Hi everyone, just wanted to give a quick update. We have been extremely busy with doctors appointments this week. Monday, Liam and I reported to the Lehigh Valley Hospital for a test that would check Liam's swallow function. Our little man was strapped into a booster seat with large Velcro straps, and was a complete angel through the entire test. The test was very interesting, Liam had to swallow foods and fluids with barium and on xray the doctor and speech therapist were watching to see if the food went down the correct tube. Unfortunately, the test showed that Liam is silently aspirating fluids. What this means is that when Liam is drinking, some of the fluid is entering his trachea and going into his lungs. When this happens, Liam looks completely comfortable.... there is no gagging, coughing, or choking - so one would never have any idea this was happening. The good news is that the solid foods that Liam was ingesting went down the correct tube into the stomach. When it was discovered that Liam was aspirating, the speech therapist added a thickening agent to Liam's drink so it would be easier to swallow. Once this was done it seemed that Liam had an easier time getting the fluids down the right way.
So what does all this mean?
Basically, all of us aspirate some of the time and it will not affect us... the severity of the issue depends on how much and what it is we are aspirating.... and if we are able to work it out, or cough it up. However, for Liam these results are "abnormal." There could be several different reasons for this problem. Of course, swallow function can always be related back to neurological function. Since Liam did have a brain injury at birth a neurological deficit cannot be ruled out at this time. We have spoken to our neurologist, and she has told both mommy and daddy (more than once) that we should not be too concerned at this time because there could be many other reasons for this issue. Some of the other reasons could be immature GI tract, as well as reflux issues, and even possible unknown allergies.
What is the big concern?
We all know Liam has been getting sick frequently throughout his first year of life, and we have been told that this could possibly be the culprit. After speaking with our asthma/allergy doctor, pneumonia is a huge risk factor, as well as damage to the lungs. We are hopeful that will be able to continue to prevent aspiration until Liam is older and has better coordination, or he learns new behaviors of eating, which I will explain more about later. In addition, we have been told that Liam's wheezing and asthma may have been largely due to this aspiration.
What happens next?
Today, we met with Dr. Paul, the pediatric GI doctor at Lehigh Valley Hospital. Dr. Paul feels confident that with feeding therapy as well as speech therapy Liam will completely overcome this hurdle. Some of the things we learned were that Liam should avoid drinking out of a straw, since this makes him work harder and may be too much for him to concentrate on while breathing, chewing, drinking, etc. Liam also often fills his mouth with food to the point that he looks like a chipmunk (it is somewhat funny but at times concerning) and our doctor is assuming that Liam may have some sort of discomfort with swallowing which could be why there is a delay. Liam will be put on a trial of reflux medication to see if this will deter this eating behavior. Liam also chugs mostly every drink you put in front of him. We have been trying to break him of this habit, but it has been a challenge for us. We are hoping that feeding therapy will assist in this process.
Coming up....
In about a month we will be having what is known as a milk scan completed, in which we will for sure confirm that the thickened fluids are effective for Liam, and also this will look at some of the anatomy of his esophagus and be able to look for any reflux that might be occurring.
In the meantime we will continue with thickening Liam's fluids, and work with feeding therapy for a few months. Hopefully once Liam is a bit older the next swallow test will show that he has fought his way through yet another obstacle in his short life. Our little fighter is such a happy, healthy boy and this continues to remain our biggest focus! We are going to continue to incorporate these tests, therapies, and changes as naturally as possible, as to not interfere with the amazing, chaotic, adventures of toddlerhood : )
As for us, this was all a ton of information. I hope I summed it all up pretty well! We will keep you posted! Love to all and Happy Easter!
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