Intro, EFA's, surgery and adenoid removal.....

[Guest guest]

Hello to all,

I have been reading these boards and gathering info for awhile now but haven't

introduced myself so I thought this was a good time to do so. I am in Canada,

Toronto to be exact and I have two great children. Jenna is 16 months (speech

seems on target) and (4 yrs Nov. 16th) who's SLP suspects apraxia and

dyarthria. He is currently with a SLP 2x per week doing PROMPT therapy and I

have seen progress (however slow). He is taking PRO efa and he works very hard

at his sounds. He is due to have his adenoids removed Nov. 21st. Do I need to

take him off the efa's before surgery? Doc said shouldn't be a problem but

wanted " your " advice as well. I recently have read some info about probs with

adenoid removal and oral motor children. I think I may ask to have a partial

removal but I wanted first hand information. Are there parents on these list

servs whose children have had adenoid/tonsils removed who are

apraxic/dysarthric? If so, any advice, info., concerns etc that I should know

before doing this. I am quite worried about it He has sleep apnea and snores.

The ENT says he has the breathing space of about a crushed straw so he needs

something done, however I don't want him to have further speech issues. Thanks

so much for any input and thank Goodness for these boards, I have learned more

reading from fellow parents than I could have possibly anywhere else.

[Guest guest]

Hi ,

I have a 7 year old with dyspraxia and dysarthria. He had his tonsils

and adenoids out when he was 3 1/2 (wasn't on Pro EFA yet). Since that

surgery, somehow his adenoids grew back and filled up his breathing

space again. The new ENT said that it was probably because during the

first surgery they didn't remove all of the tissue, so it regenerated.

So, we had his adenoids removed again. I called Nordic Naturals about

stopping Pro EFA and they said to stop it 2 weeks prior to surgery. I

did it just to be safe, although the ENT didn't feel it was necessary.

I didn't see a regression in those 2 weeks and started him right back on

Pro EFA after he was healed.

I'm not sure what the problem is with adenoid removal and oral motor

children, so I can't comment. But he hasn't had a sinus infection since

his adenoids were removed and he has stopped snoring.

Liz Dunn - Mom to 7, oro motor dyspraxia, dysarthria

MacGregor wrote:

> Hello to all,

>

> Are there parents on these list servs whose children

> have had adenoid/tonsils removed who are apraxic/dysarthric? If so,

> any advice, info., concerns etc that I should know before doing this.

> I am quite worried about it He has sleep apnea and snores. The ENT

> says he has the breathing space of about a crushed straw so he needs

> something done, however I don't want him to have further speech

> issues.

[Guest guest]

-Hi ,

I had privtatly emailed you but will post this just in case. Jack my

oral apraxic son had his adenoids removed in late August of this

year. I too stopped the Efa's 2 weeks prior to surgery. He only had

his adenoids out and did wonderfully. I have never heard of having

issues with with adenoidectomy and oral motor issues in children. I

think that the adenoid removal is a good step with all the issues he

is having especially the breathing issue which can affect speech.

Jack was very nasally amongst other issues and now everything is

fine. Did you speak to your dr. about this concern you have, if not I

would before you do surgery. I would assume that his Dr. would know

if there is a problem between the 2 and able to answer your

questions. Sleep apnea is a very large concern and you need to weigh

the issues with his Dr. I did lots of research on this removal of

Adenoids before his surgery as well as post here and speak to his ENT

about my concerns with; adenoids growing back, sleep, snoring, etc. I

felt very confident when going into it and that is how you should

feel too. But my point is never was it a topic about Oral motor

issues and Adenoidectomy and JAck has Oral Apraxia low tone so I

would hope I would have come across that.

Good Luck,

Eileen

-- In @y..., " MacGregor " <gina1627@r...>

wrote:

> Hello to all,

>

> I have been reading these boards and gathering info for awhile now

but haven't introduced myself so I thought this was a good time to do

so. I am in Canada, Toronto to be exact and I have two great

children. Jenna is 16 months (speech seems on target) and (4

yrs Nov. 16th) who's SLP suspects apraxia and dyarthria. He is

currently with a SLP 2x per week doing PROMPT therapy and I have seen

progress (however slow). He is taking PRO efa and he works very hard

at his sounds. He is due to have his adenoids removed Nov. 21st. Do

I need to take him off the efa's before surgery? Doc said shouldn't

be a problem but wanted " your " advice as well. I recently have read

some info about probs with adenoid removal and oral motor children.

