Holden - 21 months

Dear Holden,

This past month has been an interesting one for you! At the end of September, we went to see a pediatrician to discuss the ‘episodes’ that you’ve had previously (blue lips, lethargy, fever spike) when you were sick. I mentioned previously that you ended up in the hospital once, seriously dehydrated from a bout of strep throat, a raging double ear infection and the beginning crackles of pneumonia. That was your first incidence of blue lips, and it scared the crap out of us. You've since had a few more episodes, which always ended fairly quickly, but of course, were quite frightening while they were happening. Thanks to an abnormal x-ray result and the repeated occurrence of these episodes, we saw the pediatrician to discuss a diagnosis and next steps.

Her diagnosis was asthma. Not a severe case, since you never really actually seem to struggle to breathe, but clearly there are some viral-induced issues present in your little lungs. She seems to think it’s a good possibility you will grow out of it, as your lungs grow and you mature, but we need to work to treat it now so it gets better and not worse. Thankfully, you do not currently face a chronic treatment plan – instead, we have a steroid puffer that we’ll give to you for two full weeks whenever you first show signs of a cold. This should hopefully help to eliminate any symptoms your troubled lungs throw at us (namely, those worrisome blue lips!), but if not, we also have an as-needed puffer that is a bronchial dilator to open up your airways should you run into trouble. Cold and flu season is upon us, so we’ll get to test these out shortly I assume. The doctor will be following up with us regularly at the Pediatric Asthma Clinic at the hospital (we have our first appointment there in a few weeks), changing your ‘action plan’ as we figure out what works for you and what doesn’t.

In addition to addressing the lung issues, Dr. Hansen was also troubled by your snoring (and potential mild sleep apnea) and heavy breathing. That’s upper respiratory, not lower respiratory (as asthma and abnormal lung x-rays are). She referred us to an Ear Nose and Throat doctor (ENT), who we met with yesterday for the first time. The ENT said that your tonsils are quite enlarged, and this is likely a very clear explanation for your heavy breathing and snoring issues, and could quite possibly also explain ear infections, throat infections and of course, those dreaded blue lips episodes! When you are ill, your tonsils enlarge even further – pressing against each other and leaving little room for the mucous generated by a virus to pass through (the ‘mucous flap’ that more than one walk-in doctor mentioned to us as an explanation for the blue lips). She re-iterated that the upper respiratory and lower respiratory systems are obviously interconnected, and that if we remove the tonsils, it would help you breathe easier, help you sleep better (without snoring!), help reduce incidences of throat/ear infections, and hopefully reduce your viral-induced asthma symptoms and the blue lips episodes.

So, it seems pretty clear that removing your tonsils would be a good option – but man oh man, does it scare me. My logical brain knows that this is a fairly routine surgery (heck, I had it done when I was three years old!), and that young children bounce back from this remarkably quickly. I can see clearly that it will only benefit you, but it’s still such a scary thought to picture my sweet little boy put under general anesthesia, staying overnight in a hospital (with me there, thankfully!), forced to stay home for a week to recover, unable to eat the foods his big sisters are eating. I know the risks may be minimal, but as parents, our job is to reduce any chance of you hurting – and so it seems so counter-intuitive to hand you over to a surgeon so they can cut something out of you. We haven’t 100% decided yet, in part because I need some time to digest the idea of it and the logistics and further weigh the risks and benefits. But it seems likely that in the spring you will undergo the surgery, with your Mama there by your side. Good luck to all of us!

Love,

An always-protective Mama