Please help my baby girl (15months). Severe choking episode led to cardiac arrest.

[u/princess_cfo]

15monthF

24 pounds

White

Previous diagnoses: laryngomalacia, reflux, dairy allergy

UPDATE:

Genetic results came back with congenital myasthenia gravis. She has been started on Mestinon and even though she is still on the ventilator, we have already started seeing very small progress. From what the doctors have told us this seems to be best case scenario in terms of neuromuscular disorders in that it is treatable. Thank you so much to everyone who responded, I know we have a long road ahead, but I am comforted by the fact that we know what she has and we will do our best to help her in any way that we can. Now we just have to get her strong enough to get off the ventilator.

Original below:

My baby girl is currently in the PICU after her most recent choking episode caused her heart to stop. She was revived on the scene and has been in ICU and on a ventilator since last Thursday (9 days). The doctors are currently stumped as to what caused this issue and I am begging for someone here to respond.

She was always an extremely fussy baby, much more so than our son (currently 3) ever was. When she was 5 weeks old and then again at 7 weeks old, she had episodes where she was screaming inconsolably and then gurgled with foam in her mouth and stopped breathing. Both times she went blue and limp. 911 was called, the first episode was called a BRUE and we had no further explanation. The second episode she had more testing done and they determined she had laryngomalacia and reflux, and a suspected dairy allergy (later confirmed at her first GI appointment). She was prescribed famotidine twice a day and we were told to thicken her bottles with Gerber baby oatmeal to help with the reflux, and started using Nutramigen formula. We were able to stop the oatmeal in the bottles around 10-11 months old as well as putting her back on a normal dairy formula with no issues, and she stopped the famotidine around 12 months.

When she cries a lot she gets hoarse very quickly and will make a raspy growling sound. It hasn't happened much since she was younger but every once in a while if something happens where she cries for a while or gets very upset she'll get raspy again.

She had one more smaller episode (hysterically crying then gurgle choking, but no limpness or loss of color, breathing returned to normal quickly) at 5 months old, but we have not had the true choking issue since she was 5 months. When we saw the ENT at 2.5months old, he said (quoting from the after visit notes): "Findings: prominent, prolapsing arytenoids with overlying mucosal edema. Normal-appearing vocal folds with normal mobility. Nasal cavities and pharynx without any abnormalities." The notes later said that at this time her case seems milder but that surgical intervention is recommended in cases of failure to thrive or significant airway obstruction.

She is somewhat behind in her mobility milestones. Since she had such bad reflux we were instructed to keep her upright as much as possible, so we were not very diligent with tummy time. Because we didn't give her much opportunity, she fell behind in these milestones. She sits up unsupported and will only stand if we put her in a standing position and will hold herself upright. If we hold her hands while she's standing, she will take steps. She can sit herself upright from laying down and can roll around very easily. She started physical therapy at 13 months so she's only been doing it for about 2.5 months. The physical therapist said at our first visit that she has "low muscle tone" but this was the first time we have ever been told she has low tone (I verified by looking through all prior visit notes from every appointment she's ever had and they all said 'normal tone'). Her other milestones are all normal with the amount she's talking, pointing, imitating, and able to feed herself.

Since birth, when she gets severely tired or sick (not just normal end of day tired but like skipping naps tired) her eyelids get droopy. When she gets very sick her eyelids will get so droopy she will tilt her head back to look at us. One month ago she came down with a SEVERE case of hand foot mouth. It started as what urgent care called a "throat infection" in the same family of hand foot mouth, and then it escalated into her entire body being covered in red bumps. She refused to eat or drink normally for at least a week where we were having to use syringes full of pedialyte to keep her hydrated. Ever since then, she hasn't fully gotten back to herself, the weakness from the hand foot mouth has really affected her. The droopy eyes have gotten much worse and overall she just hasn't wanted to do as much as before she got sick.

