Nina Alvarez, then 17-years-old, and her mother made an all too familiar drive from their home in Winterset, Iowa, to the University of Iowa Stead Family Children’s Hospital on Nov. 4, 2019. Although the drive had become a tradition, Alvarez was on her way to an entirely new opportunity — one that could change her life forever.

Today, in an intermediate state of her recovery, she can essentially breathe on her own.

Since she was a baby, Alvarez hadn’t known how it felt to “breathe easy”— she was born three months early and required ventilator support and many surgeries that caused scarring in her throat. But Sohit Kanotra, a pediatric otolaryngologist and director of the pediatric airway program, offered her a chance to breathe again.

When Kanotra first met Alvarez and Laresa Carney, Alvarez’s mother, he felt inspired by their resilience.

“The biggest point for me the first time I met Nina was her resilience to undergo all these 100 airway procedures,” Kanotra said. “Her mom has been so supportive and Nina is such a beautiful human being … her whole character, her nature, her vibrancy — those were the things which were really motivating for me as a surgeon.”

Because of how much trauma Alvarez had in her airway, Carney said she began looking for long-term solutions.

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“The more she was having surgeries they would say that she can’t keep doing this,” Carney said. “Surgeries were becoming closer, and we had to decide because she couldn’t go on with that narrow of an airway.”

After looking at how much throat scarring Alvarez had developed from monthly esophageal dilation surgeries — a treatment to help stretch areas near the throat that experience abnormal narrowings — Kanotra recommended a cricotracheal resection.

“We elected to do a really complex and major airway reconstruction, in which we resected the part of the airway that was narrowed down and stitched the rest of the airway together,” Kanotra said. “It was a very difficult procedure — everything was scarred down because she had had so many airway procedures done.”

Alvarez had already had three major airway reconstruction surgeries, so their options were very limited, Kanotra said. With her fourth surgery, however, Kanotra was able to resect two centimeters of Alvarez’s trachea and stitch the rest together, he said.

Although the surgery lasted nearly 10 hours — about six hours longer than expected — Alvarez’s surgery was successful, Kanotra said.

“I got short of breath very easily, walking up the stairs and other normal daily activities were a struggle for me,” Alvarez said. “Now, I see an improvement in my breathing, I don’t get tired walking up the stairs or short distances. This feels quite normal … it’s as close to a normal life that I can have.”

Alvarez is currently in the intermediate stage where she is able to ‘cap’ her ‘trach’ during most of the day and at night, meaning she can essentially breathe on her own, Kanotra said.

The next step for Alvarez is a couple more surgeries before removing her ‘trach,’ Kanotra said.

Shortly after recovering, Alvarez turned 18 and graduated from high school. Alvarez now works at Fareway Grocery and is assessing her options for college, Carney said.

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Nina has big plans for her future—she wants to travel, loves art, and plans to open a coffee shop someday. Alvarez said she wants to use her experiences to create welcoming environments for people in the future.

“I want everyone to feel welcomed and have a safe place,” Alvarez said. “In this generation and the times we’re living in it’s hard to feel accepted and safe, but I want everyone to feel that way.”

Alvarez said she hopes she can share her story about having a ‘trach,’ to inspire others to never give up.

“I want to share to others that it’s a challenge, but I want to encourage people that you shouldn’t let that challenge stop you from achieving the things you want,” she said.