Monthly Archives: April 2012

Nasal Scope And More Decisions

Ally had her nasal scope done today, it started off alright with some simple routine procedures. Then we had to spray a numbing agent into her nose and I could see that she was thinking of the barium insertion. She hesitated but continued to be brave. On the first try she yanked the scope out, we explained to her that the more co-operative she was, the faster it would all be over. Second time around she was much better but she had difficulty swallowing her saliva so the images were rather blurry. I am really proud of her, I don’t think I would tolerate having a scope down my nose.

Watching Aunty S preparing the scope

We started off by checking her mouth, this was the easy part

The next part wasn't so pleasant as you can see from her face

Even with no medical background, I could clearly see from the tv that her soft palate and pharynx didn’t fully close as she spoke.  If you look at the picture below, when we speak our soft palate actually bends downward and meets the pharynx forming a seal.

In Ally’s case, there was a hole at the side when she speaks, which explains why she sounds like she’s grunting at times.  Ally has been in regular speech therapy since she was 6 months old but no amount of therapy is going to help her with this as it’s now a structural issue. Before we ran these tests, we thought her grunting and snorting were just bad speech habits that she had picked up. Now we know she has Velopharyngeal insufficiency or VPI for short. The question is, do we put her through another surgery to close up the hole?

I am inclined to put her through it and continue with speech therapy but we won’t make any decisions till we meet with her surgeon in May. Honestly if you met Ally you would have never guessed that she has speech issues. Not only does she sound ” normal” she has a wide vocabulary and speaks articulately. Occasionally you might be able to pick up her grunting or snorting if you are observant enough. But due to that hole, she will always have trouble making high pressure sounds like ” s, z, sh….etc”

Important decisions have to be made, but we’re going to wait and consult her plastic surgeon before making our decision.
 

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I Wish I Could Read His Mind

It’s been awhile since I’ve sat down to write something. Max has been testing the limits of my patience on a daily basis. One could argue that its the terrible 2s/3s, on the other hand people have been saying its middle child syndrome. Whatever it is, its tiring. I wake up in the morning with all good intentions to try and be patient and understanding with him. By the 5th time he has thrown a tantrum, all good intentions have flown out the window. He is being openly defiant and at times, rude. Nap and bedtimes have become a battle as well. I really wish he could express his feelings , or better yet, if I could read his mind. I know he wants to spend time with me and I’m trying, even for a couple of minutes each day. Our bedtime routine hasn’t changed, I have held firm with that. He fights his sleep nearly every night even though he is so tired. I’m more worried that he’s not getting enough sleep than anything else.

On days where he is once again my sweet little boy, we have a great time together. Other days I feel like he has morphed into this little monster whom I have no idea how to deal with. I thought it was just me but even my mom has commented that she finds him difficult to deal with at times. And that’s saying a lot cos grandma is a lot more patient than I am.

When I’ve had a particularly bad day with Max, I’m racked with mommy guilt. I feel bad that I’ve yelled at him, that I haven’t spent enough time with him..etc. I hope he knows I’m trying my very best.

Max with his new hair cut, wearing a Mama made shirt

 

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Speech Videofluroscopy

The day finally came for Ally’s speech videofluroscopy. She needed to have it done so that her speech therapist and plastic surgeon could check the movement and length of her soft palate and decide what needs to be done next. We made this appointment a month ago and I have been gently prepping her for it. I knew she would have no problems sitting through the X-ray, but the barium insertion was another story. They would insert a small tube into her nostril and she would have to swallow the barium, this allows the structures in the mouth and throat to be clearly seen on the X-ray. Ally is good with most medical procedures but I knew this would be stretching her limits. She was scared and asked if it would hurt, I didn’t lie to her, I just told her it would be uncomfortable.

Her speech therapist asked her to lie down on the X-ray table and showed her the syringe and tube which would go into her nose. First she dropped one tiny drop, Ally swallowed it without any problems. I was a bit alarmed to see that she had drawn out 5ml of the solution, in my mind I was thinking there is no way Ally was going to let her insert that much!

Then the time came for the real thing. She pumped a little bit more liquid into her nose, as expected Ally gagged and struggled. Her whole face turned red but she didn’t cry, we had her favourite penguin beside her and I was holding onto her hand. Once she swallowed that liquid we had to do the other nostril. Again she gagged and spat some of it out , it was clearly uncomfortable for her but she held back her tears. Luckily she had swallowed enough and we didn’t have to subject her to it anymore.

