Yesterday Massimo had another bronchoscopy, this time under sedation rather than under general anaesthetic because the doctors wanted to look at his lungs whilst he was breathing spontaneously (under general anaesthetic he would be on the ventilator). They did actually see something that explains all these blue episodes that he has been having. The lower part of his trachea, beyond his trachy tube, appears squashed. We are assuming that this is the tumour on the outside of his trachea which is putting pressure above and below the trachea. When Massimo cries really hard or panics for any reason, the trachea collapses totally closing off his lungs and therefore turning him quite blue. The long term solution is to get rid of the tumour, which the chemotherapy is doing, albeit slowly. The short term solution, to get us through the next few months whilst the chemo is doing its bit, is to insert a longer tracheostomy tube to hold the trachea open. The plan is to insert a variable length tracheostomy tube as soon as they can get hold of the right one and see how he copes with it and whether or not it is a viable solution. If all goes well, then they will have to order specially made ones that are the right length for him.
The bad news is that as long as he has the variable tracheostomy, he will not be allowed to come home. It is likely that Massimo will stay in hospital for the next month or so.