The issue was almost total lack of voice and rapid re growth of presumed Richter's transformed node in neck (see prior post). In ER, they did (repeatedly, unfortunately) nasal direct laryngoscpy ( see http://www.fauquierent.net/endo.htm) and found possible obstruction above the vocal cords and maybe unilateral cord partial paralysis. ENT was very worried that my airway would close off and wanted to intubate.right away. When we ( me and my stepdaughter recent RN grad but a doctor in her thinking patterns!) pressed for trying chemo for presumed CNS lymphoma first, the ENT team brought their attending down who noticing the apparent obstruction above the vocal cords ordered a stat CT which showed a large mass (possible lymphoma) causing the obstruction. So plan became intubate, go to ICU overnight and get tracheostomy tube placed and biopsy mass in AM. But anesthesia wanted to intubate in more controlled setting of OR so decided to place trach that night.
Operation went well, they got biopsy of mass, placed trach tube ( see http://www.mayoclinic.com/health/tracheostomy/MY00261) and noted much pus below ( later said to be an obstructive tracheitis) I went to ICU and woke up with my new tube and on ventilator which they weaned me off by mid-morning.
I can't eat because of mass and new tube so got nasal gastric tube for liquid nourishment. Onco team has me on Decadron to rapidly shrink nodes (hopefully mass as well, pathology report pending). More chemo will be given once down to onco floor and pathology back.
I feel pretty good but cough from tracheitis ad pus needs to suctioned fairly frequently so need to stay in ICU for a few more days...
I know, more bad news, but this admission beats coma, seizure, etc of last admission when had lymphoma in brain!
