Saturday, December 8, 2012

ENT Visit

Today, we saw Dean's ENT to get his opinion on Dean's recurrent sinus infections and his obstructive apnea that has persisted even after taking out Dean's tonsils and adenoids. Dr. Brager, the ENT, thought that these two issues were not related.

Regarding Dean's sinuses, his bet is that allergies underlie the recurrent infections. His recommendations were to continue the Zyrtec, Nasonex (we just switched a few days ago from Fluticasone), add Singulair (Dean used it a while ago and then we stopped because it didn't seem to do anything), and most importantly, flush Dean's sinuses with a saline wash three times a day - whether he's sick or not. I have my thoughts about how Dean is going to appreciate this (or not), but we'll see.

If doing all this doesn't keep things under control, then we will look into a sinus CT scan and some other minor procedures that can be done to open Dean's sinuses some more.

Regarding the apnea, Dr. Brager suspects Dean's palate. I was going to show you pictures from Google, but they make me squirm a little. If you're curious, Google "high arched palate" and you'll get an idea of what Dean is dealing with. Dr. Brager recommends a palatal expander (again, proceed to Google) and that would happen through a pediatric orthodontist. He said because kids are so malleable (figuratively and literally), they tend to be very successful in changing the facial anatomy around the palate. I'm hopeful. I mean, Dean will probably pitch a total fit (understandably) if he has to have one, but I'm hoping the results will be well worth it. Assuming he doesn't stop eating or anything. :/

There are other, much-more invasive measures, like jaw surgery, which could help open up Dean's airway and help him with apnea. But there's hardly any way we'd go that direction since the bipap does work and is obviously a lot safer. We'll see what's next!

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