We went for Aubrey's swallow test today. She wasn't allowed to eat for 4 hours beforehand so she'd be hungry--boy was she ever. She was good and mad and crying by the time we got started. She sits in a little seat and they move the x-ray thing in beside her so they can watch the barium solution that she's eating from the bottle go down her throat. They started out with regular thin formula--she aspirated. They moved to a little thicker formula called nectar. She aspirated. She did fine with the next thickness called syrup. She got madder and madder each time I had to take the bottle away from her, so I was scared she wasn't going to take the final one but her hunger overcame her anger. When I looked at the syrup-consistency bottle, it looked about like what we feed her on a regular basis; so, when she tells me her formula isn't thick enough by not drinking it, she's telling me that she CAN'T drink it without aspirating. Funny how she knows.
The speech pathologist that watched her said that it looks like her tongue motion isn't very coordinated when she's sucking. It's supposed to be one smooth flow from the front to the back when the tongue is moving the liquid backwards; Aubrey's has a little jerk towards the back of her tongue, and when the formula is too thin the tongue flicks it backwards before the airway has time to close and that's what causes her to aspirate. So, we'll just continue to thicken. No biggie. We kind of knew that already anyway. Oh yeah--she's a silent aspirator...that's not good. It means that she doesn't cough or choke or anything when the food goes down the wrong way, so we have no way of knowing when she does it. But it seems that we've been doing ok so far, so we'll just let her continue to tell us what she needs and what she doesn't.
Spending the evening together with the birthday boy before he goes back to work tomorrow.
-Keli
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