So . . . What exactly is Parker having done?

Parker is going to have a single stage laryngotracheoplasty (LTP). This surgery is used to widen and/or strengthen the trachea so that the airway may be supported safely without a tracheostomy.

Essentially, the surgery involves extracting rib cartilage (though on occasion thyroid cartilage is used) and then reshaping the trachea and stitching in the rib cartilage in order that the new shape becomes integral.

The single stage LTP involves removing the trach at the time of the surgery. In a double stage LTP the airway is actually stinted temporarily and the trach is removed at a later date.

The surgery will last approximately five hours. After the surgery, Parker will be heavily sedated and on a ventilator in the PICU for about a week. At that time they will take him back into the OR to check how well the rib grast has integrated into the trachea. If all looks good he will be brought out of the sedation the next day and extubated. He will be hospitalized for another week or two and then released but will need to stay in town for out patient visits and another trip to the OR before we can go home.

Why Cincinnati Children’s? A lot of factors went into this decision. First of all, we knew that “surgery” would take place at a time near when we would be moving home from Canada. The follow up to this surgery is extensive and years in nature. It makes sense to have the surgeon who will do the follow up do the surgery. There are surgeons at Sick Kids who do the LTP but they do many less per year than Cincinnati does. That is another important factor. As with any surgery there are lots and lots of risks. Cincinnati Children’s, under the guidance of Dr. Robin Cotton, has positioned itself as the “epi-center of the airway universe,” as I like to call it. This surgery is routine for them. They know how to handle the bumps along the way in the recovery process.

And then there is Dr. Cotton. Once you enter into the world of complex airways it doesn’t take you long to learn that he is the man. He’s developed many of the procedures and he’s trained the finest airway surgeons out there. And his daughter did her Master’s at Purdue! But, I digress. We hoped in the beginning that we would escape needing to meet the famed Dr. Cotton but here we are . . . humbled that he has taken Parker’s case.

I will be honest though and say that in some small way, I am saddened that we will not go full circle with Sick Kids. I remember clearly the awe that first day when I walked in the atrium and that awe did not waiver for our entire experience there. I actually cried last fall when we had our last visit with Dr. James . . . it was truly sad to walk out the door and know that I might never return.

What is the follow-up? For the first year or so there are pretty regular check-ups and even OR trips to ensure the integrity of the airway. Over time, those become further and further apart. The surgery can fail. Generally, if it is going to fail it happens slowly, over time. Some kids have to have the surgery repeated. There is no way to predict. Essentially, having this surgery makes you a lifetime airway patient.

What does the future hold? We’ve been advised that Parker shouldn’t play contact sports. The strength of his neck will be compromised and blows to the area would take a greater strain or even be deadly for him. So, football, wrestling, and karate are not in his future. Swimming and track are good bets. And like most things in life, there are lots of gray areas with sports. We will just have to take it a day at a time when he gets old enough to want to participate in sports. As a side note: the nurse at Cincinnati laughed when I asked her if goofing around with your older brothers is considered a contact sport. Honestly, that is the thing that worries me the most about keeping him safe while he is still under my roof: Tweedle Dumb, Tweedle Dumber and Tweedle Dumbest getting into a brawl that ends with an elbow to the neck.

Two weeks from today, Ian, Parker and I will step on a plane and fly to Cincinnati to face our future. I’m excited and not too nervous . . . yet.

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3 Responses to “So . . . What exactly is Parker having done?”


  1. 1 Rene Dereksen March 28, 2008 at 3:50 am

    I know exactly what you’re feeling! Parker and Tommy are about to walk the same road….Big Hugs!!!

  2. 2 Amber Cornell March 28, 2008 at 1:38 pm

    Hi Upton Family,

    We wish you the best of luck with Parker’s surgery – a lot of warm wishes and thoughts will be with you guys through your journey.

    Take care, travel safe and take care of each other.

    Amber & Jeff xoxo

  3. 3 Ava Pelz March 31, 2008 at 12:27 pm

    Hi there Suzanne and clan

    I love the hair! He is too adorable! A very strong NO to a haircut!

    I hope that all goes well for Parker with the surgery and beyond.
    All the best as you return to the States for you and your family.

    Hugs

    Ava 🙂


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