I got an email today from a blogger friend reminding me that I had not posted about how Caden’s appointments went last week. The short version of the story is that the MBS is still showing no signs of swallowing functionality. The feeding via g-tube is still in play for all of Caden’s nutrition and hydration needs at this point. We do have a plan of attack on what we will be doing next based on some conversation with the ENT.
Sometime in the near future (hopefully by the end of September) we plan to have Caden back in for outpatient botox injections into the UES (upper esophagus sphincter). During that procedure the ENT will dilate Caden’s UES with a balloon. Within the next 72 hours we will take Caden back in for a MBS (modified barium swallow). The thinking behind this comes from the fact that Caden almost always has a few really good days with clearing secretions without suctioning right after an ENT procedure. The ENT doc believes that this is due to the dilation caused by the EGD scope itself used during the procedure. The doctor thinks that Caden’s UES might have some sort of sclerosis that has the UES hardened and constricted all the time when not dilated. That might explain why the recent botox has had little noticeable affect.
The underlying reason for this dilation exercise is to see if the UES is truely the root problem affecting Caden’s ability to swallow. The next medical recommendation is to do a UES myotomy. that basically means they would cut the muscle of the UES. This procedure is not very well documented in children and has mixed results in adults. We and the ENT doc are very cautious about this surgical approach for Caden.
The ENT is on board with us trying to make trip to St. Joseph’s Pediatric Feeding and Swallowing Center in NJ if they will accept Caden’s case. The ENT doc here thinks that the center might reject Caden’s case because he believes Caden’s case is a medical and physiological problem more than a behavioral one.
Caden’s Current Health: Caden will have a sick visit to the pediatrician tomorrow morning due to massive amounts of green goop. That will take us to more than 12 rounds of antibiotics in as many months.
Mommy Update (Praise Report)
As for Sherry…she is doing great! I have an AWESOME wife. The spinal headaches and nausea are gone and she is adapting well after day three of being solo with all the boys without a visiting friend or family member. I reminded her Sunday night that if she faced a problem or question this week that was related to anything other than the health and safety of her and the boys, then it was not a priority and it could wait. As hard as it is for her to say no and let things slide when necessary, she really is doing a great job.
Fun Stuff
Check out the 4 year old biscuits on my Grill’n Time blog.