John’s procedure is finished and he’s stable, was removed from the ventilator, and is resting in his sauna box. However, the report we received from the OR was not necessarily what we wanted to hear…. 

The goal today was to replace the stents in his nose which was somewhat accomplished. The left side of his nose had completely closed off again, so no air can get through. The intention was to replace the stent but the continued pressure on his septum was starting to cause real damage, so for now he has a protective barrier in that side to help his septum heal. A huge risk of continued stents is septal perforation, so they’re working hard to avoid that. Since no stent could be placed back in that side, it’s still closed and not useful for breathing purposes. 

On the R side his tissue had grown around the NG tube, so they trimmed that back to open it more. So he has a stent on his R side and an extra lumen so that his steroid drops can go in. 

Because his left nostril is closed and his right nostril is at high risk for reocclusion, they also had to put a stitch in his tongue so that it can be taped to his chin and preventing it from blocking his airway. In terms of breathing- he has very little margin for error and we’ve seen multiple instances of his heart rate dropping dangerously low when his airways get blocked. 

The goal is to maintain him in his sauna box, with frequent suctioning, and revisit things in a week. Next steps will be dictated by how well we heals in the meantime. For the time being, he will remain in the ICU in the event that his breathing is further compromised.