldn't make too much dust because the floor was being lacquered downstairs.
We decided we are still moving on Wednesday with Noah out of Doetinchem. Our stuff will arrive from storage early Thursday morning. The house won't be completely finished, as we are still waiting for some materials. However we had already booked nursing care, and we are at the point of running out of money, so it may be a few months before we finish the last things. I'm sure our the Drosten Seniors love us, but by the end of a few more months .....! ;)

The stairs, which had to be remodeled are being put back into place. They need painting and handrails. Not finished.......


Our bedroom will get a big cupboard, to replace the walk in closet we had at the old house. Not finished....

Big family bathroom. Some tiles still need to arrive, as the amount required was miscalculated. Not finished....

Kitchen. They ordered the wrong top cupboards, so the right ones will arrive in about two weeks. Functional - but not finished.....


And of course some more trash in the garden, which will need to be removed somewhat to prevent the movers from walking too much dirt into the house.
Not finished.....

So this was the situation Thursday in the early afternoon. They will have almost a week (luckily our builders are working over Dutch national holidays, "Queens birthday" and "Remembrance day" on May 5th), to finish a lot of stuff. Most of the rooms are close to being finished so we hope that they will get quite far, most likely only being delayed by the tiles that have not been delivered yet.


The Ugly: Noah had to go into hospital because he had troubles breathing on Wednesday. Louise was taking care of him, and suddenly he started hyperventilating. She gave him oxygen but in the end she had to do an emergency canule change, as it seemed that the canule was blocked by something.
While changing the canule she realized that the old one was a size too small. This must have happened Friday when one of the nurses supervised grandmother doing a canule change, and we didn't think to check it. So the combination of labouring hard to breath for 5 days, and then the blockage tipped him over the edge.
Although the size differences seems small 4mm compared to a 4.5mm, there is overall a 25 % increase in the size of the breathing tube, so he had been doing the equivalent to running a marathon for 5 days - which is how hard his heart and lungs had to work.
Just after Louise changed his canule the ambulance arrived, as his breathing did not improve much. Noah fell asleep on his way to the hospital, probably completely exhausted, but his oxygen levels stabilized and he could do without oxygen after sleeping for about 2 hours. This convinced the doctors to let us go home, after much discussion between the local doctors, and the doctors in the Sophia. We were advised to put Noah on his breathing machine, to speed up his recovery and give his overworked breathing muscles a rest. He slept a lot for a few days afterwards, but seems fine now:



So, a big shock, but looking back we recognized the symptoms from previously when he needed a larger canule. No harm was done, it was just a sharp reminder that you can not let down your guard and get complacent, and also small mistakes can have a big impact.

So, more here in (maybe more than) a week as we will probably be too busy moving to even connect our computer to the internet.

Thijs