Big Gulps

Today Charlotte Amalie is supposed to have a quick look down her throat. (I say "supposed to" because we all know how the medical system works-- oh, you don't? Lucky you.) So yeah, it should be today, but might be later this week.

What are they looking for?

The ENT doctor will take a peek and see if he can visualize some movement on the part of her vocal chords.

Why does that matter?

The vocal chords play a role in swallowing. Basically, they cover the respiratory track while swallowing, preventing aspiration.

Why are they looking at Charlotte Amalie?

They are looking at CA for a number of reasons.

First, and of course, LEAST likely has to do with the nerve that innervates the vocal chords. It is pleasantly placed right around the duct that had to be surgically closed way back when. One of the possible side effects of that surgery (the PDA Ligation) is vocal chord paralysis. Of course, since they know that is a side effect, the surgeon goes to extensive means to prevent that from happening, so it's doubtful that her vocal chords are severely damaged.

Second, CA just doesn't make noise. Every now and then, I hear a "ahhh" outta her, but in her four months of life, between me, the doctors and the nurses, we believe we've heard her make a noise approximately 10 times. Now, at 3 am when a new born is wailing their head off, not being able to make noise sounds great. However, we'd kinda like to go to her third grade Winter Holiday Concert and hear her sing in it.

Third, CA has a tendency to aspirate. They're trying to figure out why. Possibilities include a problem with her vocal chords, but it could also be something as simple as, oh yeah, she was born at 24 weeks. Severe prematurity can do a lot of things to you.

Fourth, CA has some nice, friendly acid reflux. Stomach acid can burn and damage the vocal chords.

So... What?

So IF they can visualize a problem, little miss CA will win herself a trip via ambulance down to CHOP for a swallow study. No worries. It won't actually be an emergency (that would be a trip via helicopter) but since she's so needy and all, an ambulance is required. A swallow study entails giving your child something semi radioactive and then taking pictures of where that stuff ends up. If it ends up in her lungs (called aspiration, or micro aspiration) we'll probably be staying at CHOP for a bit. woo. hoo. (note lack of excitement).

So... What?

If you get a chance to say a prayer, or think a positive thought, or light a candle, or help a stranger on the street, or WHATEVER it is you do to help good things happen, we sure could use a win on this one. Peter is gone for the next few months (we'll see him on a few weekends, and he comes home the beginning of November) on away rotations for medical school. Having CA transferred to CHOP, which is the finest of fine institutions, would be super, well, HARD.

Plus, like I said, those elementary school concerts pretty much rock. We'd love for her to be able to sing her little heart out one day.

Good thoughts are needed. Thanks.