I think I may ask to have a partial removal but I wanted first hand

information. Are there parents on these list servs whose children

have had adenoid/tonsils removed who are apraxic/dysarthric? If so,

any advice, info., concerns etc that I should know before doing

this. I am quite worried about it He has sleep apnea and snores.

The ENT says he has the breathing space of about a crushed straw so

he needs something done, however I don't want him to have further

speech issues. Thanks so much for any input and thank Goodness for

these boards, I have learned more reading from fellow parents than I

could have possibly anywhere else.

>

>

[Guest guest]

Hi and welcome!

Are you also a member of ECHO of Canada -it's a wonderful resource

for you as well. Rhonda (the co founder of EHCO) is one of the co-

founders of Speechville http://www.speechville.com and there are

many resources there for Canada as well!

Regarding your question about EFAs and surgery. For now most

experts suggest stopping the EFAs a week or two before the pediatric

surgery and then starting again a week or two after just for

precautions. Even though in adults there is no links between those

patients like my mom going through heart attack and increased

bleeding from the EFAs -just the opposite -there is only one way to

know for sure in our children. And I'm sure you have other things

to worry about as your child prepares for surgery.

You may notice a regression when you stop the EFAs -but once you start again

you'll notice another surge. Just on a side note for a moment on

stopping. It just came up about EFAs and tantrums. I noticed that

Tanner had tantrums when he was little and I switched him to a pure

Omega 3 formula -or gave him too low a dosage..and especially if I

stopped the EFAs -crying tantrums! I no longer stop the EFAs for

Tanner nor lower his dosage now that we know. I greatly suspect the

tantrums in Tanner's case were because he was able to do and

get " it " when on, and then suddenly it slipped away again when off. I was

thinking

about the mom who said she noticed the tantrums when she switched

her child from a generic brand of EFAs to ProEFA. I suspect the

dosage of the generic was higher because most are -and most of us

instead only start with a very low dosage with the ProEFA formula -

and yet the child's system may have been accustomed to a higher

level. Of course that's just my hunch -but after years of seeing

what happens with various formulas -which I encourage you to all try

at some point -you will see it's all in the formula -and the

dosage. (and quality matters too of course!)

Some here have reported not stopping EFAs prior to pediatric surgery

with no extra bleeding at all -but in the sue happy times we are in -

I don't think you will hear anyone (esp a professional) suggest it

until it's proven.

The closest you will hear to it being OK is what Marilyn Agin MD

stated here

" The only way we are going to know for sure is to do a bleeding time

on a group of kids on EFAs. It is a blood test to check how fast

your blood clots...

In summary, we should say the EFAs appear to be safe and are

unlikely to cause bleeding... but we typically advise parents to

check with their pediatricians in these situations. "

Here is another article I found on bleeding and PUFAs:

From Bender NK, Kraynak MA, Chiquette E et al Effects of marine

fish oils on the anticoagulation status of patients receiving

chronic warfarin therapy J Thrombosis and Thrombolysis 1998; 5:257-

261

" Only one patient developed bruising and there were no major

bleeding episodes...the authors concluded that fish oil supplements

at doses of between 3 and 6 grams per day did not affect the

anticoagulation status of patients receiving chronic warfarin

therapy. "

Effect of fish oils on anticoagulant status

Warfarin is commonly prescribed to reduce coagulation risk among

patients suffering from cardiovascular disease to help prevent

thromboembolic events. However, warfarin's narrow therapeutic window

means that interactions with other drugs can lead to complications

ranging from clinically insignificant changes in the International

Normalized Ratio (INR), a measure of prothrombin time, to

potentially fatal haemorrhages.

Moreover, physicians and patients increasingly use omega-3 LC-PUFA

supplementation to reduce cardiovascular disease risk. While many

producers of omega-3 supplements advise patients not to use fish

oils if they take anticoagulants, little evidence supports this.

Indeed,

one previous study suggested that while fish oils may slightly alter

INR, the decrease in clotting time was not sufficient to warrant a

dose reduction for warfarin. To obtain some determinations in this

regard, a study from the University of Texas* assessed the impact of

concurrent omega-3 LC-PUFA supplements in patients taking chronic

warfarin.

INR values for each fish-oil treated patient

Over a four-week placebo run in, the authors measured INRs in 16

patients. If stable, patients randomly received either placebo, or 3

or 6 grams of fish oil daily for four weeks. The authors measured

INRs and assessed adverse events twice during that time.

Over the run in, two patients withdrew due to non-compliance and

three following unstable INRs, leaving three subjects in each fish

oil group. The remaining eleven patients completed the study.

By the end of the study, there was no statistically significant

differences in INRs between the placebo period and during

supplementation or between the various groups. Only one patient

developed bruising and there were no major bleeding episodes.

