Anna C.'s Story
Ana Carolina is a 3 year old girl who lives in Quito with her parents and older brother. She was born prematurely and required prolonged mechanical ventilation, which led to her needing a tracheotomy. Her father is in the rental car business and her mother, who used to work in design, now stays at home to care for Ana Carolina. It has been financially difficult for them on a single salary now especially with the costs of caring for Ana Carolina’s tracheotomy. She is also susceptible to infection and missed school in January and March with pneumonias. Ana Carolina attempted to wear a valve over her tracheotomy tube that filtered air in order to decrease the chance of contracting a respiratory infection from other children during the cold season in Ecuador. Her airway was so tenuous that she was not able to breathe through her tracheotomy tube with the filter covering it. Alternatively, her mother has kept her out of school since March in order to avoid viral infections. The family realized the opportunity that our team’s evaluation and treatment presented and the importance of being healthy while our team was in Ecuador, knowing full well that any sick child could not safely undergo anesthesia or airway surgery.
Ana Carolina’s parents have not heard her voice in 2 years. They have accepted the tracheotomy, but they were desperate to hear their child’s voice. Having been told that Ana Carolina had airway stenosis, her parents had anticipated needing reconstructive airway surgery. However, our team evaluated Ana Carolina and found that her airway was without narrowing. Yet she had a granuloma, or tissue buildup, in her airway as a result of the tracheotomy tube contacting the inner lining of the airway thus preventing any perceptible voicing. Our team removed the granuloma from Anna’s trachea and afterwards for the first time in 2 years her mother and grandmother were in tears as they heard her voice. We are hopeful that in a year or two we will be able to remove her tracheotomy.
Anna Carolina is growing and thriving. After her salivary procedure, she is handling her secretions much better. She can use a speaking valve and is talking and walking. Her jaw is still small so she still needs her tracheostomy, but we hope to remove this within the next year or two.
Ana came to Boston to see us this year! It came time for her procedure to move her jaw forward, so in March, she underwent a mandibular distraction. She did well from this, but because she continued to have problems with her secretions, we kept her up here to remove some of her salivary glands. After these procedures, she finally passed her swallow study and was able to start taking some food by mouth! We saw her again in Ecuador this year, and once her jaw joint is a little looser and she can open her mouth more easily, we will plan on taking her tracheostomy out.
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