We discussed the options, and decided to wait. We didn't even do the bronchoscopy. Dr. Huffard did prescribe a "Passy-Muir" valve, also called a "speaking" valve. This is a small valve that attaches to Garren's trach, allowing him to breathe in through the trach, and out through the mouth. This will help him as he begins to learn how to swallow again.
We also asked Dr. Huffard about Garren's swallowing. There is a rehab technique called "vital-stim" which is used to help people with swallowing. You have to be specially trained and certified to do this, so it is rather difficult to find a speech therapist that uses this technique. From everyone we've talked to, It sounds like Garren would really benefit from vital-stim. Dr. Huffard is going to help get us connected with someone who can help Garren with this.
Here's what I explained to the doctor: Anytime anyone has "taught" or "shown" Garren how to do something, he seems to pick it up very quickly. It's as though he literally has to be reminded how to do things. Once he he reminded, things seem to progress. I want someone who can show Garren how to swallow, to wake up those muscles, to remind him how it works, so his brain can take back over that function. So Lord willing, we will find that person who will take agressive and proactive steps to get Garren's swallow going again.
This afternoon Garren was in the garage (which has become his therapy gym). The OT and PT were there, and I was helping out. As he was doing some exercises, he become visibly upset. We stopped so we could figure out what was wrong. "Does anything hurt?" No. "Do you feel sick?" No. In the street we could hear a couple of his buddies laughing and having a good time. Garren spelled out for us "I want to play." I haven't hurt for him this much in a while. We've been doing our thing, we've been working hard, and he's been progressing so well and so quickly. I hugged him, I told him that he's doing great, and I fought back the tears.
Tomorrow we go in super early for Garren's arteriogram. It will be interesting to see the results of this test. Thanks for your prayers, I'll keep you posted.