Friday, February 22, 2013

And the pulmonologist says...

After waiting a week for the results of our visit to the pulmonologist, he thinks he knows what the problem may be: aspiration.  For those of you ready to Google "aspiration", let me save you the trouble:

Pulmonary aspiration is the entry of material (such as pharyngeal secretions, food or drink, or stomach contents) from the oropharynx or gastrointestinal tract into the larynx (voice box) andlower respiratory tract (the portions of the respiratory system from the trachea (windpipe) to the lungs). A person may either inhale the material, or it may be delivered into the tracheobronchial tree during positive pressure ventilation. When pulmonary aspiration occurs during eating and drinking, the aspirated material is often colloquially referred to as "going down the wrong pipe."
So in case you didn't get all that, it basically means that some of her food and liquids are going into her lungs, sitting there and collecting bacteria, and essentially causing pneumonia. This is mostly based on the fact that she's had pneumonia in the same exact spot all three times.   Here's another link with some information as well.

The next steps will be to verify this by doing a speech/swallow study and possibly a bronchoscopy.  Depending on the results of the tests, one of the way we will try to alleviate this is to thicken Tera's liquids to some consistency to be determined by the doctor.  She will probably also have some feeding therapy.

The doctor wants to get on top of this right away because it seems to be becoming chronic.  In the meantime we're going to continue with her nebulizer treatments and schedule the swallow study.  The plan is to schedule a follow up visit with him about in about four weeks from now.

I think that's all for today's lesson in aspiration.  If you have questions, hopefully I'll have more answers in a few weeks.  Until then, we wait.  As usual....

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