Update
Remy saw the internal medicine team at Davis on Jan 24th.
Their assessment - airway disease, specifically airwave collapse and bronchitis. Esophagus is fine. Heart stable. Multiple xrays demonstrate the trachea is narrowed. There is a crackling sound detected in his lungs. Two new meds prescribed: Flovent inhaler and Theophylline (bronchodilator).
The Theophylline seems to be making a difference. It is a pill given twice daily. The Inhaler is another story. It is a human inhaler and I have to give him the propellant with a mask on - that has to stay over his nose and mouth for 30 seconds / 8 complete breaths. Let's just say this is going to require some adaptation.
As far as diagnostics... they did not do a fluoroscopy. We did discuss it. The docter said the number of xrays clearly showed her what was going on with the trachea so she did not need additional assessment of that and the fluoroscopy would not help to further assess the lower lungs. As a result it was her opinion it would not offer any new info.
They could do a bronchoscopy - it would be to confirm the lung diagnosis and to determine if there is mucus. If this were to happen it would be at a future date - requires special scheduling. They did indicate it would be risky given his age, and it requires anesthesia for about 30 minutes.
We are going with meds in the near term to see if we can cut the coughing down about 50%
Bottomline, the unfortunate fact is that he is old. At 14 1/2 this is a disease for which their is no cure or silver bullet. We are at symptom management / mitigation. Hoping these two new meds have a demonstrable impact.
__________________ Susanne  and Remy 
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