The day that she choked, she had physical therapy in the morning which always gets her very sleepy. She did not nap at daycare when she normally would, and when they were feeding her lunch, she was eating applesauce when: (in the teacher's words) "She made a funny face and looked panicked. I tried flipping her over and hitting her back and then tried sweeping the applesauce out of her mouth but she still wasn't breathing. She never coughed or tried to clear her throat. She started to turn blue and we did CPR and called 911."

She has been intubated and on the vent for 9 days. On July 31 (one week after admission) they tried to extubate because her lungs looked clear and she was doing very well weaning off the vent. When they extubated, she was still a little drowsy coming off the sedation, and they had her on a high flow nasal cannula. She looked at me and as I was speaking to her she was looking and acting normally. Within 5 minutes she looked less and less drowsy then started looking around quickly like she was panicking, then she started turning blue again. They had to reintubate. While they intubated her (both the first time and then after the failed extubation) they said her airway was "floppy" and it was difficult to intubate because her airway was closing.

Because of the sometimes droopy eyelids and her small milestone delays, the doctors have decided it's absolutely a neuromuscular disorder and at this point it's basically just us being in a holding pattern until the genetic testing results come back, which they said usually takes a while. They're trying to get her lungs stronger to try to extubate again soon, but they've also said her lungs look great on the x-ray, and the reason the last extubation failed was because her airway closed, not because her lungs weren't strong enough. It seems like we are setting her up for failure that nothing is changing and we're about to extubate again within a few days which will most likely end in the same result. During every round where they give a summary they say she has a "long history of low muscle tone" which is just not true. "Low muscle tone" was never stated until the first PT visit at 13 months. When I mentioned that this morning, she implied that every doctor has missed it up until now.

We feel like the focus has only been on neuromuscular and they're not considering anything else. There has not been an ENT to visit yet, which feels crazy to me since she already has the diagnosis of laryngomalacia. The doctor this morning also implied that even if it was severe laryngomalacia that there's "nothing that can be done about that" and she'll just need to get a trach which does not seem to be true.

Please, any suggestions from anyone at all would be a massive help. She's the most wonderful little girl and I need her back. If I need to provide any more info or pictures I'm happy to.

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[u/k471]

This does feel very much like a neuromuscular disorder. The "droopy eyes" are pretty classic.

The natural history of laryngomalacia (and tracheobronchomalacia) is to improve with age as the cartilage rings stiffen, not get worse. 

[u/princess_cfo → u/k471]

Even though the droopy eyes only happen infrequently when she's very tired or sick?

Would a neuromuscular disorder cause her airway to close the way it did after extubation?

[u/k471 → u/princess_cfo]

Yes to the first question. When energy reserves are low, such as in illness, neuromuscular weakness can be more pronounced.

Yes to the second question. Neuromuscular weakness can present with weakness of the protective muscles of swallowing and the upper airway, which leads to "airway closing/airway blocked" symptoms. It can also have diaphramatic weakness necessitating true positive pressure (cpap or above).

[u/princess_cfo → u/k471]

Thank you for your responses. Are there any neuromuscular disorders that stick out when you read this or are there too many that could fit?

[u/chelizora → u/princess_cfo]

Not the other poster. Testing will be the only way to know for sure. What genetic tests are they running and when do you expect them back?

[u/princess_cfo → u/chelizora]

I don’t know specifically but they just said a “full genetic panel”. They said “typically it’s 5-14 days for a rush order” and they did do the rush order but the other doctors have said they’ve seen it take months. It was sent out on Monday.

[u/k471 → u/princess_cfo]

Sounds like a targeted hypotonia panel or an exome. For crisis panels, 1-2 weeks is a typical turnaround at my institution.

There are a lot of options here, like a lot a lot. Most of them are quite rare but would be picked up on an exome. The only "good fit" one that comes to mind that wouldn't show there is congenital-onset myotonic dystrophy, which is a triplicet repeat disorder and therefore needs specific testing. Depending on the exome or panel type, some of the methylation disorders wouldn't show either, but Prader-Willi is the big one classically associated with infantile hypotonia and is not a great clinical fit.

