| We found that if we broke the numbers down
to below the age of 3 and above the age of 3, we came to
some statistical significant conclusion. [see Figure 3] 10
of these patients out of the 45 had had a previous
operation, but 6 of them had an operation which was not
neurosurgical, but because they had problems with reflux,
failure to thrive, difficulty with swallowing. They already
had fundoplication (that means tacking up the stomach so
that they dont regurgitate). Gastrostomy was for feeding,
and because of difficulty with breathing and swallowing and
aspiration; in other words, food going down the wrong way,
and landing up with pneumonia. Two of them had previous
tracheotomies, (that means an opening in the windpipe so
that youre bypassing and making sure they dont have a
problem as far as going the wrong way). |
|
| If they strain then theyre
going to increase their headache, so they become further
constipated, its a vicious cycle. The next thing that
happens is there is a hard stool that is coming through and
they get a fissure that makes it more painful, so they
scream before in anticipation both of the headache as well
as now for the rectal fissure problem. So headache was
one, the next was repeated aspiration and pneumonia. Ill
explain to you what repeated aspiration means. That means
things going down the wind pipe, both liquid and solid but
most of the time its liquid because in the food pipe, the
pharynx has a chance to grab onto food, it can propel it
down, but liquid (now Im not talking about yogurt or soft
ice cream, Im talking with straight liquid) the pharynx
doesnt have a chance to grab onto it, so it can go the
wrong way.
Sleep apnea, you all know what sleep apnea is, meaning,
you know there was a term that was used a long time ago
called ondines curse and that was the curse of a woman
whose lover jilted her and left for somebody else. She said
that "when you sleep with somebody else youll fall asleep
and you wont wake up, youll stop breathing."
Weakness and gait abnormalities. Now remember a child
starts walking, starts cruising around at about 10 or 11
months of age and becomes steady on the feet only at about 2
years of age. They walk like they are on a boat, wide stance
and then they are toddling around; we have to go past that
normal phenomenon. Were talking about true gait
abnormalities, a child who has already achieved independent
walking and then has difficulty again; so a backward step.
Failure to thrive. Scoliosis is in about a third of the
patients and then developmental delay because youve got
nutritional factors that come in. |
