Tuesday, August 11, 2009

Vocal Cords

Today Ellie and I ventured to the pediatric ENT (ear, nose and throat) doctor's office. Here's how it went...

The Process

When the ENT came in, he was very personable, which I appreciate since it's never enjoyable to have to take your baby to see a specialist. He talked with us a bit about why we were there, looked in Ellie ears and nose with that magnifying tool that has the cone tip. Then he took two of the big popsicle sticks and looked in her mouth. Then he explained that, unless we wanted Ellie to be re-hospitalized and put under anesthetic again, the way to look at her throat was to put a little liquid anesthetic in her left nostril and then put a scope in through her nostril and down her throat.

As much as we enjoy having Ellie hospitalized (sarcastic comment), I quickly agreed that this seemed like the best way to check her out. So out he went to get his scope. Meanwhile, Ellie and I were sitting semi-reclined on a child-sized chair similar to a dentist chair. And we were a few feet off the ground (enough for Ellie to be the same height as the doctor when he was sitting on his rolling chair).

While he was gone, Ellie started making her signature noises and heaving body movements. I knew what was coming next and began wishing I had grabbed a burp cloth before we sat down. I looked around the room to see if there were maybe paper towels close enough to me to reach . Nothing was close. We were high enough off the ground that I couldn't get down without initiating the throw up. And the last thing I wanted was her bodily fluids all over their carpet. So I put an arm on either side of Ellie and both hands beneath her chin to catch what was about to come up.

Sure enough, she filled my cupped hands. Luckily (though it didn't seem like it at the time), she had spit up halfway through her bottle right before the appointment, so she only had about half of a bottle (two ounces) in her stomach. At this point, Ellie was crying as I tried to keep the liquid from going everywhere while not inadvertantly pouring it back into her opened mouth. Although the door to the room was open, no one was near enough to come without me having to sort of yell. And it didn't seem like a big enough deal to yell.

So I carefully poured the liquid onto Ellie's clothes, trying not to get it on myself since I only had a change of clothes for her and not for myself. I'm proud to say that I was fairly successful. I only got a little bit on my shirt and jeans. At that point, she was done throwing up so I slid off the chair just as the doctor came in.

I was then even more glad that the doctor was so nice because he was completely understanding and watched Ellie (she was lying on the chair at that point) while I grabbed a burp cloth and wipes from her diaper bag. I'm guessing he might have this effect on babies and small children since no one likes having anything shoved in their mouth. He finished getting his scope ready while I cleaned her up. I left her undressed since I only had one extra outfit and figured the scoping might cause more of a mess.

The doctor used a small syringe to drop the liquid anesthetic in her nostril. Then I got back up on the chair and held her in my lap while he put in the scope. I held her still, held down her arms and held her head in place while he put the scope tube (which was as big as her nostril) in and down her throat.

For the next two or more minutes, he looked around through the scope while Ellie turned bright red all over, sobbed, gurgled, spit up little bits and broke out in a full body sweat. After he finished, she was fairly soaked in sweat and had a large indentation in her cheek from where his finger nail had pushed into her face to keep the scope from going down to far. And her cheeks were extremely flushed. As he explained the prognosis, she smiled at him. To which he responded something to the effect of, "Oh no, don't smile at me. You're just going to make me feel even worse for what I had to do." She obliged and went straight into a huge pouty, quivering lip.

She seems to have popped blood vessels in her face and neck as she has small red spots on the lower half of her face and all over her neck. I left the medical assistant at their office a message to make sure that's what it is, but that's what it looks like. Poor thing. I've never cried hard enough to pop blood vessels in my face and neck.

The Prognosis

He explained that, although vocal cord damage can occur from being intubated, it's rare. He said that it looked as though the placement of the coil actually caused the problem. The ductus (the part of her heart that the coil closed) is very close to the left vocal cord. And when they place the coil, it often causes some inflamation, which then makes it so that the left vocal cord cannot open and close properly. He said that even if they left vocal cord doesn't heal entirely, her right vocal cord will compensate so she won't have problems with her voice when she gets older. He's going to see her back in six months to check on how the vocal cords are doing.

So that's that. Not a pleasant experience or prognosis, but now we know what's going on and that it's not anything to be overly concerned about. Although this may sound strange, I was glad that he was able to clearly see that a problem exists. I never like it when doctors say, "Everything looks fine. I'm not sure what the problem is." It's much more reassuring to know what's going on.

The ENT also commented that the Prevacid must be working at least partially because he didn't see any irritation in her throat that is commonly associated with uncontrolled reflux. I'm glad he mentioned it because it's reassuring to know she's not doing damage to her throat even if she's still having some pain with her reflux.

And now all my fellow new mommies can commence being jealous that I get to enjoy some time of having a baby who can't fully cry but doesn't having an overly concerning problem. It's hearbreaking to see her crying hard but quietly or silently. But I realize when I'm around friends' babies who are crying full boar that it's a little bit of a blessing in disguise because she doesn't do the piercing screaming other babies do.

When we got home from the ENT, Ellie wasn't feeling all that great.


Daddy, Ellie and Coco snoozing while mommy did stuff around the house on Saturday.

Ellie loves cuddling with her daddy.

Coco enjoying his $1 dried turkey patty from the pet food store.

On Saturday night, we managed to sneak in an hour and a half or so where Ellie was sleeping while we cooked dinner/did dishes and then watch an episode of a television show on DVD. We took a few pictures to commemorate our first "date night" since she came home. This is the least goofy one as I ended up crying because I was laughing so hard when we tried to do serious poses.

Napping on the couch while dad watched golf this past Sunday.

Showing off her cute sundress she wore to church on Sunday (and adorable little roll on her thigh).

Trying on a sun hat.


KK said...

Love the pic of the 3 of them relaxing :)

melissa said...

You are amazing to be able to have held her while the ENT was doing that! I am impressed. I make David do the holding while I cower in the corner. You're a good mommy. =)

Anonymous said...

She is SO adorable! I love her facial expressions.

Susan Carson said...

I love the new pictures! Sorry about the experience at the ENT. Can't our little gal just catch a break?! But glad to hear the prognosis is good and that they know what's going on.

Once again, I am convinced our kids are psychically connected. This morning as I had Anthony strapped in the carseat ready to head out for daycare, I saw he was about to spit up his morning bottle (this was for the second morning in a row on the way out the door!). My first thought was to cup my hands under his chin to catch it! I had never done that before. I think Ellie and Anthony had a discussion last night. This is how it went:
Ellie: "Tomorrow let's make our Mommies catch our spit up in their hands. That will be so funny!"
Anthony: "I don't know, Ellie. I'm not sure Mommy will like that."
Ellie: "Trust me, Anthony. Didn't I get us out of the NICU like I said I would?"
Anthony: "Well, okay..."

Sara said...

Ok, the dr appt sounds absolutely traumatic. I am glad for you both that it is over!

Great pics - she is such a cutie. I love the ones of her on her belly!

Becca Sue Congdon said...

What an adorable hat! I'm glad you were able to find some information from the appointment. And... YAY for thigh rolls! YAY!