Poked, Prodded and Scoped

Seems our little pumpkin is struggling at night to breathe. I am taking him to the doctor almost weekly, and we are trying to figure out why he is so congested. He's happy as can be, but sounds like an old smoker, hacking up this big wet cough. So we try breathing treatments, and no improvement. We take him for an xray and set up an appointment with Pediatric Pulmonology at Vanderbilt for fluid on the lungs and wheezing. We increase the breathing treatments while waiting for our appointment and that leads to a horrible night where Tyler really struggled and had us worried at 1:00 a.m. So the next day, Saturday, we head to the ER. A quick visit yields no immediate concern from the physician, so we wait for our Pulmonology appt.

Pulmonology confirms what our pediatrician suspected: malacia and reflux. They schedule a bronchoscopy (looking at the throat/lungs via a fiber optic camera strategically placed in the nose) for the following Monday and prescribe zantac. We go home to wait for the procedure.

The day of the procedure has me, the Mommy, pretty uptight. I've been told that I must withhold food from my sweet little baby for 6 hours. Dear me! I anticipated crying towards the last 2 hours, but our angel baby boy fell asleep in my arms at the hospital, dressed in the cutest little hospital issued infant pajamas. He remained asleep until the anesthesiologist gently plucked him from my mommy-clutches. I was doing fine until he said, with that "look", "I'll take good care of your baby, Mom." Gulp (big lump in throat, followed by tears). Fortunately, the procedure lasted less than 15 minutes and we were soon called to the recovery room. As Scott and I walked in together, we saw a man and woman hovered over a crying baby. The man was sitting with the baby in his lap, who appeared to be close to Tyler's age. I thought, "aww, they have a baby like ours." We walk up and it IS our baby! The man was a nurse. Silly me! And boy was our baby wailing. Poor thing. He was upset. It took quitet some time to calm him down, and each time he stopped crying and sighed a big sigh, he'd look up at us, breathing deeply for a moment and then he'd start crying again. After 30 minutes or so, we gave him some Tylenol and he continued to have bursts of crying for another 15 minutes. And then....he looked up at me and smiled a great big smile. Our baby was going to be ok!

The diagnosis: nasalpharangealmalacia. For the common folk: soft cartilage in the throat that causes the airway to be floppy. Tyler's is effected below the nose and above the larynx. It causes the airway to collapse a little when lying down. No treatment; prognosis is great. He should grow out of it by age 2 or so. They also found evidence of reflux damage in the trachea. All in all, great news! To address the reflux, we now use zantac daily, are investigating further food sensitivities, elevate one end of his crib and try to sit him up for 20-30 minutes after each feed. There is nothing to do for the malacia, except to keep him healthy as best we can until he's at least 6 months old. At that point he should be able to breathe through his mouth...which will help in the event of a cold. Did you know that babies don't breathe out of their mouths before they are 6 months old? Neither did I! Overall, Tyler is doing great and doesn't seem to have any lasting issues from the bronchoscopy. We are so thrilled that he is doing better!