With all of the extra fussiness and changes in Ashley's breathing and changes in eating habits, we decided a second opinion was needed. Really this is a third opinion. We felt like a pediatrician would serve us better since their specialties are children and that's who they see all day. So, we made an appointment with Dr. Newlin at the Wichita Clinic. I've heard good things about him and was encouraged that he would be a good fit. And I would say he is a good fit! We liked him a lot. He spent a lot of time with us and listened to our concerns and answered our many questions. He thought that it did sound like Tracheomalacia. He did want us to go ahead and get another opinion and make sure that someone else didn't think that something should or should not be done to improve her symptoms. He also wants to do an upper G.I. (where she will drink barium and then we will see how it flows through her body).He scheduled us to see Dr. Regehr at the Wichita clinic. We went in to see him today. We also like him, he spent a good amount of time with us and spent some time looking at Ashley as well. He put a lighted tube in her nose with a camera to get a good look at what is going on and he has determined it is laryngomalacia. This is when the supraglottic larynx (the part above the vocal cords) is tightly curled, with a short band holding the cartilage shield in the front (the epiglottis) tightly to the mobile cartilage in the back of the larynx (the arytenoids). These bands are known as the aryepiglottic folds; they create the movements that opens and closes the vocal cords for phonation. The shortened aryepiglottic folds cause the epiglottis to be furled on itself. This is the well known "omega shaped" epiglottis in laryngomalacia. (or in words I understood...her voice box (which is immature for her age) is collapsing as she is breathing and this obstructs the airway).
Laryngomalacia results in partial airway obstruction, most commonly causing a characteristic high-pitched squeaking noise on inhalation He has not totally ruled out tracheomalacia, but he believes the problem is with her larynx and he also feels it is severe case.
Opinion #1- congestion.
Opinion #2- tracheomalacia
Opinion #3- tracheomalacia
Opinion #4- laryngomalacia...confusing, I know!
We discussed some of her eating problems and so he prescribed some acid reflux medicine to hopefully help her out. It is common to have the reflux issues with laryngolamacia. I also mentioned the wheezing, and then gasping for air that she does while sleeping..it really scares me when she does it because it appears that she is not breathing/getting air. So, we are now set up with an apnea monitor to put on her at night to see how she is breathing during sleep. we are encouraged by these doctors and their knowledge and their interest in getting the right answers and treatment plan. Dr. Regehr says that majority of patients outgrow the condition by age 2, but he also said that if surgery was needed, it would be specialized and would be at Children's Mercy in Kansas City. We are scheduled for the upper G.I. test next Wednesday and will go back to see Dr. Regehr at the end of next week to discuss the results and our plan of action.
On a lighter note...
Ashley is 6 weeks old and yesterday at Dr. Newlin's office she measured 20.5 inches long and 10lbs 1oz. She is growing and getting bigger, even some of her newborn outfits are too small now! I captured this cute picture the other day when she was smiling...at daddy of course.
Cute picture!!
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