Yet another contrast study - video fluoroscopy

Raphael had another barium swallow study test today, a video fluoroscopy. This is where they take an x-ray video of him swallowing various different textures to see what his swallow actually looks like.

Sure enough the speech pathologists called his swallow uncoordinated and there was a very clear aspiration when he was drinking thin textures, such as his Nutrini milk. There was no sign of reflux during this study but that doesn't mean that it doesn't happen at all, it just means that it didn't happen during the study.

Notably after he had a drink, later in the day, he did a massive vomit, the largest one I have ever seen him do.

Another Kind of Barium swallow attempt #2

This time it went well. Tube in, down to x-ray, short wait, the correct radiologist was there (phew) and the barium swallow was done with the appropriate x-rays. The result was even good news (not something that we were used to getting). There was no communication found between the oesophagus and the trachea.

Another Kind of Barium swallow

We arrived at the Paediatric Ambulatory Care Unit (PACU) on time to have the tube inserted for a barium swallow test but after waiting for a short while a nurse came out and sad “You are not supposed to be here today, it is for next week”. After a short some verbal negotiation she went back to check her calendar again and came back admitting that it must have been booked in her diary wrong as we definitely have a barium swallow X-ray booked for today.

We went into a treatment room and wrapped Raphael up in a blanket to immobilise his hands and then the procedure began. She measured the length of tube that she would need, lubricated the end of it and then slid it up his nose and slowly down the back of his throat. Of course he wasn’t very keen on this and thrashed his head from side to side (oops, I was supposed to be holding his head firmly to stop that). The poor boy gagged and choked and coughed and of course this made it all the more harder for the nurse to get the tube inserted. Finally it was over and the tube was tested to make sure it was in his stomach by sucking some bile out and testing it on some litmus paper.

Finally when we got to x-ray a puzzled radiologist asked us if we knew why he was asked to perform this procedure as the order from the paediatrician specified a particular radiologist was to perform the x-rays. He was very nice and very apologetic of the obvious administrative error that had occurred. After a phone call to our paediatrician, he confirmed that it would not be worth him performing the test. He informed us that his specialities were livers, kidneys, breasts, and penises and if we ever needed x-rays for these then he would be the man to see but the last paediatric barium swallow that he did was a long time ago and he would not be confident that he would be the best person to perform the procedure on Raphael. We agreed and were very civil about the whole thing, but afterwards Annie and I had a good rant to each other about the time that I had to take off work and the pain my boy had to suffer for no reason.

Barium swallow

This is turning out to be a very busy day. Went to have a Barium swallow performed at Calvary hospital with a paediatric radiologist persent. For this test he laid on an x-ray table and was presented a bottle with barium meal in it to drink. To my surprise he hungrily gulped down this apparently milky substance and a series of chest x-rays were taken of him. These showed that he aspirates a bit (sucks the fluid into his lungs), he has significant gastro-oesophageal reflux and that his oesophagus may be being slightly squeezed by an artery.