Spotlight on Respiratory Care: Nicolas Reny
In April 2013, Nicolas Reny—a young man with Duchenne muscular dystrophy—caught a simple cold that became worse. While a respirologist prescribed some medication for the cold, he also recommended Nicolas startlung volume recruitment exercises. A respiratory therapist came to Nicolas’ house to train him in these respiratory exercises and to conduct a few tests. The therapist noticed that Nicolas’ blood oxygen levels were very low,that he was coughing a lot and that the medication hadn’t decreased his lung secretions.
On April 12, Nicolas was admitted to Cité de la Santé in Laval. After attempts were made to reduce his cough and lung secretions with intravenous antibiotics and bronchoscopies, Nicolas was transferred to the intensive care unit (ICU). In the ICU, Nicolas was intubated—a flexible plastic tube was passed through his mouth into his trachea in order to maintain an open airway and facilitate ventilation of the lungs using mechanical ventilation. He remained intubated for 12 days. His lung secretions were so abundant that the staff recommended that he undergo a tracheotomy, a surgical procedure that creates an opening for an artificial airway. Nicolas and his whole family were surprised that the situation had become so serious so quickly.
The operation took place at the end of April. At the beginning of May, Nicolas was transferred to the Montreal Chest Institute and enrolled in their ventilator assistance program. The Institute’s staff monitored his recovery, prescribing both lung volume recruitment exercises four times a day and nightly use of a bi-level positive airway pressure ventilator. At the end of May, Nicolas’ tracheostomy tube was removed; he was back home by the beginning of June to the great delight of his entire family. The Institute has continued to support the family by providing them with equipment, training, at-home care from a respiratory therapist and a 24-hr helpline. Nicolas—who has continued his lung exercises and the use of his bi-level device at night—is enjoying life!!!
Read more in the Guide to Respiratory Care for Neuromuscular Disorders.