13 December 2009

Ear/Nose/Throat Answers

Congestion, congestion. That's what we've been dealing with since the start of the cold season. Vera's been having relatively clear breathing in the day and able to sleep through most nights - until December started.

Now, her breathing is noisy when awake, and she's breathing mostly through her mouth. Nights have been fitful for her, complete with more choking and stuffiness. She's not sick, so is it the air? An allergy? What?

After nights of carrying, putting down, rocking, putting down...we really needed some answers.

I brought her to a pediatrician in the neighbourhood, hoping for some topical meds to give her some relief. No luck. The pediatrician insisted the problem was her Obstructive Sleep Apnea, and the solution was CPAP.

We know she needs CPAP. We know she needs to be on the oxy prongs. We also know we're too soft-hearted and have not been able to force them on her.

But could there be any other explanation for the congestion?

We brought her to see an Otolaryngologist (ENT specialist), who performed a Laryngoscopy on her. The probe looked like Vera's nasal feeding tube, but thicker, and with a camera and light at the tip. The little girl didn't like it going down through her nose and in until her voice box. I could see into Vera's airway on the screen, constricting with her cries of discomfort.

The scope threw up some new findings: It's not an allergy. It's not sinusitis. The ENT doctor believes it's something called Laryngomalacia. Although she has had a fundoplication, which is supposed to control her reflux, some acid was still coming up into the voice box and causing the flaps to swell. This narrows the passage and mucus/phlegm becomes harder for her to clear.

We got some meds (finally! It just feels better to be able to do something about a problem): Omeprazole for the reflux, and Sinupret - to thin the mucus, so it can hopefully flow easier. My eyes popped at the cost: $200 for 1 month's supply. Vera, you sure are a high-maintenance girl!

Right or wrong, at least we're getting some answers at last.

Once this Nose/Throat issue is more or less resolved, then we'll follow up on her hearing with an Auditory Brain Stem Response. We know she can hear, but it would be good to know how well, or how much she hears. She will have to be sedated for this test, so we're in no hurry to get this done.