Monday, June 25, 2012

Two for the Price of One

Bobby's pulmonologist/sleep doctor was able to work us in today, so we didn't have to wait for our scheduled followup on July 2nd.  Although we had to wait almost two hours before we saw her, I'm just grateful we didn't have to wait for the 2nd.  She went over the sleep study results very thoroughly and told us that Bobby has both of the kinds of sleep apnea - obstructive and central.  Basically, obstructive sleep apnea means that something is obstructing the airflow (hence the name), so you have events of decreased (though not totally absent) airflow.  Usually it's tonsils or adenoids that are causing the obstruction, but it really can be anything.  Central sleep apnea means that there is a neurological issue that causes the body to stop breathing, so you have events where there is absolutely no airflow.  Thankfully, Bobby's central events are short - five to fifteen seconds.  While this seems like forever for my baby to be not breathing, the doctor told us that if they'd been using a less sensitive test, these events actually wouldn't have registered - the threshold for the less sensitive machine (the name of which I can't remember) is twenty seconds.  The doctor gave us a prescription for Singulair, in the hopes that at least part of the obstructive sleep apnea is related to swelling due to his congestion.  She said that the x-ray showed his adenoids are actually unusually small, so she doesn't think that's the issue.  She did refer us to an ENT to see if he can determine exactly what the obstruction is.  If they feel it's necessary (and can find an obstruction), obstructive sleep apnea is correctable by surgery.  As far as the central apnea goes, she's referred us to the pediatric neurology department.  Unfortunately, she told us that it will probably take at least a few months to get in to see neurology.  On the bright side, she said that it's fairly common for premature babies to have central sleep apnea, and they usually outgrow it.  While 37 weeks is considered term for twins, Bobby was still technically three weeks early.  We're going to do another sleep study in three or four months (oh joy), and hopefully the central sleep apnea will have resolved itself by then.  In the meantime, hopefully the Singulair will help, and maybe the ENT will see something fixable.  The doctor says Bobby seems to be meeting all his developmental milestones just fine, so she's not really concerned about the neurological front.  Ordinarily, the treatment would be a CPAP machine, but this isn't really an option for an 8 month old!

And now for a couple of cute pictures of Jamesie, since this was all about Bobby...

James enjoying his first tortilla - once he figured out it was food and not a toy!

 James sleeping on the sofa next to Jeremy

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