Christian is having trouble managing his secretions (spit) and is coughing a lot. The options are:
1. Give saliva reducing meds
2. Remove his salivary glands.
3. Give him a tracheostomy
4. Inject botox into his salivary glands
5. Pretend to be a dentist
Medicine in general has an infinite number of interventions, but in our case they are typically not recommended even if we wanted them. As I've revisited why they are worth avoiding, I'm really floored by the comprehensive nature of this disease. Sure you can remove the salivary glands, but it doesn't really help because there's too much soft tissue in the throat (caused by the disease process). Surgical options are super invasive and high risk with not much payout. Medications don't help much because swallowing is just really important if you'd like to wear no more than one shirt a day. So you get awarded a suction machine. You're jealous, I know.
Suction machines are not as gross as rectal medications, but they are up there. Not the suction part so much as cleaning the thing. I pretty much never do (sorry nurses, I love you all!). Of course, the container is clear. Some day, I'm going to manufacture opaque ones and they will be mad popular with the parents. Nurses are more or less immune to the grossness of body fluids (and the hideousness of medical equipment).
In any case, a whole lot of cortisol has already flown through the brains of the involved caretakers over the color of Christian's snot, which he also cannot wipe on his sleeves or sniffle back in. So it is proudly displayed on his face in order to evoke anxious responses for all involved.
I'm not one to get excited about these things, but when the sky is falling, it's hard not to run.
Dr. K is coming on Thursday for her first home visit for Christian. While I love her dearly, this is not a good thing. It more or less signals the beginning of the end - the end being the smooth sailing of April 2013-now. My cortisol levels are more or less a response to the impending doom I sense coming my way. I do not want to do this again.
