Colin during his attempted extubation
After being re-intubated
Heading down for surgery (that's Trichelle with him)
During the surgery, they first checked out Colin's airway and then proceeded to cut a hole in his trachea and inserted a tube that the ventilator hooks right up to. This is a trach (along with a couple of other accessories I will explain in a bit):
Colin's trach is a 3.5 Neo Shiley, 3.5 is the diameter of the tube and Shiley is the brand (the one in the picture is a 3.0, which is a downsize in case we have trouble getting the 3.5 into his stoma). This gets changed once a month, unless there is an emergency such as a mucous plug, which is just a big booger that builds up over time (we've only had one emergency trach change). We change the ties every other day unless they are gross, and these keep the trach from falling out. I remember first getting trained and thinking how impossible it seemed and how much work it was. Now, I could change a trach in the middle of the night, half asleep, and probably with one hand tied behind my back (not to sound braggy). Colin makes it really easy too, he is such a good boy during trach changes. The other accessories in the picture are a Passy Muir Valve (PMV for short) and an oxygen adapter. Let me just say that the PMV is my favorite invention of all time. Without it, Colin would not make any sound. The trach is placed below the vocal chords, therefore, no air passes over them when the trach is in place. The PMV is a one-way valve. He breathes in through the trach with the PMV, but the valve then closes when he breaths out to allow the air to pass over the vocal chords and come out of his mouth. This way, Colin can make all the noise that he wants. We didn't hear him make noise for a long time, about three months, so this little piece was a God-send.
We very much look forward to the day that Colin is decannulated (taking the trach out). We're hoping that it could be as early as March 2015. It is an unwritten rule that trachs are not taken out during cold and flu season. We could fight to get it out sooner, but if Colin were to get really sick and, for example, needed CPAP, we could treat him at home instead of having to be hospitalized. So, we will be patient and do our best to keep the little man healthy during the winter months. I will do more educating in the future, but for now I will leave you with Colin opening his Halloween present from Grammy from this morning: