Another appt, another diagnosis

Yesterday, we had an appt with Dr P who is the pulmonary doctor.  We started going to him because Jacob was having some shortness of breath and he was having some major dips in his oxygen sats.  So our pediatrician sent us to see Dr P.  When we first went to him, he said that he was shocked at how well Jacob was doing when it comes to his breathing.  He said that he has Jacob on his watch list and any time we get admitted for anything breathing related, I need to call him ASAP!  Well after listening to what has been going on, he wanted a sleep study done.  We got it done and went back to his office for the results.  He said there wasn't much on there and he was surprised that it wasn't worse.  Well that is...until our last appt.  He looked at the sleep study again and totally missed something the last time.  They put this little part in his nose and it measures how much he is breathing and how much air is getting through.  Apparently, not much is getting through his nose.  So she said that it could very well be something called upper airway resistance syndrome.  He read that and said...ah ha!  The missing piece of the puzzle.  So he said he wanted a cat scan done of his sinuses.  I remembered that about a year ago Jacob got a MRI of his brain and I remember that it said something about his sinuses in the report.  And so I told him that I am pretty sure he can look at the MRI and see what he needed.  So off he went to look at the MRI and he said...yep, exactly what I was looking for!  He called me over and showed me what was going on.  In a normal persons sinus cavity, your sinuses are straight.  In Jacobs, the left one is straight but the right one curves.  So its blocking most of the air coming through.  Upper Airway Resistance Syndrome  is.. During sleep the muscles of the airway become relaxed. The relaxation of these muscles in turn reduces the diameter of the airway. Typically, the airway of a person with UARS is already restricted or reduced in size, and this natural relaxation reduces the airway further. Therefore, breathing becomes labored. It can be likened to breathing through a straw.  And to top it all off, Jacob always has lots of sinus drainage.  So that's even more blocking his airway.  

So what does that mean for Jacob?  Well, he is now going to be on oxygen at night to help him breathe better.  He is also going to be on hydroxyzine and hopefully that will help his allergies a little bit.  We are also going to start a nasal spray and hopefully that helps as well.