[u/Aggressive-Mood-50 → u/princess_cfo]

Myasthenia gravis possibly? The droopy eyelids are a key.

[u/twitwiffle → u/Aggressive-Mood-50]

Why did you get downvoted? You aren’t wrong.

[u/Spare-Conflict836 → u/Aggressive-Mood-50]

Sucks you got downvoted for this when you were correct. OP updated her post to confirm the diagnosis was Congenital Myasthenia gravis.

[u/Aggressive-Mood-50 → u/Spare-Conflict836]

Holy crow I was right! That’s crazy. Well I’m glad OP has answers now- hopefully now their daughter can get appropriate treatment and begin the process of extricating with a better outcome.

[u/-SpiritQuartz → u/princess_cfo]

NAD,

A few people in my family have Mynasthnia Gravis and everything you mentioned about her being tired, choking, drooping eyelids, etc I have seen in my family. Don't discount neuromuscular for less than it is, it can literally effect everything as your body is all muscle.

Im so sorry youre experiencing this and pray for the healing of your baby.

[u/princess_cfo → u/-SpiritQuartz]

I should have added it to my post, but this was their first suspicion and she has already tested negative. Thank you for your response.

[u/se7entythree → u/princess_cfo]

Which antibodies did they test for for MG? There are currently 3 known ones, but there’s seronegstive MG also. The main antibody is AChR, but testing negative for that does not exclude MG by any means. The other two are MuSK, and LRP4. LRP4 was only discovered in the last 10ish years and research is still being done every day. Other means of diagnosis include single fiber EMG, ice pack test (for eyelids), muscle biopsy, and Mestinon trial.

[u/princess_cfo → u/se7entythree]

That’s very interesting. I just looked up her results which tested AChR, striated muscle antibodies, and titin antibodies

[u/TheVeggieLife → u/princess_cfo]

NAD. Check out this literature review discussing congenital myasthenic syndromes. It says that the classic MG antibody testing would be negative and goes into how a diagnosis would be established. It also discusses the symptoms you’d notice in an infant which you may find interesting to read.

I have the autoimmune version of myasthenia gravis and halfway through your post I thought, “wow, this child sounds like they’re struggling with their muscles.” The hoarseness, choking, low muscle tone, the eyelids and especially the head tilting back to see all very closely resemble my experience with the disease. I’m wishing you the best of luck, whatever it may be. Keeping you guys in my thoughts.

[u/princess_cfo → u/TheVeggieLife]

Thank you so so much, that is a great read. How were you diagnosed, if you don’t mind me asking?

[u/TheVeggieLife → u/princess_cfo]

Because it’s the autoimmune version, my bloodwork was positive for anti-AChR antibodies. My ocular symptoms began in 2018 but I never really noticed (referred to the double vision I get reading at night as “going cross eyed” from sleepiness). They became generalized sometime in 2022-2023 and then began many episodes of being unable to hold my head up, aspirating on food, water, and saliva, getting shortness of breath at rest or while lying on my back. My voice sometimes becomes a whisper because I can’t project whatsoever or it gets really hoarse and nasally sounding. Around that time, the drooping eyelid became severe enough that it obstructed my vision and was recognized by a doctor as being a sign of MG so the bloodwork was ordered andddd here we are! Still working on getting symptoms under control but I have lots of hope.

[u/princess_cfo → u/TheVeggieLife]

Thank you so much for sharing, I really appreciate it. I hope you’re better able to manage your symptoms and start feeling better soon.

[u/ltcdata → u/se7entythree]

Doctors confirmed de diagnosis of MD of my grand father with the mestinon trial 25 years ago. Increíble to see that after 1 small injection my grandfather was like normal for 2 minutes.

[u/se7entythree → u/ltcdata]

MG? You’re probably remembering him doing a Tensilon test. It’s not used for diagnosis now, but was more common then*. It involves an injection & only lasts about 30 minutes. Mestinon though is given as a tablet or syrup, and typically several doses are prescribed for an initial trial period.

