Thursday, May 20, 2010

doctor's day...

Well, today was chock full of tons of excitement for all of us. I say that somewhat sarcastically... we started off the morning with an early appointment with the pediatrician- Emma weighed in at 18lbs 4oz, which, although it seems like a tiny gain to us, the doctor was satisfied with. We reviewed diet stuff and he thoroughly listened to her lungs and throat, still trying to determine the cause of her sometimes raspy breathing. We got a vaccine booster (sigh) and headed out the door.

Soon after was our appointment with Dr. Prussin, the ear/nose/throat specialist. We had specifically scheduled the appointment time with Emma's schedule in mind, and unfortunately when we got there, we were informed that the doctor was running 45 minutes late. We tried to pick up a quick lunch, but were constantly interrupted thinking that we would be called soon, then not. We finally got in to an exam room and Dr. Prussin got a brief history of the problem and we showed him the two videos we had taken at times when Emma was at her maximum raspiness. He decided to scope her nose and pharynx, a non-painful but also non-pleasant procedure. Luckily it was over pretty quickly, and he determined that she was a possible case of subglottic stenosis. Because of the crying she did during the procedure, he couldn't see as thoroughly as he wanted, so he followed up with a set of X-rays of her throat to be able to actually measure the area. We had to go to the hospital for that, and although it was not at all painful or unpleasant, I think Emma had come to the end of her rope, and it was very stressful for us all. She recovered quickly from it, and we were soon back on the road to drop off the x-rays and do a quick grocery stop before finally heading home.

It was a very long, emotional, and stressful day for us all, and we were so glad to get home and unwind a bit with a nice walk just before dinner. Emma has been in great spirits and as full of energy as ever since we got back home. She went to bed great and is sleeping quietly now, thank goodness!!

We're expecting to hear the results of the xrays tomorrow at some point, and that will help determine the next course of action for us. We have options of doing a more thorough internal exam under anesthesia either here or at Wake Forrest, and depending on all the diagnostic results, specialized corrective surgery.

Greg and I feel at this point that we're probably getting into the overkill area, that this is probably all a bit unnecessary for something that isn't getting worse, hasn't ever caused problems, and only in certain circumstances makes her breathe noisy. She makes no noise when she sleeps or is at rest breathing easily, and it surely doesn't make her winded or slow her down! She has never coughed from it or had any respiratory distress.

We also have discussed with the pediatrician the possibility of gastric reflux disease in Emma, since she seems to fill up so fast at meals, and we have now learned that GERD is actually somewhat of a predisposing factor for this stenosis. Dr. Prussin did tell us that Emma did have some possible evidence of GERD in her pharynx as well. Before we do anything drastic, we are putting Emma on a trial of Prevacid to see if it not only helps with her eating and weight gain, but also if it has any effect on her breathing.

Anyway, we'll be hearing tomorrow about the xrays, and that will either tell us that there is no functional stenosis and we'll search elsewhere, or that there is a mild stenosis and we can either investigate it further or we will decide to try the Prevacid for a few weeks.

It was a ton to take in today, and I'm glad we all survived it. I never knew how hard it would be to deal with any health issues in our baby- it is incredibly stressful and emotional!! We'll post again when we have more information!

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