Visiting the Speech Pathologist

James and I visited his speech pathologist today to follow up on his liquid diet.  During and after surgery, the muscles in James' throat were bruised due to the breathing tube and NG tubes being inserted in his throat for so long.  Those muscles are now somewhat weak, which makes it hard for liquids to go down the right tube when James drinks.  The esophagus (food and liquids) is behind the trachea (breathing), and when we eat/drink, whatever we ingest has to move over the trachea and back to the esophagus.  If food/liquids accidentally get in the trachea, we cough/choke/gag.  In short, with James' muscles being sore, liquid in particular is slipping into his trachea, which could result in fluid in his lungs, and potentially, pneumonia. This is why his liquids must be thickened right now-having them thicker gives his muscles a little more help in terms of moving the liquid to the esophagus instead of his trachea.  There are three levels of thickener: nectar, honey, and pudding.  James started on the nectar in the hospital, but was still aspirating liquids, so they upped him to honey consistency, which is where he is currently at and doing well.

James' speech pathologist (who knew they covered this in addition to speech development?!?) suggested we do a 2 month weaning program to get him off of thickener all together. She is keeping him at the honey thickness, as he still coughs a bit while drinking liquids-I'm glad she heard that while observing him drinking, as this has been worrying me.  The weaning has to be a gradual process in order to strengthen his throat muscles over time.  He'll stay on the honey consistency for the next week and a half and then I'll start decreasing the amount of thickener in the liquids; we'll go in for a check up so the pathologist can watch/listen and see if the decrease is okay.  We have a lot of other guidelines to follow, and it was extremely helpful to learn why this happened, as we didn't really think to question this while in the hospital.  Our insurance unfortunately does not cover the thickening gel packs, so we'll have to pay for that out of pocket.  However, it does cover unlimited speech therapy sessions, which apparently is not a common occurrence-for that, we are very thankful!

We have James' pediatric and surgical follow-ups this week as well, and then his cardiology follow up in two weeks.  I can tell he is ready to be done with doctors for a while, but continues to acquiesce to all these check ups.  He's a trooper!