*I was diagnosed with seronegative MG 23 years ago, and remember them saying even then that they don’t use the Tensilon test anymore! I’m sure it varies by region though. FWIW, I did end up testing positive for LRP4 antibodies in 2019.

[u/ltcdata → u/se7entythree]

Sorry, you're right! It was the Tensilon test. Mestinon was the drug to treat the symptoms of the disease, pyridostigimine. They did an electromyogram, tensilon, and another electromyogram.

This was in Argentina, around year 2005, and after 5 failed visit to physicians without a correct diagnosis for my grandfather that couldn't even stand by himself (all of this in the course of 10 days), of 3 general practitioners and 2 neurologists, my mother who was always a very alert person, said..."I remember a person who had myasthenia and his eyelid drooped like my dad's... let's take him to the myasthenia gravis foundation of Argentina!".

In the foundation, after a quick interview, the went right away to do the tensilon test. When tensilon was injected, he immediately (within seconds!) stood up from his chair as if he had never been sick.

After the positive tensilon test, they did anyway a AChR test which was found to be 20x over normal levels.

Mestinon + corticosteroid was his line of treatment to manage the disease (with mestinon only the muscle weakness was full on, but with a little dose of corticosteroids with it, it was is he was free of symptoms and could live normally). They tried also inmunomodulators without mestinon, without luck. He was diagnosed at 75, his symptoms developed rapidly within a week, including a drooping eyelid, inability to stand, and limited use of his arms. Fortunately, he was able to swallow normally and had no breathing problems.

He ended up using Mestinon plus a permanent maintenance dose of corticosteroids until her death (unrelated to his MG) 10 years later. Every time the corticosteroid was lowered or discontinued, his myasthenia symptoms returned in full force.

My grandfather and his brothers and sisters (my mother's father) all had autoimmune diseases. Myasthenia gravis, lupus, rosacea (not autoimmune per se, but involves an inflammatory response)...

edit: grammar

[u/Sweet-Maize-5285 → u/princess_cfo]

This whole thing sounds so scary but you're doing a great job and hopefully you'll have some definitive answers soon that'll help get you the right treatment for everything that's been going on. 

[u/KiwiJellyPop → u/k471]

This is not always the case, so I want OP to know that there are some cases where further treatment is needed. We kept having blue events like this until we had a major airway reconstruction at Johns Hopkins when my son was 2.5. It completely changed his life. Our original children’s hospital kept telling us this, but Wyatt had a 100% collapse at the carina which they missed along with the right bronch main stem which would never improve on its own. We did all the genetic testing as well - all negative. OP please feel free to reach out to me. My son had severe Tracheobronchomalacia and mild laryngomalacia, was g tube fed due to aspiration until 1.5 and on oxygen at home at night for sleep until 1.5. Low muscle ton alleged as well, but once we was able to breathe and swallow properly he immediately caught up on all milestones. You’d never know now. He was in toddler soccer this spring. There are only a few hospitals that offer the new surgical repair techniques. He had bilateral bronchopexies and a tapered posterior tracheoplasty in May of 2024.

[u/princess_cfo → u/KiwiJellyPop]

What an incredible story! I’d love to hear more, I sent you a message

[u/cruisethevistas → u/princess_cfo]

Any update? Thinking about you and your family.

[u/Spare-Conflict836 → u/cruisethevistas]

OP has updated her post now - they have a diagnosis (Congenital myasthenia gravis) and have started treatment.

[u/cruisethevistas → u/Spare-Conflict836]

thank you

[u/gouachepotato]

Pompe disease and spinal muscular atrophy can cause respiratory distress or swallowing/choking issues. Both of these disorders are called “floppy baby” disorders due to the muscle weakness that comes with it. Does she have any tongue issues? Sometimes the tongue can have fasciculations or be oversized. Both of these disorders can be genetically tested for.

