We had another discussion with the MD's yesterday which included a real conversation about the potential of Josiah needing a tracheostomy. That thought has been looming in the backs of our minds for a while now but yesterday was the first we've actually discussed it with the doctors. It appears that is the direction we are heading with this latest failed attempt at extubation. A tracheostomy is where they surgical insert a tube through Josiah's neck and into his trachea (wind pipe). This would remove the need for the tube in his mouth and throat. Basically it is a way for us to be able to bring Josiah home on the ventilator. There is a ton that goes into all this and at this point I don't have all my questions answered. There is good and bad that go with a tracheostomy. So we are in the process of finding out information and discerning our feelings through all this. I can't at this point even figure out my feelings for myself. At one point I am hopeful at the possibility of bringing Josiah home and then a moment later I am overwhelmed by the possibility of never hearing my sweet baby cry.