Tuesday, March 2, 2010

Up her nose with a rubber hose...

In between all the Chinese New Year activities, we also paid another scheduled follow-up visit to Gillette Children's Hospital. Our objective at this visit was to find out how well Wynn's palate was working, and not just by listening to the sounds she makes when speaking. This time, we were going for video!
The endoscope itself, about the size of a power screwdriver. The action end, however, is the thin wire extending out on the right.

After a short speech evaluation, where Wynn showed us which words she can say the "B" and "P" sounds particularly well, we moved over to an exam room where we encountered this computer workstation and the nasoendoscope. I have to admit I wasn't quite sure how big the wire was that we were about to snake up one of Wynn's nostrils, but when I saw it was only the size of a thick strand of spaghetti, I was immensely relieved.

(Yeah, I admit I was thinking co-axial cable instead of fiber optics. Shows me for not Googling the procedure beforehand. Hey, I'm a busy guy.)

Most of the time we spent in the exam room was actually waiting for the hospital IT people to get the new release of recording software to work right. The procedure itself took about five minutes: first, a quick spray of lidocane up Wynn's left nostril (since we'd taken that bead out of the right side a few weeks before...), then the speech pathologist snaked the line into Wynn's nose.

All of us - Wynn included - watched everything happen on the screen next to us. The thin cable has two fibers: one serving as a flashlight, and the other as a camera lens. After one big sneeze, the end of the cable was where it needed to be, and Wynn started talking. "It tickles!" she said...

The illustrations I've seen in textbooks which try to explain what the tongue, palate, and throat do during speech have always seemed a little abstract. Watching all the parts moving around, I finally 'get it.' The back of the palate is supposed to connect with the back of the throat to block airflow going up into the sinuses. With the video, you can see this happening.

In Wynn's case, it hadn't been happening, which is why her B and P sounded more like M. She was 'faking' the sound. However, we'd noticed in the past few weeks that she was occasionally beginning to speak some clear consonants ... we've been practicing rhyming, like her favorite funny phrase, "Shadow likes to NIBBLE on a bowl full of KIBBLE."

Sure enough, after a couple minutes of speaking "mama" and "mall", she'd connect with a clear "baba" and "ball." And right there on the screen we could see the palate making contact with the back of the throat.

Her surgeon reviewed the video. "Well, that's not so bad, then." In fact, the team was pretty impressed with Wynn's progress over the past few months.

Most importantly, it means we can put the question of whether she needs surgery on the back of the palate off until this summer. And that's a real relief.

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