Wednesday, April 18, 2012

ENT visit 1:11pm April 18th

They are bringing the scope in right now to look in Owen's throat.  The Doctor will be over shortly.

The Doctor got here and he scoped out Owen's vocal cords.  He does have paralysis on his left side and he doesn't quite get full closure.  This means that when we are feeding him we should put him on his right side so that gravity can pull his paralyzed cord down to get better closure.  Speech had already suggested that we feed him on his right because he did start to cough when he was on his back.  The doctor also looked at Owen's tongue and he is slightly tongue tied, but it isn't significant so he won't do anything to it right now.  That is something that can be snipped at any time and if it isn't giving him issues now it might only give him problems making some speech sounds later on.  As far as his vocal paralysis, there is about a 20% recovery rate in kids.  There are a couple of reasons as to why it would be paralyzed, they might have stretched the nerve, irritated it, or possibly even severed it because the nerve for his vocal chord is right by the aortic arch.  If Owen's voice gets any stronger, they will reassess him, but there is a really good chance that Owen will be able to compensate for the paralysis if it doesn't get any better.

OT/PT stopped by again.  His preference for his right side might actually be related to his vocal cord paralysis.  Owen really wasn't willing to turn to his left yesterday while she was working with him.  She tried to loosen up his muscles, but she ended up starting at his pelvis and slowly working her way up his back.  She eventually got him to turn his head to the left.  She wants us to put him in his crib with his head to the left so that he it loosens up his muscles and eventually he might be willing to go to the left all by himself.  Because he has been in a bed for so long, they are also slightly worried that his abdominal muscles might be weaker that they should be so we are supposed to try to pull and tip his pelvis when we are changing his diapers, not pick him up by his legs.  She also asked one of the surgeons if we could experiment with tummy time, but they want to hold off on that for a while yet.

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