My life with Duchenne muscular dystrophy: The Good, the bad, and the ugly
Josh,So now you are an international celebrity! Well done, Josh, well done…Kathie
Josh,Once again, I am so impressed by your willingness to speak out to help MD patients and their families. Now you're a Canadian superstar!I agree that every patient is different, but I just want to add one advantage of getting a trach earlier rather than later that my family and my brother certainly did not realize until we were faced with an emergent situation. In my brother's particular case, the positive pressure ventilation through nose plugs worked well for him for many years. However, none of us were prepared for the fact that it made it nearly impossible for him to be given anesthesia if he ever needed surgery. When he broke his leg last year and needed surgery, the anesthesiologists were not able to put a tube down his throat to administer anesthesia because he could not open his jaw very far, therefore, we had to make a very difficult decision. They could try to give anesthesia through nose tubes, which is apparently a very difficult procedure (b/c of the undetermined amount of time he would've been off his machine as they attempted to insert the tubes). With the nose tubes, there was a chance that he'd have to have an emergency tracheostomy. Our other option was for him to undergo a planned tracheostomy. We decided on the latter because he was so nervous about being off of his machine for any length of time. If he had already had a trach, the anesthesia would've been a cinch to administer and perhaps he would still be with us. In addition, if he had had a peg tube earlier in life, then I am confident that he would have had better nutrition and some things would've been much easier for him. For one, he would've been in much better shape for the surgery. As it happened, he was given a trach for the surgery, but at this stage, his trachea was not strong enough to accommodate it. But, truly, one never knows what would've happened. Maybe it would've been easier, but maybe not. It is very difficult to predict, but for people with MD and their families who are faced with a difficult decision about whether to get a trach or to use positive pressure ventilation through nose plugs, I just want to offer our experience as food for thought. Regardless of whether or not a patient and his family decide to use a trach, I feel strongly that, in my brother's case, he would have benefited from having a peg tub inserted as a teenager.Again, I am no medical professional. I certainly do not know what it is like to rely on machines for my every breath and I do not know how I would feel or what I would want if it were me who had to make the decision for myself. I can only offer my observations of one MD patient in an effort (hopefully) to help one other person or family who may find themselves in similar circumstances. Thank you, Josh, for reaching out to so many people. I wish I had known you a long, long time ago! Lori
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About Me: Diagnosed with Duchenne muscular dystrophy (DMD) when I was 4 1/2 years old, I have been in a motorized wheelchair since age 10. Now 31, I have been ventilator-dependent for seven years. Despite my disease, I have strived to live as normally as possible. I was mainstreamed in public schools, graduated college with a journalism degree, and am currently pursuing a master's degree in urban studies.
Winheld's World chronicles my daily experiences in living with DMD and with a disability in general. I also use this blog to promote my autobiography, Worth the Ride: My Journey with Duchenne Muscular Dystrophy (iUniverse, 2009).
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2 comments:
Josh,
So now you are an international celebrity!
Well done, Josh, well done…
Kathie
Josh,
Once again, I am so impressed by your willingness to speak out to help MD patients and their families. Now you're a Canadian superstar!
I agree that every patient is different, but I just want to add one advantage of getting a trach earlier rather than later that my family and my brother certainly did not realize until we were faced with an emergent situation. In my brother's particular case, the positive pressure ventilation through nose plugs worked well for him for many years. However, none of us were prepared for the fact that it made it nearly impossible for him to be given anesthesia if he ever needed surgery. When he broke his leg last year and needed surgery, the anesthesiologists were not able to put a tube down his throat to administer anesthesia because he could not open his jaw very far, therefore, we had to make a very difficult decision. They could try to give anesthesia through nose tubes, which is apparently a very difficult procedure (b/c of the undetermined amount of time he would've been off his machine as they attempted to insert the tubes). With the nose tubes, there was a chance that he'd have to have an emergency tracheostomy. Our other option was for him to undergo a planned tracheostomy. We decided on the latter because he was so nervous about being off of his machine for any length of time. If he had already had a trach, the anesthesia would've been a cinch to administer and perhaps he would still be with us. In addition, if he had had a peg tube earlier in life, then I am confident that he would have had better nutrition and some things would've been much easier for him. For one, he would've been in much better shape for the surgery. As it happened, he was given a trach for the surgery, but at this stage, his trachea was not strong enough to accommodate it.
But, truly, one never knows what would've happened. Maybe it would've been easier, but maybe not. It is very difficult to predict, but for people with MD and their families who are faced with a difficult decision about whether to get a trach or to use positive pressure ventilation through nose plugs, I just want to offer our experience as food for thought. Regardless of whether or not a patient and his family decide to use a trach, I feel strongly that, in my brother's case, he would have benefited from having a peg tub inserted as a teenager.
Again, I am no medical professional. I certainly do not know what it is like to rely on machines for my every breath and I do not know how I would feel or what I would want if it were me who had to make the decision for myself. I can only offer my observations of one MD patient in an effort (hopefully) to help one other person or family who may find themselves in similar circumstances.
Thank you, Josh, for reaching out to so many people. I wish I had known you a long, long time ago!
Lori
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