Grifyn & I spent a long 4 hours at Children's Hospital today visiting with 5 different specialists. I had no idea that his one appointment was going to be such a big production!! We went to find out if Grifyn has a
submucous cleft, which is an opening in the mouth that doesn't close when it's supposed to (when making sounds to talk, eating, etc). Our speech therapist suspected that this was the reason that when Grifyn talks, it sounds like he's talking out his nose. She's actually suspected this since he first came to the US, but she wanted to give his language skills time to develop. So today, we headed to Children's Hospital to get some answers. We went to what they call the "cleft clinic". That means that we saw a variety of doctors that cover all aspects of problems that come with cleft related issues.
We started out with the audiologist. She explained that children with clefts often also have problems with their hearing. Our morning started off with a bang when Grifyn....my child with Down syndrome that has NEVER had any problems with his ears in the 2 years he's been in our family....FLUNKED the hearing test. She started out by measuring the vibration in his ear drums....and the right one didn't move! I knew as soon as she said, "Hmmmm, let's try this again." that things weren't going well. She then did the tone hearing test and he has what is considered mild hearing lost in his right ear. That was not what I wanted to hear first thing this morning! The audiologist told me not to worry...that hopefully the ENT would find fluid in his ears. We'd see the ENT later in the day.
Our next stop was the genetics doctor. This was another surprise for me, since I had no idea that kids with cleft issues often have a genetic component to it. I ended up having a very interesting conversation with the genetics doctor that went something like this:
Him:
Are you sure that Grifyn has Down syndrome?Me:
Yes, I am sure (internally rolling my eyes because we get asked this ALL. THE. TIME.)
Him:
Was he actually tested in the US or did they diagnose him in Serbia?
Me:
He had genetic testing done in Serbia. When we brought him to the US, we requested genetic testing and they tested one cell, found an extra chromosome and that was that.
Him:
We can test him to determine what type of Down syndrome he has. (he says this as he's looking intently at Grifyn and then examining his hands)
Me: I don't care what type of Down syndrome he has. He is who he is.
Him:
hmmm (as he continues to examine Grifyn's hands...now with a magnifying glass and a light)
Me:
I am aware that he does not have the crease in his palm. I am also aware that studies say that this means that he does not have Trisomy 21. Quite honestly, it does not matter.Him:
Well, if you are curious, we can find out.
Me:
It doesn't matter to me, not at all. Knowing what type of Ds he has won't change a thing (at this point, what I wanted to say was: It seems to matter to YOU)He seemed quite perplexed that I didn't want to know if Grifyn has Trisomy 21 or Mosaic Ds. He went on to ask me if I would be interested in taking Grifyn to a doctor at another hospital that specializes in children with Down syndrome. I told him only if the doctor would see all 3 of my boys during the same visit ;)
Now, I could say A LOT more on this subject. We talked for over 15 minutes about all of this. I will say that the genetics doctor was very nice. He seemed genuinely curious and genuinely confused as to why I wasn't jumping at the opportunity to have more testing done on Grifyn. But seriously folks,
it doesn't matter. It wouldn't change one darn thing that we do for Grifyn nor improve the quality of his life or anything else, so I don't see any need in having Tricare pay the big bucks for a test just to be able to say "out of 500 cells, ___ have an extra chromosome"
(because seriously, how often does that come up in conversation??? lol).Next, we saw the speech therapist. She came in to listen to Grifyn talk in order to determine if she could hear the noise coming out his nose when he talks. She did. She said that the interesting that about Grifyn that is
not typical in a kid that is suspected of having a submucous cleft is that while you can hear the noise when he talks in casual conversation, if he focuses on a word and articulates it slowly, the noise does
not come out his nose. Hmmmm.....
Then, the surgeon came in. He examined Grifyn's mouth and he started off by saying, "Grifyn is not the
typical case". Leave it to my kid to be the one that doesn't fit the mold! He went on to draw out what a typical mouth looks like on the inside and what the mouth of a child with a submucus cleft looks like. When a child has a submucus cleft, 3 things are present inside the mouth. Grifyn has one, does not have one and has half of the third. *sigh* So, there was no way to know just by a visual exam if Grifyn actually has a cleft. We talked about surgery options...and about the fact that if Grifyn needs surgery, there is not a 100% guarantee that it will help his speech.
The last doctor to join the party was the ENT. He brought in the scope in an effort to try to determine once and for all if Grifyn has a cleft. While he was numbing Grifyn's nose, he checked out his ears (remember that hearing test I mentioned above?). He said that the right eardrum has compacted wax around it. He hopes that this is what is keeping the drum from vibrating like it should. Finally, it was time for the scope. The surgeon and the speech therapist joined us in the room for the scope, so that they could see whatever the ENT found. Grifyn was PERFECT during the scope! The doctor put the scope inside his nose and Grifyn sat perfectly still and laughed through the whole thing! The speech therapist got Grifyn to pronounce certain words so that the ENT could observe the movements inside his mouth while he was trying to talk. It took only 2 words out of Grifyn's mouth before the ENT said,
"He has a cleft... a pretty good one too." The surgeon took a peek through the scope, as did the speech therapist. Grifyn continued to charm them all with his laughing and answering their questions(to get him to talk) all while having this big scope up his nose!
The result of all of this is that Grifyn will have surgery to repair the submucous cleft. The ENT will also be there during surgery and he will clean out both of Grifyn's ears. If he finds fluid, he will go ahead and place tubes in Grifyn's ears. Once the ears are cleaned out, Grifyn will have another hearing test to see if this corrects the hearing loss (praying that it does!).
Surgery is scheduled for August 27th at Children's Hospital. As many times as we've been through procedures and surgeries with Xander, this will be the FIRST time that Grifyn has ever been put to sleep or had anything done more than a basic office visit.
His mama is a little worried about all of this right now.....