Dr. Terry Such-Neibar (I have been spelling it wrong the whole time-sorry) came in today and tested Coop’s gag reflex. She pried his mouth open and with a tongue depressor scratched the back of his throat. He had a slight gag response although it is delayed. Terry said it is a good sign that it is present because it may be a sign it is returning to normal. Of course, there are no guarantees. However, a delayed response does not protect his airway anymore than no response because if he vomits he needs to gag at the same time so it does not get anything into his lungs. She has ordered a swallow test today where they put something in the back of his mouth and allow him to swallow and see what happens. I’m interested to see how they make a child swallow when he is not alert. She has ordered a chest CT for today instead of Friday to see how his lungs look since he has been having a lot more mucous and his oxygen is down a little. She is also going to pull his NJ-tube (the feeding tube that goes from his nose to the first part of the intestines) back into a NG-tube (go from his nose to his stomach). See picture above. This is a little more risky because if there is food in his stomach he can easily reflux and if his gag does not react the food could go into his lungs (aspirate). So when that is done we are supposed to watch him closely for any signs of vomiting or reflux.
Audiology wants to repeat hearing testing after all fluid in his ears has dried out to verify results probably right before we go home. They said that hearing aid trials can actually do further damage in certain situations so they would rather repeat testing instead of trying hearing aids. We will be going up to their sound chamber tomorrow to test any behavioral reaction to sound. For this test he needs to be awake and they will apply noise in the chamber and watch for any physical sign that he can hear.
Addendum: The results of the chest CT came back as no fluid in the lungs. One side has a little less volume capacity than the other but that usually returns when he starts feeling better or sitting up more. We will have a member of the Pediatric team come take a look at him to see what they would recommend. They could possibly suggest a steroid treatment to help him breathe better or humidifier. Since he isn’t coughing he is not able to clear his own secretions. Right now his lungs sound and look fine, but because of the gunkiness (yes that is the word everyone is using) we are not going to pull his feeding tube into his stomach until after he feels a little better.