Hello! First of all, I wish to thank you for your time and offering your expertise to the boards. It is very much appreciated.:-)

My youngest son Iain is a silent refluxer, age 34 months now and has had breathing problems since birth. He was diagnosed with RSV at 11 days of age and spent 8 days in hospital for it. After that, he just got sicker and caught everything going around and began the path to FTT. He was pretty much labelled as asthmatic at 7 months of age and that is unheard of here as they wait until a child is at least 2 years of age normally. We did not acheive a diagnosis of GERD until he was nearly 15 months of age. The test they used was a milk test and it showed reflux, DGE, and "mild aspiration". I understand that this test is not the definitive test for aspiration but our pediatric allergist ended up diagnosing him as asthmatic with the GERD connection.

He is on Prevacid, Zantac, and is to have flovent every day and ventolin as required. We pull back on flovent when he is having a good spell and have had great success with that as we gauge when he is "snurgly" and begin to do the protocols as set out by our ped and allergist. We experienced a GREAT summer with minimal use of flovent, but once autumn hit we are back to using it everyday again.

With this last bout of reflux, his chest has remained clear and the ped feels he is aspirating again. (he will see his GI again in January to check this out again). He has a sinus infection that just will not quit (one month course of antibiotics with a changeover at 2 weeks, but finally is getting better on the second antibiotic). My question is that if he was diagnosed with aspiration, then would he not aspirate all the time? Or is it just when he is having a bad flare of reflux that this will occur? Right now you can hear him snurgling and the noise out of him is tremendous at times, yet his chest is clear. In the past when he has been like this his chest has been affected as well. Then again, he is on antibiotics, too which were started early on for the then suspected sinus infection.

So, to clarify a bit, how does the aspiration work? Is it all the time or only hit and miss for them during reflux flares?

Leigh,
Thanks for your question - you're my first!:grin: Aspiration is when the GI contents trickle up the esophagus (GERD) and then penetrate the larynx (vocal cords) and enter the trachea causing irritation and possibly infection. So, when Iain's GERD is well-controlled he may not be aspirating as there is little to nothing trickling up the esophagus. However, when he has a flair, I would not be surprised that he would aspirate again. In fact, it could be possible that the sinus infection is also due to the GERD, if gastric contents are leaking into the sinuses. The sinus infection could also be responsible for his snargly sounds since you're not hearing it from the chest, especially if he's fairly congested (nasal). As for the aspiration, I'm sure you're familiar with keeping the head of his bed elevated (we recommend 30 degrees minimum), and are probably already doing this.
Thanks again for asking my first question; it was a really good one. It sounds like you have your medicaiton regimen down to a science. Flovent (a steroid) is a maintenance medication, so be sure to keep using it until he is well past any symptoms, and be sure to have Iain rinse his mouth after using Flovent as it can cause a nasty yeasty thrush. I hope he's feeling better soon.

Thanks so much for your response, Lori.:-) Makes perfect sense to me. Although I must say big time "yuck" on the gastic contents leaking into the sinuses. :hairpull: Never really thought of it like that.

We do rinse out Iain's mouth after flovent use as he was a constant yeast infection boy as an infant and got it once as a toddler, too. NOT fun, so I avoid poking the bear with a big stick, if you KWIM?! l I definately make sure we do not provoke any yeast infections in this kiddo.:-)

We actually do not elevate his bed anymore.:oops: He is in a sleep and snuggle car bed and we have tried about 100 different ways to elevate it, but he constantly skips around the bed so much that whatever way he goes in is not the way he will be pointing when we go to check on him later. It is as if he is a hamster on a wheel as you never know what way you will find him in bed. When I was propping I found he just slid down and never, ever used the incline. Pillows do not work, either. When I am changing him I use a pillow, but he just snuggles a pillow in bed.

The only way I think I can get him to be more upright at night is if I duct tape him into a swing...;-)

He is still recovering and we are almost done the antibiotics. Egad. At least he is eating again!:yahoo:

Yup, that's my job - all the YUCK stuff!:burp: I hope Iain's feeling better soon!