Bronchoscopy is an endoscopic technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument (bronchoscope) is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient's airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs. The construction of bronchoscopes ranges from rigid metal tubes with attached lighting devices to flexible optical fiber instruments with realtime video equipment.
Theatre overran yesterday, so after a day of nil-by-ahhhh-mouth, his broncoscopy was postponed. Not unusual - our beloved NHS is cracking. After a feast (and a coughing fit so hard he threw it all up again anyway) we had a very long night. We fell fitfully asleep early, only to wake later. He was worried, and we talked into the small hours. I cannot possibly describe how much in awe I am of him, and how much we all love him. And in hospital, he lets me love him that bit more. We were placed top of the emergency list for this morning, and went up to theatre early. After the emotionally torturous step of watching him be put to sleep (we've been through this many times, and it never gets any easier - I would defy anyone to not find the eerie vacant stare spine-chilling), Dan and I did our usual; try to eat, drink, talk, but we inevitably end up stalking peadiatric recovery even though we're supposed wait for the bleeper to call us back). Ear pressed to door, I could hear him coughing before the bleeper even went off.
The good news: he tolerated the procedure well. It was estimated that he would be under for 45 minutes, but they took two hours (our first inkling that not all was well). He came out puffy, pale, and coughing horribly, but a different kind of cough. We were in recovery for an hour more, but back on the ward now, he has sats of 94 on just two litres of oxygen, which is good. His throat is very very sore, as they have been in and out so many times.
The not good news: his consultant came to see us and described his lungs as one of the worst CF bronchoscopies she had ever seen, even showing us stills from the video of his airways, that I'm not sure I wanted to see, or can ever unsee. Written on the screen I saw 'airways extremely inflamed, from his larynx to his lungs, with copious amounts of very sticky mucous'.
As well as looking at his lungs, they suction the mucous out, but in his case this was not always possible, as it was thick like chewing gum (their words, not mine) and some airways were impenetrable. They also flush his lungs with saline to help shift mucous, and the physio shook his lungs in an attempt to loosen the secretions; all of which add to him feeling so horrendous when he first wakes up (and probably will continue to do for the next day or so). They took away samples of mucous, bloods, and cells to test for his inflammation response (a whole frickin box full of pots - it looked like they might have removed a whole lung) which means a waiting game now for a vast number of test results (will take a week).
He is asleep now and looking peaceful at last. Although we told him he would feel very unwell when he came to, I'm not sure he knew how much. The plan for now is as before; lots of physio, IV's, steroids and O2 as required for the weekend. Early next week they will have a meeting to discuss the plan for next week and beyond and come back to us. One thing we know is that this will certainly change his treatment regime long term.
As a family we also need to think a lot of things through, and make our own plans for the future. The news was so much worse than we had hoped - and we can't help feel like we have failed him somehow. He is always compliant with physio, doing the routine set out for him each day, but we're always left feeling there is more we could do... could have done. We just want him home, the girls seem lost without him too x
Huge thank you's again to all our family and friends for their help and support. I got home tonight to find my gorgeous friend Gem (THE most empathetic person you will ever meet) had come out of her way from town to drop off homemade food and treats, and then spent a whole hour on the phone listening to my sorrows. Gem, the lasagne was lush! Love you x x x
