Apraxia of Speech & Surgery

Upon first writing about Apraxia of Speech, I made a goal to write weekly updates, and I did...at first.  As progress was slow, and our therapy schedule/routine changed, I lessened.  At the beginning of this year, the 1 year mark, I made no promises.  In my mind, I had planned to write a mid-year post on July 1.  Why do I make these goals?  I know life will get in the way.

Fun filled evenings and weekends.  Swimming every week.  Soccer.  Speech Therapy two to four times weekly.  Busy.  Summer life.

Oh, and fluid concerns...

Back at the Early Intervention (EI) assessment for Harvick & Jarrett, the therapists could not get a reading with the tympanogram - an instrument inserted in the ear (like a thermometer) that forms a seal, and a pressure test - intended to check for fluid.  Harvick is a mouth breather, and had a bit of a cold.  Jarrett was wiggly.  The therapists weren't concerned - both boys respond to commands, and passed the birth hearing screening.

When our EI therapist visited, she made mention of no result.  She wasn't content with not having a reading, so she brought the machine to our home at the next visit.  She was having issues with the machine working properly - it would error, or would read as though there was fluid.  Weird.

So, we had the boys' doctor look at their 2 year appointment.  He noticed both ears were "sucked in", but thought it was fairly insignificant - likely due to allergies (Patrick has them, and Ryder seems to as well).  So, the boys took a low-dose allergy medication.  The doctor's tympanogram results a month later showed definite fluid in Harvick's ears, and some in Jarrett's ears.

But, wait.  The boys are healthy.  They have each had an ear infection in each ear (one in Spring 2012, and again a year later).  Antibiotics resolved the issue each time.  Nothing chronic. 

An appointment with an ENT revealed Harvick has "significant and thick (mucus like) fluid".  Jarrett has the same viscosity of fluid, but slightly less.  Harvick also has enlarged adenoids (something we've suspected since birth, but without any significant issues (chronic sickness), it isn't treated).

Both boys need tubes.  In both ears.  Harvick will likely have his adenoids removed (they will do a scope when he is under anesthesia to be sure).

So, how does this relate to Apraxia of Speech?

Well, had we not been through the thick of Apraxia of Speech, Patrick & I (and our doctors and therapists) may have been concerned sooner about Harvick & Jarrett's lack of speech.   Harvick & Jarrett have still not been diagnosed with Apraxia, but it is suspected.

The surgery has a multitude of outcomes - the best case is that the tubes are a "magic pill".  That, with the fluid removed, they are able to hear clearly, which will allow them to talk clearly.  Worst case is that we are only battling Apraxia, now with no fluid to impede progress.  And, a million in between possibilities.

But, as I wrote earlier this year, we are facing this challenge head on.  Harvick & Jarrett have already received EI therapy and private therapy earlier than Ryder.  And, Ryder has made immense progress.  To think that at his 3rd birthday party he was still saying very few words, and today - Ryder's 4th birthday - he talks constantly.  Endlessly.  He is witty.  He has his father's sense of sarcasm.  He is funny, and he knows it.  He is curious & inquisitive.  He can express himself - with words.

The boys will be in surgery tomorrow morning.  The surgery is short (Harvick's will be a little longer because of the scope, and possible removal of adenoids).  Recovery time is quick as well.  We may be able to tell a difference in their speech as early as hours following.  Or, it may take a little while, as they re-learn to hear words and sounds correctly.  Or, an improvement may not come directly relating to the tubes, but with the intense Speech Therapy big brother received.

Please say a prayer for our little boys as the surgery is completed.  And, while my prayer will be that it is the "magic pill" to resolve their speech, it will be okay if it isn't.

You see, I have a love/hate relationship with this diagnosis.  Because, I want to end this post with "DAMN APRAXIA!"  Yet, I know that without it, Ryder may not be the reflective child that he is.  He understands the power of words.  He knows he can effect emotion with what he says.  He is empathetic because of it.

So.  I'll end this post as I have all other times I have written about Apraxia.

One-step-at-a-time.

Harvick, Ryder, and Jarrett
(taken at Harvick & Jarrett's 2-year-old session)