A Brighter Future for Lincoln

February 2, 2018

Like many twins, Lincoln Dunning and his twin sister were born prematurely. They were in the Neonatal Intensive Care Unit for two months, needing time to develop and grow. Lincoln came home on Christmas Eve 2014, a few weeks after his twin, but with no major health issues and no restrictions.

Escalating Health Challenges

Four months later, all of that changed. Lincoln started getting sick. His first hospital admission was fairly routine – he was hospitalized with bronchitis, but only required oxygen and was discharged quickly.  The next time was more severe. He was admitted with pneumonia and had to be flown to a children’s hospital in St. Louis where he was in the intensive care unit (ICU) for a week. At this point, he was referred to a local Otolaryngologist to check into why he was getting sick so often. The specialists recommended a bronchoscopy (where a camera is inserted in the throat to view and monitor the airway) if and when he became seriously sick again. After his next illness, when he was well enough, he went through with the bronchoscopy. During the bronchoscopy, they intentionally ruptured subglottic cysts in Lincoln's throat. But, after the procedure, his condition worsened and he struggled to breathe. He ended up back in the local emergency room and was eventually transported back to St. Louis, where he was intubated.  Lincoln’s doctors discovered that he was fighting an adenovirus, in addition to the severe swelling from the rupturing of his cysts, and these problems were causing an airway issue. After six days of intubation, Lincoln had a full cardiac arrest. His otolaryngologist said he would continue to have issues, and recommended a tracheostomy (trach) to help Lincoln breathe. While recovering in the ICU, his doctors identified a third-degree heart block meaning Lincoln would also have to receive a pacemaker.

Life with a trach quickly presented its own unique set of challenges. Lincoln could no longer experience the joys of his family’s backyard pool since his trach couldn’t get wet. Once joined at the hip, he was no longer able to partake in the same things as his twin due to his new limitations. Even routine outings like trips to the grocery store or a walk around the neighborhood weren’t options anymore since his trach could need suctioning at any time. Since he was now more susceptible to illness, his exposure to people had to be as limited as possible, so even a church gathering could be risky.

A Second Opinion

When Lincoln was finally discharged, his medical team recommended close monitoring but no further action. In a few months, they would try another bronchoscopy and go from there. Lincoln’s family had a lot of questions about his escalating health issues and they were ready for a second opinion. They researched multiple institutions and scheduled a consultation with Jonathan Ida, MD, and the Lurie Children’s Aerodigestive Program. The team set up several appointments and studies to be done during the week of their visit to Lurie Children’s, in order to get as much information as needed to make a plan. The team’s recommendation was another bronchoscopy to further investigate Lincoln’s airway.  The family traveled six hours to Chicago for the procedure and not long after, got the call that Lincoln had grade three narrowing of his airway (a condition called subglottic stenosis). The team did not think that his condition would improve with time and recommended a single staged laryngotracheal reconstruction. While nervous about moving forward with a surgery, Lincoln’s family was even more concerned that every time he got sick, his condition was gradually worse and worse. They wanted to take action.

A Life-Changing Result

Exactly one year from the date that Lincoln received his trach, he underwent airway reconstruction. The procedure widened his airway and allowed for the removal of his trach. Everything went as planned during the nine-hour surgery and Lincoln began his recovery. He was discharged from the hospital after the typical three-week recovery period. One of his first adjustments was learning how to eat again with a bigger airway. But he adjusted quickly and has never looked back.

Lincoln has been loving life since his surgery. Now an active three-year-old, he spent the summer swimming, going for walks, playing outside, and keeping up with his twin. The entire family could go on outings that weren’t possible before – like eating dinner at a restaurant and going to the park together. Now that he has recovered, his mother has noticed dramatic changes in her son. She said, “Lincoln was always so happy before, but since his procedure, he seems so much happier! He has been talking like crazy and his speech therapist is amazed.” The future looks bright for Lincoln, and he is thriving and living life to the fullest, as he should.