Scope is telling~

Well, the scope is telling.  By the way, I liked the doctor.  I was a bit apprehensive, but when he came in he was great with developing repoire with Reagan and so I was at ease.  She acted shy, and sadly had no way of knowing what we were going to do.  We went over history and thankfully I brought in a copy of the latest swallow study, considering they didn't receive the fax.  Well, I am over it.  Anyway, I had to hold R securely in my lap as we did a scope to look at her vocal cords which revealed that the left side had no movement at all.  The doctor said it was paresis, but if you held a gun to his head, (his words) that he would say that it was paralyzed completely.  He said that by her age (in development) weakened cords would have fixed themselves by now.  He is under the suspicion that the laryngeal nerve, which is on the left side and near the site of her surgical repair, is either stunned or completely damaged.  He asked if I heard Reagan rasping for air and I said every night but that she always sounded that way so it wasn't alarming.  However, I thought it was just a noise.  He asked if I had ever had her do a sleep test.  Oh great?!  No, but now I am concerned.  Anyway, the most crucial thing at this point is that we need to fix the opening so that she isn't as defensive with her throat and eating and may breath better at night.  We are waiting for scheduling to call us back because the ENT wants us to get into the Operating Room ASAP.  The idea is to only have her under anesthesia one time and complete in the following order:  MRI of her head and neck, to see muscles and brain activity to see if there is something not sending the correct signal to her throat muscles; an laryngeal EMG:

Laryngeal Electromyography (EMG)

Laryngeal electromyography (EMG) is a diagnostic exam that evaluates the health of the vocal cord muscles and the nerves that control them by measuring muscle electrical activity. This test is most commonly performed to determine the cause of muscle weakness, as well as to predict recovery from vocal cord paralysis and other related conditions.

During the EMG exam, thin needle electrodes are inserted through the skin and into the muscle, where they detect electrical activity while the vocal cord muscle is at rest and contracting. Patients may experience mild pain when the electrodes are inserted, but this is tolerable for most. This test is usually performed in conjunction with a nerve conduction velocity test;

and finally an injection:

Injection Laryngoplasty

Vocal cord paralysis is a common condition that involves a malfunction in one or both of the vocal cords, resulting in a weakened voice and symptoms such as difficulty swallowing or breathing, as well as coughing. Injection laryngoplasty restores bulk to the affected vocal cord(s) and allows both sides to once again come together to effectively produce a strong vocal sound. This procedure involves the injection of a material, such as fat, collagen or calcium hydroxylapatite, through the skin and into the vocal cord. Most patients achieve effective symptom relief from this procedure.

The last thing, the injection will be sort of like BOTOX, acting like a filler so that there is some closure and we can protect her airways and see if that might help.  Shortly after this injection, we will go in for yet another radiology appointment and have another swallow study done.  If the injection works, then just like BOTOX, she will have to get injections routinely.  If this doesn't seem to work then we will have to explore other options.  Either way, R is not out of the water and at least we were able to have some answers and we got a good DR. to explain things and we saw the imaging.  That was great.  Now I can, with some understanding help R and together with the therapists help her to get stronger in eating and speaking areas.  

I will continue to post updates.