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My 10 month old has aspiration....diagnosed with a swallow study. He was aspirating to the vocal cords on all thicknesses, all temperatures. He did the best with thickened warm. They did not see any aspiration into the lungs during the study, but said he probably does at times....hard to tell since he is always wheezy.
3 times now he has (for lack of better description) choked. The first time he turned purple and limp and I had to stimulate him by rubbing his chest to get him to breath. Tonight was the latest...not as bad though, thank goodness. The dr. called it ALTE (acute life-threatening event). Each time it has been when he threw up his formula. FREAKS ME OUT. So my question is, has anyone else had experience with this? What did they do? What can be done? I'm a pediatric nurse, but I swear everything I have ever known is gone when it's my kid.
The other thing I wanted to ask is, does anyone else feel like the dr. is going to start thinking you have Munchausen?! I feel like I am either in the office or on the phone with them every other day. He always does have something going on, like ear infection, flu, wheeze. I know alot of you have medical kiddos, and it must be worse for you. I'm not sure why I would worry about it, other than the fact that I worked with a family that had a mom with Munchausen and she was a nurse (typical) and the baby kept turning blue. Oh well, now I'm rambling....thanks for listening, and if you have any advice on either topic I'd appreciate it!
Hi Dana,
I just had Charlie to the ER for aspirating his food. All they did was take an X-ray and give him a breathing treatment. They did prescribe an antibiotic because they said that there are so many germs in the mouth and if he aspirated them he'd get a raging infection.
They then said to follow up with his ped. in a couple of weeks.
Charlie doesn't have a history of aspirations and this is the first one for us so I really have no advice. I just wanted to let you know what they did for him.
Good luck.
Michelle
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My little guy (12 mo old) is going in for a swallow study due to choking episodes he has. He has never gone limp and turned blue, he just starts choking, either when he's eating or even when he's sound asleep. The doctor thinks it's relux. She said if the swallow study shows nothing she'll just start him on reflux medication. It's scary when he does it. He can be sound asleep and, all of a sudden, he sucks breath in with a real high pitched stuttered sound and then starts coughing and gagging really bad. It sounds just terrible! He sleeps in our room and I hear him every time he does it through the night.
I don't know about the Munchausen question. I have several kids with special needs and I'm at the doctor a LOT with all of them. I've never been suspected I don't think. I think people with that usually have some specific traits a doctor looks for and I doubt you have them. Just document ~everything~ and it's always nice to have some witnesses to back you up.
Just wanted to let you know I have a special child with a history of aspiration. A couple of things I do is don't lie him down for at least 20 minutes after eating or drinking. If aspiration is life threatning, the doctors might suggest a mic-key button where you feed him directly into his stomach and a nissen-fundoplication which means the stomach is wrapped around the esphagus to lessen chances of refluxinto the lungs. Prevacid prevents acid damage to his esphagus if he has reflux. My little guy had a swallow study which he failed because the baby food didn't enter the stomach once it was swallowed because it takes a few months for the nissen-fundo to loosen up after surgery. He is due for another swallow study next month. He has his nutrician thru a mic-key button.
Re. Much. syndrome--I thot abt that,too, but if your child has a history of medical problems,his doctors are familiar with, the chances of them not believing you are slim.
Thanks for the help....I think I just needed some reassurance after another choking episode last night. He has vomited several times today (has a virus) and done fine. I am going to press the issue with the ped a bit though. I don't really believe they would think I have Munchausen....I mean there is ALWAYS something going on that is completely out of my control, like a ruptured eardrum or fever, etc. I just feel like I am at the dr. ALL THE TIME. He is my 4th kid (plus several fosters), but the first I have had this many appointments with.
Goodness knows, that would be a sick way to get attention.....and I have plenty of things to keep me busy between the 4 of them ;) . I do worry that there might be something else going on though....the OT mentioned that his tone is a little low which goes along with the feeding problems. His sister had high tone, and still does a bit, but she's fine after wearing braces for a few months to stretch the leg muscles and getting PT/OT....she's beyond age level in some developmental areas, and now only gets speech therapy. She has been pretty healthy otherwise...not picking up many viruses.
Anyway, thanks for the ideas and support. He is such a sweetheart and a real trooper....hope that is an indication of his personality in the future!
I'm a speech-pathologist with quite a bit of experience with dysphagia or swallowing disorders. Most of the time, the biggest danger with aspiration is build of fluid (or food) aspirated into the lungs causing pneumonia. If it is determined that your child is aspirating all consistencies and that positioning and temperature adjustments aren't helping, they may suggest he not eat anything by mouth and an alternative method for feeding be established. Know that this may only be temporary as there are several habilitation techniques available to help a child swallow safely. Your child may require treatment from a speech pathologist or occupational therapist (depending on who is trained at the medical facility you utilize).
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jandn....thanks for the input. We are going for an upper GI and repeating the swalllow study. The Dr. suspects he is refluxing and may be aspirating more than we originally thought. One of the options we talked about was an NG for a few weeks to see if the lungs clear. I hate to think about it, but it will be good to get some answers. Thanks again!!