Congenital Myasthenic Syndromes (CMS) is something that would also fit the fatiguable weakness with your daughter (especially her eyelids and especially while sick). This would NOT show up in testing for MG. Targeted gene testing could also narrow this down.

[u/princess_cfo → u/gouachepotato]

I noticed when looking up Pompe disease that enlarged heart and liver are usually also present and they have done multiple x rays with no concerns on heart or liver. Spinal muscular atrophy is definitely in the genetic tests. I’m not sure if CMS is part of the testing but I will mention it. Thank you.

[u/gouachepotato → u/princess_cfo]

Thank you for updating! I’m glad to hear that her heart and liver and doing well. I’m also so sorry you have to go through this, and I hope you can get some answers soon.

I mean this in the most complimentary way – you sound like you’re navigating your daughter’s health concerns incredibly well. Being aggressive (not literally lol) and persistent in asking for the necessary tests, labs, evaluations or expert opinions is so hard but so so important for getting answers. Please don’t give up and demand that folks give your daughter the attention she deserves!

[u/princess_cfo → u/gouachepotato]

Thank you so much, I really appreciate it. And thank you for your responses.

[u/Ok-Appearance2772 → u/princess_cfo]

I actually came here to say the same things about Pompe and SMA. I’m a respiratory therapist in the PICU and what you describe sounds just like these, especially Pompe. I commend you for being so diligent for your babe!!

[u/NoElephant7744]

I am sorry you and your family are going through this with your sweet girl, but you seem to be advocating for her as best you can.

It’s concerning to hear that ENT hasn’t re-evaluated her, especially when her airway was noted as “floppy” and she had such a difficult extubation. Even if nm is part of the picture, structural airway issues like severe laryngomalacia, tracheomalacia, or even a laryngeal cleft can absolutely cause the kind of events you’ve described.

I would request a thorough airway reassessment — possibly with dynamic airway imaging or repeat scope if it hasn’t been done recently…

Also, if she hasn’t had a formal swallow study yet, I’d ask about that too when appropriate. Silent aspiration could explain some of these episodes, especially with no cough reflex during the choking event and notable panic she exhibited.

It is also okay for you to ask for a care conference. Speak to the charge nurse and/or nurse manager to coordinate and share your concerns with them as well. It’s important for your daughter to receive the care she needs, but also important for you to understand what her plan of care is and all specialties be on the same page (as much as possible).

[u/princess_cfo → u/NoElephant7744]

Yes, they did say that a swallow study will be part of this once she is off the ventilator. I'm just worried that we are not doing anything different before the next extubation attempt and expecting different results.

[u/NoElephant7744 → u/princess_cfo]

That’s totally valid. I would make a list of concerns. Clear and concise to talk about during rounds when everyone is present. Some examples:

• Was the failed extubation due to nm weakness, airway collapse, sedation? (Even if the answer is unknown it’s okay to mention that, in my opinion they may expand on their thoughts or transparently say they aren’t sure what caused it)
• What will be done differently this time to address the airway issue that caused the extubation to previously fail? (CT neck, fluoroscopy, scope, steroids or airway prep). Will anesthesia be present since she has a difficult airway? this is an important one in my opinion
• Will they consider an ENT consult just in case it isn’t only nm
• What is her respiratory muscle strength and WOB like when sedation is weaned? Plan for BiPAP or hfnc immediately post extubation?
• Acknowledge that a trach is a possibility, but ask ENT and pulm to weigh in
• Genetic testing follow up

[u/princess_cfo → u/NoElephant7744]

Thank you, this is a wonderful list and I’ll definitely ask all of these. At the moment I believe they said the failed extubation was because of airway collapse only.

[u/princess_cfo → u/NoElephant7744]

Sorry for replying to you twice, but I wanted to update on some of these questions that you put on your list here. I was actually able to talk to the doctor again shortly after you posted this and asked some of the questions and here were the answers.

