What questions will I be asked at my first visit?

Your doctor has suggested that your child may have some breathing or airway problem which he wishes us to evaluate. We know that a child's breathing problem can be very alarming to parents and we would like to help you before your first visit to our office. The answers to questions such as the following will be very important in the decision-making process.

• How old was your child when the problems began?
• Does any one position make the problem better or worse?
• Is there any difficulty such as choking, gasping, or turning blue during feeding?
• Have you noticed that your child stops breathing for periods of time longer than 10 to 15 seconds?
• Does your child's breastbone suck in when he breathes?
• Does your child snore, turn blue around the lips or fingers, sleep restlessly, or sleep walk?
• Is your child over- or underweight?
• Has your child started to wet the bed when he sleeps?
• Is your child a mouth-breather when he does not have a cold?
• Did the problem begin after a coughing spell or when he was left with children or an inexperienced sitter?
• Is your child's voice hoarse or is his cry weak?
  

What types of tests might be done?

When evaluating airway problems, it is often necessary to obtain x-rays that show the windpipe, lungs, swallowing mechanism, and possible reflux of stomach acid up into the back of the throat. If you have had such studies, please bring copies of the x-rays and the x-ray report as well as any other medical records with you. Occasionally, we will need to repeat a portion of these studies. Our x-rays may be done on a day before you are seen or on the day of your visit to the ear, nose, and throat doctor.

What do I do to prepare for my visit?

On the day of this first visit to the ear, nose, and throat doctor, we request that your child have nothing solid to eat for four hours before the scheduled appointment and nothing to drink for two hours before the appointment. When the doctor sees your child, he will perform a complete ear, nose, and throat examination. Upper airway blockage can occur due to narrowing of the nasal passages, enlarged tonsils, and/or adenoids, a large tongue, collapse of the upper part of the voice box, a paralyzed vocal cord, or growths on the back of the throat or on the vocal cords.

How is the test performed?

To evaluate these areas, medicine will be placed in the child's nose and a small, lighted, flexible instrument will be passed through the nose and into the lower throat. This allows the doctor to see the motion of the vocal cords as well as other areas not visible with a tongue blade. We do not wish to sedate the child with medication at this time since this could make the airway problem worse. It is possible to show this portion of the evaluation to the parents on a television screen. This flexible scoping and review of x-ray data will usually complete this initial evaluation.

Does my insurance cover this test?

Please note that some insurance plans do not cover our costs for these procedures. Benefit reimbursement may be limited and you may be responsible for the balance.

When will I get the results of my test?

If it is possible to make a diagnosis, a treatment plan will be outlined. However, sometimes the results of these studies are not definite. On some occasions it is necessary to examine the child in the operating room while he is asleep to be able to see the airway below the vocal cords. In other cases, it is necessary to evaluate the breathing abnormalities when the child is sleeping naturally. This is called a polysomnogram (pahlee-SAHM-noh-gram), or sleep study. Both of these special studies must be scheduled later.

U-M Health System Related Sites:
Sleep Disorders Center