Surgery is scheduled for June 8th! Just 7 days after Joshua's birthday. I am thinking about taking him to Sea World this year for his birthday weekend, but that is a whole other post. Anyway, the ENT surgeon will be exploring his airway with a scope (camera) to determine the actual injury causing Joshua to aspirate fluids and have a weak, raspy voice. The strong suspicion is that the nerve to the vocal cord was clipped during his PDA heart surgery in the NICU and it has caused one of the cords to be paralyzed. This will be a baseline to determine the extent of the paralyzation or rule it out completely. Another possible cause could be a build up of scar tissue from the prolonged and forceful intubations he had. We are fairly certain it is the cord issue, but this procedure will tell us exactly.
At the same time they will be looking at the adnoids to make sure they are healthy and acceptable in size. Two of my sisters have a history of abnormally large adnoids and tonsils that caused them to have extreme difficulty breathing at night. In turn, they grew only minimally in their elementary years. After having the adnoids removed they grew like weeds within months! If Joshua's seem to be too large, they will partially remove them. This could be one of the factors contributing to his speech being nasaly, as well as to his slow growth. There is always a catch 22 though. Joshua also has air escaping his nose when he speaks. This means that if they remove his whole adnoid, his speech could get worse. I guess the palate when he speaks would not have any adnoid cushion to hit against if they remove it all, so it would let even more air escape the nose. This is why they will only do a partial adnoidectomy (IF NEEDED).
Now we just have to decided whether or not to cancel the heart contrast study scheduled for the same time or not. They will go through the femoral artery in the groin to his heart with a bubbly contrast agent known to cause critical and fatal reactions. It is not a simple procedure like we previously thought. Prayers are needed for this decision!