With the lack of sleep Garak has been getting, the neurologist referred him to a pulmonary specialist. We had a sleeping study done on Garak which brought to life some new issues.
Below are the highlighted points of the sleeping study:
The swallow study was to see if he was aspirating his food, and if so, to what extent. When they were readying for the swallow study they warned us that they don't always capture an aspirating event. Unfortunately, after the 3rd swallow he aspirated his food. What he did they call a 'silent aspiration' which means he did not show any sign of aspirating (no coughing, no flaring nose, no gagging, etc). At this point, that stopped giving him the regular liquid and they tested a nectar consistency (basically just thickening it up). Again after 2-3 swallows he aspirated (silently). We moved up to the honey consistency (even thicker) and at this consistency he started aspirating but caught it himself and cleared it. They were comfortable to say that at a honey thickness he does not aspirate and that it is safe to feed orally at that thickness.
A few days later we did the upper GI study which showed a small amount of reflux, and it appeared he didn't aspirate the reflux.
At this point, we were told to only give him formula which we needed to thicken with some gel product called 'Simply Thick'.
Below are the highlighted points of the sleeping study:
- He has obstructive airway apnea. When not in REM sleep, he has it 28 times an hour, during REM he jumped up to 46 times an hour.
- He takes him 120-160 mins to reach REM sleep, normal is 20-40 mins
- He is only getting approx 1-3 hours of REM sleep each day, normal is 12-15 hours.
The swallow study was to see if he was aspirating his food, and if so, to what extent. When they were readying for the swallow study they warned us that they don't always capture an aspirating event. Unfortunately, after the 3rd swallow he aspirated his food. What he did they call a 'silent aspiration' which means he did not show any sign of aspirating (no coughing, no flaring nose, no gagging, etc). At this point, that stopped giving him the regular liquid and they tested a nectar consistency (basically just thickening it up). Again after 2-3 swallows he aspirated (silently). We moved up to the honey consistency (even thicker) and at this consistency he started aspirating but caught it himself and cleared it. They were comfortable to say that at a honey thickness he does not aspirate and that it is safe to feed orally at that thickness.
A few days later we did the upper GI study which showed a small amount of reflux, and it appeared he didn't aspirate the reflux.
At this point, we were told to only give him formula which we needed to thicken with some gel product called 'Simply Thick'.
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