Swallow Study

Today Nina had a swallow study done.

Almost every time that Nina takes a drink, she kind of chokes a little and starts coughing. Sometimes it is pretty mild, and sometimes it sounds a little "alarming." There are times that even her saliva will send her into a coughing frenzy. And for this reason, she had a swallow study done to check for aspiration.
So let me tell you what this means for Nina. Basically when she drinks thin liquids, her epiglottis is not working properly. By all means this is the easy way to explain it because this is how I understand it. You will see in the picture below, that the epiglottis is a membrane (or muscle?) between the esophagus and trachea. This membrane is supposed to "move down" as part of the swallow reflex to close of or protect the trachea, vocal chords, and lungs in order to keep out food and liquids.

Well, Nina's does not close down when she drinks thin liquids, which is why she starts coughing. She is in fact aspirating. It seems like her liquids need to be "honey like" consistency in order for her to swallow properly.

What was the swallow study like? They gave Nina barium to drink and basically took an X-Ray video to see what her throat was doing. She aspirated every time until we got to the honey like consistency.

Food is another story, but she is not aspirating, so we will leave it at that. We don't have to be concerned about it, so we will let it be. In Nina's case, this is part of having Cerebral Palsy.

So from now on, we will be thickening all of Nina's drinks to a honey like consistency. Oh fun! Actually, I really don't mind it, I am thankful that she does not need a feeding tube.

And, Nina loved the plain barium! They ran out of koolaid to disguise the flavor and wouldn't you know it, she loved it! She would have no more koolaid stuff. Now what did they feed her at the orphanage? She likes barium? We cannot get her to eat, but she will drink barium!

I did leave thinking maybe Nichole needs a swallow study done too.

The way back home was hard. Nina cried the last 40 minutes. It was draining. Andy pointed out she was displaying orphanage behaviors, we had not seen some of these for a while. Makes us wonder what really triggered it, what is going on in her little heart and mind.

So tomorrow we go back for another full day. You can keep us all in your prayers.