Luca’s Story

Site created on July 8, 2022

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Hello, world! My name is Luca Charles Raehsler, and I was born on June 8th, 2022. Before I entered the world, I was diagnosed with a congenital heart defect called tetralogy of Fallot (TOF), which required frequent appointments at Mayo. After birth, I had a 5 day stay in the NICU, where my heart was proving well enough to go home until needing my repair later down the road. Shortly after birth, I tested positive for a disease called DiGeorge syndrome, which means there is a portion of my chromosomes that is missing and can have a wide range of side effects, one of which is my TOF. After being discharged from the NICU, I struggled to eat and cry and started to have heavy, raspy breathing that we thought was associated with my TOF. On June 23rd, while getting ready to go to bed I had a choking incident at home and had to be rushed to HCMC in Minneapolis. From there, I was transferred to the PICU (pediatric intensive care unit) at Mayo Clinic. After a week in the PICU, I was transferred to the cardiac ICU as the plan was to have a BT shunt surgery as a temporary fix to my heart until my full repair. As my amazing team at Mayo worked together to figure out what was going on with my little body, they decided it would be best to have an airway evaluation procedure prior to my shunt surgery. It was discovered during the airway evaluation that my DiGeorge syndrome had caused tracheal stenosis and laryngeal webbing. For me, this meant that my airway was smaller than a 24-week preemie and there was tissue that formed between my vocal cords. Due to this, the doctors decided to cancel my planned heart surgery to place a BT shunt and perform a tracheostomy instead. This explained so many things to my doctors of why I choked, struggled to eat, needed a feeding tube, could not make much noise. My surgery was June 30th and I continuously surprised my doctors with the improvements I have been making each day! My doctors hope that with the placement of my trach, my heart will be healthy enough to hold off on my full heart repair until 3-6 months of age. Once I am stable enough to go home, I will require 24-hour care at home to ensure I stay safe. My goal is to have my trach in for 18-24 months, which will allow my body to grow enough so that the doctors can perform a full airway reconstruction surgery allowing me to be trach free! I continue to prove myself over and over to be the strongest little baby and still give my mom and dad smiles to let them know I am okay and we will get through this as a family. I appreciate all the prayers and support I have received from so many people, many of which I have yet to meet.

Newest Update

Journal entry by Bridget Raehsler

We are home!

Luca continued to wake up and improve quickly as we knew he would when he got the trach placed and recovered from that surgery. It was a continued emotional stay as we weaned off the vent, had his first trach change and got him back to his baseline prior to surgery and anxiously anticipated seeing him doing “normal” Luca things. Last weekend, we started to see the little Luca we know as he started moving around, regaining some of the strength he lost and we even got his hand waves and smiles back on Sunday. We knew when we started to see the “normal” happy side of Luca, we were on the home stretch and discharge was in the near future. To our surprise, it happened sooner than we thought as we already know how to care for him with a trach and it was decided we could finish medication weaning/the rest of his recovery at home and be seen outpatient.

Luca had another airway check last Tuesday, January 2nd where his pulmonologist joined in to give the lungs a good look as well. He said his lungs are looking great (yay)! His ENT doctor/surgeon also said that his airway/voice box continues to improve and the swelling is going down, although there is still a lot of swelling due to the trauma of the breathing tube. She is not concerned about that and said it will continue to improve over time and he will continue to have checks.

His kidneys seem to have fully recovered, his liver labs continue to trend in the right direction (although it can take a while for them to recover) and his echo looked the same as his last one and did not get worse. There are no interventions his cardiology team wants to take at this point, but will continue to keep a close eye on him as usual.

Luca started walking again a few days ago! They are happy with how quickly his physical activity is returning and we are working on building back muscle and strength. As we anticipated, he did lose some weight over the course of his stay as his little body went through a lot and he was laying down for such a long period of time without moving. He passed his swallow study so he is able to drink and eat by mouth again as well as continue to be fed through his g tube.

We got back home on Wednesday and have been settling back in and getting back to a new routine at home. Luca and his dog, Eddie were ecstatic to see each other again, they cannot get enough play time in. Luca came home on several medications that we are either weaning or will hopefully be short term and get taken away as we continue our outpatient check-ins with his specialists.

Next Steps

Over the next few months, we will be back for appointments at Mayo almost weekly with his different specialists (endocrinology, GI, nutrition, cardiology, pulmonology, ENT, infectious disease) and we will also start his feeding and speech therapies again this month. We do not know how long he will have his trach, but it will likely be a couple more months at least. He has another airway check on January 16th and we will see how he continues to improve. Before going home, he was sized and tested for a PMV (passy muir valve) which is also known as a speaking valve. This is a form of beginning to cap his trach where Luca can breathe over his trach (which will work on breathing on his own) as well as eventually make noise as the swelling decreases in his vocal cords. We anxiously wait for the day we start hearing noises with this valve on 😊 Before getting his trach out, he will be tested in ways that proves he can independently breathe on his own by capping him when he is ready for that. We all want to be very confident that he will be successful before taking out the trach, so we are going to continue to listen to Luca as he shows this to us.

Although the Holidays were not as we expected with Luca in a totally different condition than we prepared for, unable to be surrounded by family and celebrations, we are happy with the progress he has made and that he has been able to recover to where he is at today. We are so incredibly thankful and happy to be home, words cannot describe. Luca has thrived at home over the past couple of days, I think even happier than he was prior to his hospital stay. He cannot stop smiling, giving us snuggles, playing with all of his toys and he got to see his nurses Alyssa and Isabelle again whom we all dearly appreciate. We are also excitedly preparing at home for the arrival of baby #2 as I am 33 weeks pregnant. Luca doesn’t know it yet, but he can’t wait to be a big brother and we have no doubt he will be the BEST brother!

Thanks for your continued prayers, support, love and following along on Luca’s journey.

Love,

The Raehsler Crew

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