Sunday, December 9, 2007
Question: Vocal Cord Paralysis and Eating
I know that there are a bunch of you moms out there with experience in this field, so this one is for you:
Yesterday, Sharon was eating a piece of reheated pizza and Hallie expressed a lot of interest in it, and so we thought: what the heck, she's not had anything to eat in a while, why don't we let her experiment with taking a bite and see what happens (and of course we prayed we didn't have to dust off those rusty CPR skills). It went great--it was clear that she knew how to bite (all that practice with book eating really seems to have paid off), and she knew how to chew--definitely up and down and perhaps some rudimentary rotary chewing. She still is lacking her first year molars, but she looked good chewing. And she even figured out how to swallow without panicking (we've always assumed the vomiting up of solids was a fight-or-flight thing kicking in).
That went well and we thought: maybe the issue is that Hallie can't deal with thick purees' texture but is okay on crunchy stuff (there is evidence that this is true of other kids). So we decided to see what she would do with the first real hard food kids often get: biter biscuits (or teething biscuits). We have a full stash of all possible foods you might feed kids who are transitioning to solids (of course we do: whenever she fails to eat I buy new products that she ends up not eating in the hopes that she might be able to eat them). And so I ran to the kitchen and got one and we put her in her high chair in front of a Sesame DVD and let her have at the biter biscuit.
She did great. It took awhile, but she bit off pieces, chewed them, pulled out pieces that were too big, put them back in (sorry about that graphic image) and ended up swallowing them. There was a tiny amount of choking, sputtering, spitting, but nothing disturbing.
Now we were really puffed up, so I decided to pick up some Cheese Puffs (sorry about that bad pun) at Whole Foods (they are NOT as tasty as Cheetos, by the way). We were going to our neighbor's Josh and Nancie's for dinner and thought that it might be nice to use these as a bribe for Hallie to stay in her high chair and let us eat dinner together like real people do.
This worked for a while. She bit, crunched, munched and swallowed. We were thrilled. Our kid was eating something normal. Our kid was eating the same thing that another kid at the table (Ethan) was eating. Wow.
But then the choking started. And with it, the spitting. Which turned into vomiting. And morphed into projectile vomiting.
And so my question for you guys out there is this: is she doing this because food is going down the wrong way because her vocal cord is paralyzed ALMOST but not quite at midline? Is it going to be possible to do something about this if that is the case? Will that something involve a. surgery, b. botox, c. training her once she is old enough to follow our guidance how to handle solid food when choking happens, or d. something else I haven't thought of doing? And what do we do in the meantime? Do we go back to the nasty purees like the feeding clinic wants to do, just feed her Stage 2s because they are safe and we can get them in with minimal distress and they help her get nutrients and calories, or keep trying with the crunchy stuff? We're at a loss here, and kindof sad to have moved so quickly again from elation to dejection in less time than it would take you to chew and swallow ten cheese puffs...