On the other hand, the study was relatively small and may be too

short to detect delayed interactions. However, the authors argue

that the patient population was large enough to detect any

statistically significant difference in INRs, and most common

interactions with warfarin emerge within four weeks.

As a result, the authors concluded that fish oil supplements at

doses of between 3 and 6 grams per day did not affect the

anticoagulation status of patients receiving chronic warfarin

therapy.

* Bender NK, Kraynak MA, Chiquette E et al Effects of marine fish

oils on the anticoagulation status of patients receiving chronic

warfarin therapy J Thrombosis and Thrombolysis 1998; 5:257-261.

http://www.medev.ch/pufa/pufa9903.htm

Good luck with all!

=====

[Guest guest]

,

My daughter had surgery last Thursday and the Dr. said to stop the EFA's on

Monday prior to the surgery. The EFA's do thin the blood somewhat from what

I have read and heard.

Hope this helps,

Sheila

[Guest guest]

was looking into dysarthria. when was your son diagnosed? i was wondering

because it says can be caused by brain injury. my son had 2 surgeries for

hydrocephalus and still has no speech at 3.. i'm thinking he was apraxic but

many on the board here are writing that their children have dysarthria too.

looking at the websites can be confusing. it says they overlap but what is

the actual difference between the 2 in laymans terms?

thanks

lori

[Guest guest]

Hi Lori!

Easy question! Dysarthria is weakness of the muscle.

Apraxia/dyspraxia is where there is a motor planning problem in the

muscle. In dyspraxia -they know how to move -they just don't have

the strength to do it. In apraxia -they have the strength to do the

action -they just can't figure out which way to move.

Layman's terms from me to clarify that confusion? Apraxia is like

trying to braid your hair while looking in a mirror. Dyspraxia is

like trying to move a fork with an overcooked wet noodle.

Of course the severity of one or the other can vary from mild to

severe -and yes -they can stand alone or overlap. My son Tanner had both.

Neurodevelopmental MDs with SLPs/OTs will know which or both your child has.

=====

[Guest guest]

Sorry -just had to add this too!

Apraxia and dysarthria together is like trying to move a fork with

an overcooked wet noodle while looking in a mirror. )

=====

[Guest guest]

First thank you all for all the advice and comments, I appreciate the all.

With regards to Dysarthria and apraxia. I think what wrote is

excellent. has a weak tongue, esp. the tip so he tends to use the

back of his tongue for everything. For instance /g/ is often heard in his

words. /f/ is hard so for four he might say gore or /f/..gore. The

transition is hard for him. His SLP is trying to strengthen the tongue tip.

Mommy to and Jenna

From: " kiddietalk " <kiddietalk@...>

Subject: Re: Intro, EFA's, surgery and adenoid removal.....

Sorry -just had to add this too!

Apraxia and dysarthria together is like trying to move a fork with

an overcooked wet noodle while looking in a mirror. )

=====

[Guest guest]

, I just read your post and just had to respond--ironically, my Kara

has the opposite problem as your in that it's the back of her tongue

that is weak to the point of being completely flaccid. All of her back

velars (/g/ and /k/) and fronted to d and t--the opposite of ! Her

SLP's (she sees one privately, one through the school district) are working

on strengthening the back of her tongue so that she will hopefully

eventually be able to raise it to her palate to make her g's and k's.

It's sad to me that she can't tell someone what her name is in a way that

can be understood--the closest she can get is " Tawa " . I sometimes wish I

HAD named her " Tara " or " Bonnie " or something that doesn't require the back

of her tongue! When the day comes that she can say her name clearly, I will

do handsprings and cry buckets!

Anyway, I just had to write...I hope the day comes when Kara and

(and all of our kids) can pronounce d, f, k, g and everything in between!

Take care,

, thanks for taking the time to share about Khalid's dance. Khalid

is such an inspiration.

Janice in San Diego, mom to Liana and Kara

>Date: Wed, 30 Oct 2002 23:24:14 -0500

>From: " MacGregor " <gina1627@...>

Subject: Re: Intro, EFA's, surgery and adenoid removal.....

>

>First thank you all for all the advice and comments, I appreciate the >all.

>

>With regards to Dysarthria and apraxia. I think what wrote is

>excellent. has a weak tongue, esp. the tip so he tends to use >the

>back of his tongue for everything. For instance /g/ is often heard >in his

>words. /f/ is hard so for four he might say gore or /f/..gore. >The

>transition is hard for him. His SLP is trying to strengthen the >tongue

>tip.

>

>

>Mommy to and Jenna

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