Friday, September 5, 2014

Freaky Friday, Medical Style

For the past three and a half years I've become accustomed to being "the sick one" in the family.  Hospital visits seem to be typical, a variety of specialists are on speed dial and I can't help but feel that one medical complication usually leads to another.  Throughout this roller coaster of diabetes induced boohockey, the rest of my family has been at my side and, GW in particular, has been my little trooper.  There to snuggle me through my hospital stays, to entertain us through longer than normal waits at doctors offices and to tell all nurses to "be very careful" when drawing blood because he doesn't want me to have another ouch, you could easily say that he's acclimatized to the world of medical issues. 

Left: diagnosis hospitalization at Georgetown University Hospital, January 2011.
Center:  partial-abruption hospitalization, September 2012.   Right:  week 36 ultrasound, November 2012.

Well, yesterday, GW and I swapped places and I have to say, it has me respecting him in a whole new light.  At the beginning of August, GW started speech therapy to help correct his articulation (for example, he often says the "f" sound in place of "th") and his therapist made the suggestion we have his tongue evaluated because of it's heart shape.  Indicating that this shape is caused by an overly tight frenulum (the flap of skin that connects the tongue to the bottom of the mouth), she said it may likely play a contributing factor in his difficulty pronouncing certain sounds.   

Thinking this made sense, I called our pediatrician to get her take on it and she recommended that we take GW directly to see a pediatric ENT by the name of Dr Robert Bahadori in Chantilly, VA who would be able to evaluate the situation much more accurately without being overly quick to surgery as a solution.  Stating that she'd take her children to him specifically if she were in our position, I thanked the pediatrician and promptly called to get GW an appointment with Dr Bahadori no matter how long the wait.  Having several years of experience with specialists as the "new patient" with minimal necessity requiring prompt scheduling, I anticipated it'd be several months before we could get an appointment with this particular doctor or that we'd be given the "our junior practitioner has availability" option, but much to my surprise GW was promptly scheduled for the following week for a frenulum evaluation. 

So back-roading it around the early morning commuting horror that is I-95 North, we arrived at the doctors office (which has an amazing children't play room by the way) where we were promptly seen by a nurse and then Dr Bahadori.  Walking in just as you'd expect a pediatric ENT to - aka Patch Adams style in a yellow shirt and polka-dotted bow tie - he casually asks GW to play with him by sticking out his tongue.  Looking at me for approval before doing something that would under other circumstances get him in trouble, GW darts his tongue out as far as he can (barely to the edge of his bottom lip). 

"Yep, tongue tied," says Dr. Bahadori. 

After a few more playful checks, the doctor looks at me and informs me that there are two points at which he typically sees frenulum issues.  The first is in the first four weeks of life when infants struggle with their tongue movement enough that it negatively impacts their ability to eat and inhibits growth; and the second is roughly in the three to six age range when speech issues begin to appear, as is the case with GW.  Recommending that we do a frenulectomy, Dr Bahadori explained that for those children under four months old, the procedure is a quick in office snip that can be taken care of at any time, but as GW is almost 5 years old it would require that he go to a surgical center and have full anesthesia to make the cut.  

Taking a moment to think about what's best for GW, all of these thoughts about the issues he's had flash through my head:  he can't push food into his cheeks when he takes too big of a bite, he always spits it back out… he uses his finger to swipe away the food that collects between his teeth and his cheeks… he can't whistle and substitutes a "hoot" he learned from Dinosaur Train as his version of whistling… the way he says "teef" instead of "teeth" and "birfday" instead of "birthday"…  the way he's commented that so-in-so is able to stick out his tongue (both because, well, his mom let's him and because he physically can).   Feeling like his little 4 years old life played out in seconds of random memories and snapshot images, I decided it made more sense to go ahead and enable him to use his tongue for the rest of his years by doing the clipping than it did to protect him from the terrifying idea of a scalpel anywhere near his beautiful little body. 

Estimating it'd take less than five minutes to do the procedure and roughly 1 to 2 days for recovery, Dr Bahadori helped me to schedule the procedure for two weeks later and, for better or worse, that came and went yesterday.    While I waited in a consultation room, HB escorted our popsicle-motivated little toughie into the operating room where he helped GW get into place on the table and helped to calm him as the "super-hero" anesthetic mask was placed over his nose and mouth.  While acknowledging that he was glad GW wanted his Dada to accompany him into the OR, HB reported that there was nothing quite so scary as leaving our little man lying unconscious on the table surrounded by scrub-clad strangers… 

HB and GW happily playing in the children's waiting room.

Having been "the sick one" for so long, this reversal of roles introduced a new level of helplessness into my hospital-based repertoire that I must admit I never want to feel again.  Knowing that my own cooperation with doctors orders, control of glucose levels and attempted maintenance of personal health is entirely irrelevant to the ultimate outcome what's happening with my loved ones made the experience far more terrifying than any of the other times I've been lying in any ER waiting for results on this, that or the other thing. 

Fortunately, my patience vs. parent-concern ratio wasn't tried as it otherwise could have been as it was literally two minutes after HB joined me in the consultation room that Dr Bahadori appeared.  Reporting that everything went smoothly, he cleared GW for regular activity within 24 hours and asked for us to call if there were any concerns that arose after discharge.  Impatient to get to the recovery area and see our little guy, we thanked the Doctor and eagerly walked to where GW was curled up under a blanket and eagerly awaiting not us, but the popsicle the nurses had promised to him.  Forty-five minutes, one popsicle and two boxes of apple juice later, he was discharged.  He had a rough afternoon and evening coming off the anesthesia, but in looking at him this morning he is keeping food down and appears to be happy about his new found ability to wiggle his ever-so-slightly medicated and considerably longer tongue.  

Left: Frenulum before procedure.  Right: Frenulum after clipping.

Out of all the procedures he could have had this one was particularly minor (knock on wood), but this reversal of roles provided me a considerable dose of my-own medicine and it definitely was lacking in Mary Poppins' sugar...  I've come to accept my own medical issues as typical and I'm no longer shaken when something new pops up with my body that requires additional attention, but I'd never really stopped to think about how my being sick makes my family feel.  They don't have the symptoms, they don't have to do the tests or get the injections, but they are just as much smacked in the face with my diabetes as I am and it's just as present in their daily lives because of me.  Seeing GW in his scrubs and having these doctors poke and prod at him was more painful than any of the things I've had done and it's opened my eyes to how high of a pain-tolerance this little guy has for everything he endures to be there for me.  For better or worse, he's grown up quicker because of my pancreas and he knows more about hospitals than any almost 5 year old should (Heaven help those children who know even more...), but Lord love a duck is that kid tough and I cannot say how thankful I am to have him at my side or to have the blessing of being there, as his mom, at his. 

"Can I have another popsicle?" 

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