So tomorrow is the big day. Josiah will be having his trach put in and a G-tube placed. On top of those two things Josiah is going to have a couple other things as well. We are sending him in for a complete tune-up. He is going to have a stomach surgery called a Nissen as well. This is where they wrap part of the top of his stomach around itself (I think) and tighten up the area where the esophagus meets the stomach. This will help Josiah not to have as bad of reflux as he has. The hope is he will be able to keep his feeds down better and continue to grow. A good majority of heart babies have major reflux issues for some reason. We are being a little bit proactive with this one. There is the possibility that he may not need it but it is more likely that he will and we would have to bring him back later to have it done. So we are opting to do it now and prevent a future trip to the OR. This surgery can be done laproscopically so it wont be as invasive. They have to fill his abdomen with air to do this so the the surgeon can see what he is working on. Sometimes this air can cause pressure on the heart and so there is an increased risk with Josiah. If Josiah's heart shows sign of distress then they will pull the air out and do the surgery the old-fashioned way by cutting into his belly. We are obviously praying that there are no complications like this.