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Mouth Breathing, Runny Nose, Sinus Issues? Could it Be….?

September 27, 2012

My dear friend, L., was kind enough to agree to post about her family’s long journey with her son’s language delays and how it related to enlarged adenoids.  What a lovely, giving gesture she has done by writing down her story for this blog and I am extremely grateful.  She and I both hope it will help another family somewhere at some time.

From L:

I hope is this post helps parents identify an under-diagnosed complication with young children – enlarged adenoids.  This is a story about the two year journey my dear son had to take because my pediatrician failed to diagnose a simple issue.

As a baby, my son did everything early; crawled at five months, walked at eight months and uttered his first words at less than a year old.  So just before he turned two, I became a little concerned that he wasn’t talking more.  Most of the words he uttered were just nouns, unable to link more than a couple of words together.  My husband, a physician, thought I was worrying over nothing.  My sister, a pediatrician, affirmed by husband’s opinion. My son had never had an ear infection so it never even crossed my mind that his hearing might be an issue.  The only physical symptom he exhibited was a chronic runny nose.  The runny nose started around the time he turned one, and it never stopped.

As a first- time mother, I brought my son into the pediatrician for every little ailment.  In the first six months, my pediatrician said my son’s symptoms were signs of sinusitis and treated my son with antibiotics.  By the end of the year, my son had been on various antibiotics.  My pediatrician said he was “just one of those kids” that was prone to sinus infections, and he would eventually grow out of it.  He never did.

My son’s speech was not improving.  He was growing increasingly frustrated that the people around could not understand him.  I never knew when the next tantrum was going to come…and it always came with vengeance.  I had no idea what was happening.  Friends and play dates were non-existent.  The few play dates I did have were not good.  My son would sequester himself in his room, and his poor friend would play by himself.  I just told myself “he was just tired.”  But in my heart, I knew there was something wrong.

Just before he turned three years old, I decided to pursue Early Intervention.  I had various specialists come in to evaluate my son.  Their reports were beyond upsetting – in various areas, he was functioning in the poor range – cognitive, communication and social-emotional.  At the final meeting with the EI team, the coordinator suggested that we give my son an autism diagnosis.  By giving an autism diagnosis, my son could have access to plethora of services.  I refused the diagnosis. The coordinator suggested that I was an “enabler.” She believed I was the cause of his delays. I was horrified. I quickly needed to look beyond the insult and realize that I was here to get services for my son. EI recommended occupational therapy and speech therapy. In addition to the public services, my son started to see a private speech therapist. My son saw his private speech therapist twice a week. They worked on play skills and how to have basic conversations. The sessions were as much to help my son as they were to help me. After every session, my son’s therapist reassured that everything was going to be okay. Visits to an audiologist and an allergist yielded nothing.

By this time, he was in a local 3s program. Within the week, the teachers knew there was something wrong with my son.  The school requested that an evaluation be conducted. At three years old, he was speaking at the level of a young two year old. The classroom setting was so overwhelming for him.  Circle time was an unmitigated disaster – he became so resistant to circle time that I had to pick him up early from school just so he wouldn’t have to participate. The school suggested having a SEIT (special education itinerant teacher). His SEIT helped him navigate the social complexities of a classroom.  She was his voice in the classroom.   In addition to working with my son in the classroom, we had weekly meetings to discuss my son’s areas of weakness and progress.  After a few months, she suggested that my son had APD (auditory processing disorder), a neurological disorder that impedes an individual from processing sounds.  How could this be?  He had an amazing memory, sang songs, loved being read to, and knew all the letter sounds.

Just before my son turned four, at one of my son’s weekly speech sessions, his therapist was surprised to see him with a severely runny nose in the middle of the summer. She insisted that I take him to a pediatric ENT.  I immediately scheduled an appointment. At the appointment, I was shocked by the diagnosis. My son had enlarged, infected adenoids. The adenoids obstructed almost 100% of his nasal passage. The ENT believed this was the reason for  my son’s speech delay. Additional symptoms of enlarged adenoids include snoring, bad breath, frequent “sinus” symptoms, talking as if the nostrils are pinched, ongoing ear middle ear infections or middle ear fluid in a school-aged childand mouth breathing.

I had such mixed emotions. I was relieved to finally have an answer. I was frustrated and angry that my pediatrician had never suggested that I take my son to see an ENT.

My son’s surgery was scheduled for August 2011. After the surgery, he was a different kid. He was more responsive, more talkative, and most importantly, happy.

My son had his adenoidectomy two years ago. He is a bright, happy, very talkative, gregarious, well-adjusted kid with lots of friends….without a runny nose. I often wonder how things might have been different had I received the diagnosis earlier. My sister, a pediatrician, recently told me that one of her patients exhibited the same symptoms as my son – chronic runny nose with no history of ear infections. Her patient also had enlarged adenoids and saw significant changes in her patient’s speech once the adenoidectomy was completed. Instead of thinking about what I could have done differently, I try to focus on how my son’s story can help someone.