Thursday, July 24, 2008 at about 2:00 p.m.

Hello all. The Zman is not having a good day. Chrisite and I received a call from Dr. Kelley about 12:30 p.m. Dr. Kelley said that the current breathing configuration (C-PAP) is making the little guy work way to hard. He had 2 or 3 episodes throughout the night. Dr. Kelley said that Zander's trachea now has some malasia (sp?) (softness/floppiness) in it. It should be more rigid. Dr. Kelley said that due to the softness in the trachea Zander is basically breathing through a straw (his trachea) that is flexible on the end. Each breath he takes, is like trying to breath through a straw that had flaps on the end of it. This causes build up of mucous and other secretions down around the trachea and into the lungs. He is not aspirating on the mucous, but it does cause him to work much harder to breath. As a result, Zander is now back on the ventilator for the next few hours. Around 4:00 p.m. he will be taken to surgery and a tracheotomy will be performed. By doing so, Zander's trachea, his throat and the accompanying membranes will be allowed to rest and grow stronger. Dr. Kelley said it would be a temporary thing until the cartilage in the trachea becomes stronger along with the supporting membranes. Dr. Kelley will also inject contrast into his stomach to see how it is growing. We should know more later tonight. Sorry there are no pictures, but I will post some later. Zander is resting much better at present. As parents we are worried about his little body being able to handle the surgery, but we understand why this has to take place. The care he is getting is wonderful and we thank God for all the nurses, practitioners, therapists and doctors everyday. If you get a chance on your drive home today....ask God to look over Zander during surgery. I will write later this evening. God bless each of you. We love you son!