Laringo and tracheamalacia

Having Thomas almost 4 years after my last baby allowed me to forget a lot about newborns.  When he was born he made a lot of sounds some were squeaky sounds.  I just thought these were "newborn" sounds.  None of the nurses at the hospital or the pediatrician who checked him out said anything about them.  On our first check up with our regular pediatrician 2 days after leaving the hospital no comments were made about his sounds.  Thomas was good to go.  Only Tia Laura had said something at the hospital about his sounds but I told her they were just baby sounds.  No worries.  I nicknamed him "Squeaker Magoo".  Listen to this little video of  Thomas about a week old.

At our one month check up with the regular pediatrician Thomas was sleeping as I brought him in and the nurse heard his breathing and started asking questions.  She said she wanted to get the doctor so he could hear him before he woke him and he changed positions.  It still took forever for the pediatrician to come in but Thomas continued to squeak away so he was able to hear him.  I said "aren't those normal newborn sounds?"  The pediatrician said "no".  Not something I wanted to hear.  He checked his oxygen saturation rate - it was normal, he had us do a chest x-ray - it was normal, he also referred us to a pulmonologist at Cook's Children's Hospital for "noisy breathing".  I had thought to myself that at times Thomas had strider (noise on inhalation) which isn't normal in adults but I just wasn't sure.  Having a referral to a specialist for your new baby is not fun but I knew Thomas was growing, eating well, and that his oxygen saturation rate was good so I wasn't too worried.  Here is another clip of his squeaking at about one month old.

With some pushing we got an appointment with the pulmonologist Marcus had seen about a week later.  She was very nice but of course wouldn't say much until she did a test so she scheduled him for a bronchoscopy 2 weeks later.  During a bronchoscopy the doctor places a little camera through one nostril goes down the throat, through the larynx, passed the vocal cords and into the trachea.  They are able to visualize the anatomical structures of the upper respiratory system and look for obstructions.  It is performed awake but under some sedation so you don't feel it.  Here is some more video of Thomas at about 2 months old.

The bronchoscopy was done as an outpatient and was very quick.  The worst part was watching them start his IV so he could receive sedation medication.  There is no way to explain to a newborn what is about to happen.  There is that awful delay when a baby gets poked where the needle goes in and they don't cry for 1/2 a second and then they immediately hit full out screaming with tears.  Breaks my heart.  Plus he could't eat for 4 hours prior to the procedure and he likes to eat every 2 1/2 to 3 hours.

 His tiny little arm with a splint so he wouldn't bend the IV.

Finally done with the test and just got fed.  He was able to rest.  The pulmonologist gave us the results immediately she said he has mild laryngomalasia which is a weak epiglottis that moves into his airway above the vocal cords on inhalation (i.e. stridor) and mild tracheomalasia some weakness in the cartilage of the trachea under the vocal cords.  Basically he has a "floppy airway".  He should outgrow them by two years old as the tissues become stronger.  Overall he is very healthy and I am glad we have access to pediatric specialists to care for our kids.  So for now we wait and enjoy our "Squeaker Magoo".  It is interesting to get comments or looks from people when he is being really noisy at stores or quiet places.  One lady said "oh he's laughing", others think he is snoring, some people just stare.  I am very used to his sounds now and when I see a quiet newborn baby I stare and wait for them to squeak :)  We are extremely blessed.  I pinch myself and thank God each day for our 3 healthy happy boys.