The objective of this STEAM project is analyzing the effects of disease (condition) on function and structure of the respiratory system. For the art side of the project, I created a candy respiratory system. Meet Christian Trey Davis born on February 1st, 2019, in a hospital in Anchorage, Alaska. As a new baby joining a family of four, Christian is the object of everyone’s affection. Although he looks perfect on the outside, his anatomy on the inside, however, is far from that of a typical, healthy baby. Christian is unable to swallow, and his esophagus is not connected to his stomach. Born with this inability to eat, Christian eats through a gastric tube (GT). The doctors bring the sobering news of his diagnosis, tracheoesophageal fistula (TEF) and esophageal atresia (EA). Tracheoesophageal fistula is a condition in which the esophageal tube and the trachea are one structure (Boston Children’s Hospital, 2020). Esophageal atresia is a birth defect that results in a separation of the esophagus, as shown in the attached drawing (Boston Children’s Hospital, 2020). According to the National Library of Medicine, TEFs represent one of the most common issues that present in pediatric hospitals today (NCI, 2022). On Christian’s second day of life, he undergoes surgery to correct TEF and EA. The surgery is initially successful.
After being released from the hospital, Christian frequently has bouts of pneumonia, bronchitis, and other respiratory illnesses. He suffers regularly from nasal flaring, retractive breathing, and hypoxic episodes (which cause him to turn blue around his mouth, fingers, and toes). During feedings, Christian has pain and an increased risk of choking. His parents preform full CPR on him three times over the course of a few months. Concerned about Christian’s health, his mom brings him to the hospital where he is first diagnosed with both tracheomalacia and laryngeal cleft type 1.
Since these diagnosis is not treatable here in Alaska, the parents seek treatment in the lower 48 after weeks of phone calls, prayers, and talking with doctors. They finally receive a follow-up call with a doctor in Boston who is able to treat Christian. The doctor is a specialist in a new, innovative surgery that attempts to correct the condition completely. Tracheomalacia occurs when the airway collapses during breathing. Christian suffers from a 100% collapse of his airway during exhalation. A laryngeal cleft arises where there is an opening between the larynx and the esophagus (Boston Children’s Hospital, 2020). If Christian attempts to drink milk normally, the liquid passes directly into his lungs and airway.
Doctors send Christian to undergo surgery immediately to correct tracheomalacia. The surgeon moves the thoracic duct, vagus nerves, and the esophagus out of the way and opens both the back and front membranes of the trachea (Boston Children’s Hospital, 2018). These membranes are then connected with foreign matter to the spinal column and the sternum. Following surgery, Christian’s airway maintains a 75% opening upon exhalation.
There are numerous recovery steps for Christian post-surgery. He must undergo oxygen treatments, speech therapy, and physical therapy. Around the age of one, he begins the process of learning how to eat normally. Along with this, Christian has follow-up surgeries until the age of 2. Now, at age 4, Christian has yearly biopsies to check for and detect any cancerous cells. This story is one of many testimonies of an amazing medical recovery due to advancements in the medical community. As I am looking forward to entering nursing school, this is motivation personally to be the best nurse possible.
*As a note, the patient’s name has been changed to protect privacy.
Boston Children’s Hospital. (2018). How we treat tracheomalacia [Video]. YouTube. https://www.youtube.com/watch?app=desktop&v=ArURYRYYacU
Boston Children’s Hospital. (2020). Laryngeal cleft. https://www.childrenshospital.org/conditions/laryngeal-cleft
Boston Children’s Hospital. (2020). Tracheoesophageal fistula. https://www.childrenshospital.org/conditions/tracheoesophageal-fistula
Boston Children’s Hospital. (2020). Tracheomalacia. https://www.childrenshospital.org/conditions/tracheomalacia
National Center for Biotechnology Information. (2022, May 8). Tracheoesophageal fistula – StatPearls – NCBI bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK535376/
By: Debbie Brower