05-22-2009
0455 Hours
Below is my communication to Dr. Doherty yesterday regarding our recent visit to San Francisco. I am still waiting to learn of the results from Dar’s procedure yesterday. Dr. Waters will be at the hospital and I would imagine I will learn of the next steps to be taken in both situations. Please continue to pray for Dar and her recovery.
Good morning Dr D
Know that Dr Waters is off today, I am sure you will keep her up to speed.
Will try to be brief as I know you are busy.
Doc D I know today is Dar's exploratory exam regarding her "stones", will look forward to hearing later what the plan will be for their removal.
Regarding Dar's trip to the 'city",
After taking a day to process the information and do some "internet" research, I think now I can put to pen the appropriate questions.
As I understand things, we now know why Dar is not capable of having the button or the "redcap".
If the vocal cords are "stuck/paralyzed" as I believe is the situation from the initial injury back in December, does this mean that we are looking at a prolonged period of having to leave the "trach" in?
Is this, again as I understand it a "neorological" issue directly related to the events in December? I also understand that there is a definate narrowing of the "airway" but this is not the main cause of her difficulty. In my simple terms and understanding, because the "cords" are in a "closed" position, Dar is not able to get enough air to her lungs, therefore cannot speak and maintain herself.
Now the questions: over time will this problem correct itself, are we looking at a more lengthy period of haveing the "trach" in? Are "botox" injections something that can be thought of and pursued> I read an article by Dr. Cory Masse (????) that eluded to much success releasing the vocal cords with botox injections? Will injections work in this situation of "neurological" aftermath?
If we are looking at a more lengthy period of time with the "trach" and the fact that Dar is not able to perform "suctioning" for herself are we looking at keeping a "cuffed" "trach", as opposed to a "cuffless" as was suggested by Dr. Courey?
Is Dar's new found condition enough of a "medical" issue to extend her stay at Kentfield or lengthen a stay at a lessor facility such as Caremeridian. I know we are moving that direction Dr D and I am more convinced that given Dar's circumstances I want her to be as close to you as possible when she graduates to her next facility. It is also my understanding that the Director of Medicine at Fairfax is a Pulmanary Specialist. If correct I believe that this is where Dar needs to be. With the best providers with the best and most knowledge of her specific issues.
Dar's family and I visited the facility on Saturday and this is where I would like her to be in the future, with you and the folks at Fairfax.
Please forgive my ramblings and possibly the scattered thougts, I still find myself "reeling" from Tuesdays visit to SF. Was not quite prepared for the results and what these results may hold for the future, very glad we found the problem, just did not think we would/could be looking at something that may turn out to be very long term. Keeping of the trach.
I look forward to hearing from you about this and Dar's results of her exam today. Thank you Dr.D
Danny and Family
Response from Dr. Doherty
before we make any further changes with respect to the trach, i would like to review dr. courey's report. i will ask anna to get a copy expedited over for my review.
0455 Hours
Below is my communication to Dr. Doherty yesterday regarding our recent visit to San Francisco. I am still waiting to learn of the results from Dar’s procedure yesterday. Dr. Waters will be at the hospital and I would imagine I will learn of the next steps to be taken in both situations. Please continue to pray for Dar and her recovery.
Good morning Dr D
Know that Dr Waters is off today, I am sure you will keep her up to speed.
Will try to be brief as I know you are busy.
Doc D I know today is Dar's exploratory exam regarding her "stones", will look forward to hearing later what the plan will be for their removal.
Regarding Dar's trip to the 'city",
After taking a day to process the information and do some "internet" research, I think now I can put to pen the appropriate questions.
As I understand things, we now know why Dar is not capable of having the button or the "redcap".
If the vocal cords are "stuck/paralyzed" as I believe is the situation from the initial injury back in December, does this mean that we are looking at a prolonged period of having to leave the "trach" in?
Is this, again as I understand it a "neorological" issue directly related to the events in December? I also understand that there is a definate narrowing of the "airway" but this is not the main cause of her difficulty. In my simple terms and understanding, because the "cords" are in a "closed" position, Dar is not able to get enough air to her lungs, therefore cannot speak and maintain herself.
Now the questions: over time will this problem correct itself, are we looking at a more lengthy period of haveing the "trach" in? Are "botox" injections something that can be thought of and pursued> I read an article by Dr. Cory Masse (????) that eluded to much success releasing the vocal cords with botox injections? Will injections work in this situation of "neurological" aftermath?
If we are looking at a more lengthy period of time with the "trach" and the fact that Dar is not able to perform "suctioning" for herself are we looking at keeping a "cuffed" "trach", as opposed to a "cuffless" as was suggested by Dr. Courey?
Is Dar's new found condition enough of a "medical" issue to extend her stay at Kentfield or lengthen a stay at a lessor facility such as Caremeridian. I know we are moving that direction Dr D and I am more convinced that given Dar's circumstances I want her to be as close to you as possible when she graduates to her next facility. It is also my understanding that the Director of Medicine at Fairfax is a Pulmanary Specialist. If correct I believe that this is where Dar needs to be. With the best providers with the best and most knowledge of her specific issues.
Dar's family and I visited the facility on Saturday and this is where I would like her to be in the future, with you and the folks at Fairfax.
Please forgive my ramblings and possibly the scattered thougts, I still find myself "reeling" from Tuesdays visit to SF. Was not quite prepared for the results and what these results may hold for the future, very glad we found the problem, just did not think we would/could be looking at something that may turn out to be very long term. Keeping of the trach.
I look forward to hearing from you about this and Dar's results of her exam today. Thank you Dr.D
Danny and Family
Response from Dr. Doherty
before we make any further changes with respect to the trach, i would like to review dr. courey's report. i will ask anna to get a copy expedited over for my review.
dr. d
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