Vocal Cord Scope

This is Erika again (sorry if this is confusing). I visited Carrie and Toby this afternoon. While I was there they had a consult with Neurology. The neurologists want to do an MRI tomorrow to see what is going on with the "Chiari" malformtion in his brain. This malformation causes part of his brain to compress into the brain stem and spinal canal.

The Ear/Nose/Throat doctors also came and did a scope of Toby's vocal cords. They inserted a long, thin camera through his nose. This did not make him very happy! Carrie and I were able to watch his vocal cords in action. Afterwards, the doctor replayed the tape for us and explained the things we were seeing. First of all, there is some cartilage that is usually taut, but in Toby's case is swollen and flopping over his airway. The right vocal cord is not working as well as the left and when the vocal cords are supposed to be open, they close and when they are supposed to close, they sometimes open. Basically, the conclusion was that the brain malformation was putting pressure on the nerve that controls the vocal cords and swallowing. The severity of this condition fluctuates. That's why sometimes his cry sounds better and why he has trouble breathing sometimes and not others. They will just have to monitor him and make sure it doesn't get any worse. When I left they had lowered his oxygen from .2 liters to .1 and he was doing great!

The MRI tomorrow will determine if he is eligible for surgery to "decompress" his brain. The neurosurgeons do this by removing some bone from his head. Then the brain has more room and isn't pushing on the nerve. Carrie isn't sure they perform that surgery on a baby as young as Toby, but they will find out tomorrow.

Pray for wisdom as doctors discuss the options!