ENT Consult

Lily visited an ENT specialist last Friday, following up from her sleep study which showed obstructive apnea. The doctor was great. He had reasons to back up his opinions, he was very nice, fun to talk to, and he even made Lily laugh. I really enjoyed visiting with this doctor, and that always makes a doctor visit better!

The doctor's opinion of Lily's situation almost made me laugh out loud. He said, "I'm sorry I can't give you a clearer answer, but it's just not black and white with Lily." Ha! That is pretty much the story of Lily's life. It is NEVER black and white. Not that there's anything wrong with that; it was just very funny to me when the doctor summed it all up that way.

He said he prefers to go by parents' reports of how the child sleeps, rather than the highly sensitive sleep study. While the study showed obstructive apnea, Lily does not snore very often; she doesn't snore loudly; her breathing is not labored; she can breathe through her nose with her mouth closed; she gets enough sleep overall and is well rested; the lower oxygen sats during her apnea episodes are not hindering her development. Without the sleep study results, there would be no reason to suspect that Lily had any kind of sleep apnea, which in the doctor's opinion means that she probably doesn't NEED treatment for it.

However, now that we have these test results, we're faced with the decision of whether or not to do anything. He asked me how aggressive we wanted to be in treating the apnea. (Treatment in Lily's case would mean removing her adenoids. She's too small to have her tonsils removed, and the doctor said he would not recommend anything more aggressive for Lily.) My response was, how do you even know it will help her? And he said, WE DON'T KNOW. And while I continued through the motions of the rest of the conversation, that was pretty much the clincher - If we're not sure that treatment would even help her, and we're also not even convinced that she really needs treatment in the first place, there's just no way that Lily is going to have surgery. That's ridiculous.

The doctor was sort of conflicted between recommending the surgery and not. His conclusion was that it was really up to us. It wouldn't hurt Lily to not have the surgery, and it wouldn't hurt her to have it. So we're not going to do it, and the doctor recommended that we just make a point to listen to Lily's breathing while she sleeps at least a couple times a week. (Like I don't already do that. The kid was on oxygen for over a year. I'm not sure that I'll ever NOT pay attention to the way she's breathing. This recommendation was almost as funny to me as "It's not black and white with Lily.")

I don't know if anyone else sees the humor in any of that, or if it's one of those things where you have to be there for it to be funny. Oh, well. At least you got the news about the doctor visit somewhere in this rambling blog entry!

Oh, and he also said that the obstructive apnea is highly UNlikely to be related in any way to Lily's swallowing troubles. He agrees with the pulmonologists that Lily will outgrow the swallowing problem, just give her time.