[Dysphagia] Pediatric Neuro Case

[minniejor at yahoo.com (Minnie Bray)]

Thank you Suzanne, Scott, and Carmen for additional thoughts (and questions) to 
consider. 


He doesn't have a runny nose on a regular basis but his skin is very easily 
irritated.? His skin honestly reminds me of someone with Down syndrome.? I will 
ask about family history of allergies.? They have a dog in the house.? Very 
clean house and no second hand smoke.? The thought on it following a period of 
laying down makes sense.? All testing procedures (Upper GI series, sleep study) 
will take some time to get scheduled.? People in our area seem to wait a few 
months.? A trial of Zyrtec may be worth it in the mean time if the pediatrician 
felt it was possibly allergies.? 


He has not had an Upper GI since I started seeing him.? I am not aware if he had 
one after the Nissen was placed or not.? In his last swallow study in October, 
they did not see anything coming back up the esophagus.? It was a VFSS, not a 
Barium Swallow, so they didn't follow it to the stomach either.? They are in the 
middle of changing his formula to half Pediasure/half Pediasure with fiber due 
to concerns with constipation.? He has vomited through the fundo when he's 
had?GI viruses?a couple times this winter.? 


His breathing pattern did not appear to change during the episodes with me.? His 
parents indicated he does not gasp for air or look like he's having trouble 
breathing.? The changes in behavior indicate the problem.? His heartrate was up 
to 145 briefly when I was there last week.? Mom indicated that it jumps up when 
the episodes happen. 


He went to the doctor at the sleep clinic (the appointment prior to scheduling 
the full overnight sleep study) and that doctor said he didn't need a sleep 
study and thought the episodes were related to eating.? She referred him to GI 
but nothing was scheduled as of Friday.? 


Thank you again for your thoughts. 
Minnie Bray, M.S., CCC-SLP