Once they got her into position, she had to repeat the phases that her therapist said. Oh, did I forget to mention that we had to remove her earrings? This cause more tears and drama than the barium insertion itself! She finally allowed me to take them off and we could continue with the X-ray. It was really cool watching all of it on the TV, I could see all her bones, the structure of her mouth, and lots of other things that I couldn’t identify. From the X-ray you could clearly see that her lower jaw has still some way to catch up with the upper. Once the lateral view was done, her therapist decided that we needed to insert more barium. Since she cried when I had to remove her earrings, her tears had diluted the solution and it wasn’t showing up clearly on the X-rays. When they gently explained it to her, you could see she was very upset but she bravely held back her tears and nodded her head. My heart went out to her , she behaved so bravely and maturely for her age. It went a lot smoother the 2nd time round, I guess she knew what to expect and didn’t gag so much.

After the whole procedure was done, we bought her a present as promised and told her how proud we all were of her. She still has a nasal scope coming up at the end of the month, I’m hoping that would go as smoothly as the X-ray.

 

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Random Pictures

Each day seems to slip by so quickly, I hardly have time to take photos of the children but here are a few random shots from the last few weeks.

Ally has a new pair of Roller blades! She hasn't quite gotten the hang of them yet

Max at the playground, our morning hang out after dropping Ally off at school

Luke, who is growing up way too quickly

We took the kids to East Coast to ride their bikes and push car

The boys hanging out with each other

Max went to his first Mandarin class all by himself!

Sorry for the random pictures, I’ve been trying to catch up on some sleep!

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Meal Time Survival 101

I had this whole meal thing down pat, taking Ally and Max out to lunch on my own was second nature by now. Most days I could get all 3 of us fed without much drama. Then we had Luke and suddenly meal times became complicated affairs.

Taking 3 young children out for lunch on your own is a feat in itself. First location is very important, hawker centers are out of the question cos a) the pram doesn’t fit at any of the tables,  b) either one or both children are slipping off those little round seats since they have to perch on them to reach the table and c) poor Luke will be melting in his pram by the time we are done eating.

So that leaves us with food courts or restaurants. When one is at a food court, it’s all about location. You need to find a table that close enough to the stalls you are buying from so that you can keep an eye on the kids. This can be tricky if one child wants to eat something at this end of the food court and the other child wants something at the other end. What does one do? You either tell the kids to choose food from stalls in the vicinity or you take all the troops with you to one stall, buy the food, walk them to the other end , find a table and get everyone settled while you buy food for second child. By this time you probably look harassed and overwhelmed and hopefully some kind soul will help you carry your tray.

Even the type of food that you have to buy can pose a problem. Suppose you need to buy something from this end and walk over with kids in tow to the other. Now , if its a rice dish that isn’t too bad, but what if its a bowl of steaming hot noodles? Do you attempt to carry the tray with one hand while pushing the pram with the other and at the same time shouting at the other two kids to follow you? I choose to ask the stall holder to help me carry the tray, at least I know I won’t end up burning one of my kids! Most of the time they are willing to help but of course you get the odd one or two who couldn’t give a damn.

Once the food is actually bought, cut up and served to the kids, now its time to feed yourself. Gone are the days of buying what you actually felt like eating. Now I choose foods that I can either eat with one hand or gobble down in 10 minutes. No more hot soups for me! The meal goes rather smoothly if Luke stays asleep, but should he wake up in between then that’s when I wish I could grow an extra set of arms. Luckily for me, Ally is old enough to eat on her own and loves her food so I don’t have to constantly remind her to stop day dreaming and eat. Max is a different story, he can feed himself but will take forever and will fidget, day-dream and do about a 100 other things besides eat. So I end up feeding him half the time to make things quicker. Take today for example, we were all having lunch when Luke woke up and needed a feed. So while I fed Luke, I was trying to feed Max and myself all at the same time. By the time lunch was finished, I was ready for bed.

If Matt is around that makes thing much easier, in fact we can even have a decent conversation over meal times. Sometimes we end up playing what I call ” pass the baby” which just means one of us carries Luke and tries to feed ourself while the other manages the two older kids. Then we do a swap so the person carrying Luke can now finally use both hands to try and finish his/her meal.

Is it tough handling all 3 on my own during meal times? Of course it is! But I know it’s one of those things that won’t last forever. As the kids get older it would hopefully get easier , in the meantime , I’ve better master the art of speed eating.

 

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The Day of No Technology

The children are allowed 1/2 hr of television daily, they usually watch Hi-5 when Ally comes back from school and that’s their TV allowance for the day. After their naps, they are allowed to use the ipad for 20 minutes.

Last Friday, both had their TV and iPad privileges taken away. They knew that they were in BIG trouble and didn’t argue about their punishment. Instead of complaining, they found other ways to amuse themselves and at the end of the day I don’t think they actually missed the tv or the ipad that much.

They fixed puzzles, played make believe games and built structures with their Legos. Does that mean I’m going to cut out TV completely from the kids’ lives? Not exactly, I think 1/2hr a day isn’t too bad but I am going to re-think the ipad issue as I notice the kids tend to squint while using it or they hold it too close while watching videos.

 

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