Raspy mouth breather while capped

SammyJo · #1 03-13-2012, 10:28 PM

Is it normal for a smaller child to mouth breath and to be raspy whole time they are capped or during PMV usage. Sam has recently jumped to 5+ hrs a day capped or with an unmodified PMV (really exciting), but it is so forced and raspy the it kind of keeps me on edge the entire time. She is happy, plays, and keeps sats up. She never sounds this way during a trach change, so should I just assume this is because of the trach obstructing the airway and is normal? The mouth breathing is good for her because her restricted nasal passages, but I am wondering if many capped kids mouth breath? It seems she does it because it easier to exhale through the mouth when the breathing is more forced and not because of nasal obstruction. Thanks for any info!

Felix's Mom · #2 03-14-2012, 05:48 AM

I don't have any answers for you, but it's so wonderful that she's tolerating the cap and PMV for longer periods of time. How exciting!

principe · #3 03-14-2012, 07:10 AM

I don't know much about PMVs but I was wondering if besides capping if it also humidifies. Because if it doesn't humidify that could dry up secretions and make her sound raspy.

kshell · #4 03-14-2012, 07:33 AM

Pmv use can dry out. Capping is less drying because the upper airway I s used in a traditional way. Natalie was more dry until capped and them she was not dry but had next to no secretions

jennymclelland · #5 03-14-2012, 09:48 AM

I'm vaguely recalling some high school physics here, so let me see if I can remember enough to explain what I'm thinking.

Mouth breathing would be like putting a funnel on the end of a long skinny tube, as opposed to nose breathing which is a much longer skinny tube. I remember having to do a problem where we had to calculate the maximum length that a person could breathe through a snorkel tube. She's mouth breathing to shorten the snorkel tube that is her airway.

Will you move on to capping at night? I'm curious to see if she nose or mouth breathes when she's asleep.

Sweet Harrison's mommy · #6 03-14-2012, 11:21 AM

Fantastic news about the capping and PMV use! I know you guys have been at it for a while, so it must feel very rewarding to get to this point

Harrison also mouth breathes sometimes. I would say, 1/3rd of the time while wearing his PMV, he mouth breathes. I've never been too sure why he does this...I've always assumed it was because he is breathing around the trach tube and the mouth is just easier for him??

Not sure about the raspy voice. All that i've noticed is that sometimes, his voice seems a little gurggly...like he needs to clear it, cough, or swallow. That's the closest thing to "raspy" that we have encountered.

Good luck and keep up the good work

klhanway · #7 03-14-2012, 12:14 PM

Abby is a mouth breather because one side of her nose is completely closed off. She doesn't really sound raspy when capped, but she sometimes sounds a little gurgly. I tell her to cough, then she swallows her secretions and it is a lot better. Before her latest surgery, which was to debulk the muscle flap in her mouth, she did sound a little raspy when sleeping capped, but I think that was more of the OSA than the way she was breathing.

SammyJo · #8 03-14-2012, 09:43 PM

I am starting to wonder if it isn't related to her subglottic stenosis, sounds a little croup-like. She did well for about 3 hrs today and as she wore out her breathing got louder, so it could also just be due to forcing air around the space of the trach. We'll see how she does at decann. She could also have a small granuloma, but it can't be too large since she is able to tolerate them at all. Thanks for the input!

Jenny- We may see how she does for a little bit once she falls asleep, but she is such a pill to get to bed, I'll probably just wait until decann to do a night capped. There was no sleeping instruction from the ENT, just to worked up to all waking hours.