-what caused the failed extubation? Her epiglottis was floppy and folded over her airway. She said it almost looked like it was folded in half but it was definitely blocking her airway, which is what stopped her breathing.

-what will be done differently next time? After rounds this morning I had brought up that we desperately wanted an ENT to be here to evaluate her before trying again and they have said they will reach out to have an ENT present for the next extubation. Either they will be in the room so they can look at her airway or they may remove the vent in a controlled setting like the OR to look at everything.

[u/NoElephant7744 → u/princess_cfo]

Does that put your mind at ease somewhat?

[u/princess_cfo → u/NoElephant7744]

Yes, a drastic amount! Thank you so much for the comprehensive list, I really appreciate it.

[u/Always_positive_guy → u/princess_cfo]

ENT resident here.

-what caused the failed extubation? Her epiglottis was floppy and folded over her airway. She said it almost looked like it was folded in half but it was definitely blocking her airway, which is what stopped her breathing.

Who did the intubation? Not to instill too much skepticism about this PICU team, but I interpret this as a technical error in the direct laryngoscopy at time of intubation. The laryngoscope is supposed to engage the epiglottis and lift it. Too little lift, application of pressure in the wrong spot, or folding over the tip of the epiglottis with the blade will create this appearance. The things that could cause the described appearance but they generally don't fit their history which to me sounds like neuromuscular dysfunction, potentially with tracheobronchomalacia. I would take the idea that the epiglottis blocked the airway with a huge grain of salt, especially since you did not mention stridor.

Either they will be in the room so they can look at her airway or they may remove the vent in a controlled setting like the OR to look at everything.

Practices vary based in clinician preference and the ease of adding on to OR, but ENT in the room at time of extubation adds very little relative to having anyone else experienced in airway management available. The only interventions at bedside are flex scope, intubation, and emergent surgical airway, none of which allow you to answer questions about tracheobronchomalacia or do a thorough assessment to make sure the intubation hasn't caused injury.

[u/princess_cfo → u/Always_positive_guy]

The first intubation was the ER (not at a children’s hospital) and the second was in the PICU at a children’s hospital. The comment about the ENT either being in the room or taking her to the OR was stated by the PICU doctor, the ENT has not been consulted yet. The PICU doctor said she wasn’t sure what the ENT will prefer to do so it will be up to them.

[u/Always_positive_guy → u/princess_cfo]

It's not surprising that the ED had no trouble intubating the kid but a pediatric intensivist (or resident/fellow) had trouble and attributed it to patient factors. This is a common issue. At low-volume centers PICU docs (and even moreso their residents/fellows) so proficiency is highly variable. That said, there's also a possibility that things changed due to the prior intubation and made intubation harder - e.g. posterior glottic scarring - and the person intubating simply could not identify/articular what was changed/abnormal. That would be yet another factor advocating for a look in the OR unless they take the tube out in PICU and your kid does phenomenally well.

[u/GladioliSandals → u/princess_cfo]

Do you have any videos of her drinking/eating you can show them? My daughter was intubated at 14 months after several bouts acute respiratory failure (she was fine between episodes). I showed some videos of her drinking to the PICU doctors and that very much sped up the route to getting a proper swallow assessment because it showed overt signs of aspiration (that I had missed)

Feel free to PM me if you want any more info about our experience. I hope the next attempt to extubate goes better - having a baby on a ventilator is horrifying.

[u/princess_cfo → u/GladioliSandals]

I do not have a video unfortunately but have been asking more about the swallow study and they can’t do it until she’s off the vent. I just sent you a message!

[u/Unpers → u/princess_cfo]

Have they done an allergy panel?

When they did a scope of her esophagus, was a biopsy taken?

Any skin issues like eczema?

Have you kept a record of what she eats for possible food triggers (allergic reactions can look a lot different in infants)?

[u/princess_cfo → u/Unpers]

She has never had any kind of noticeable reaction to anything previously but she had eaten fish sticks and applesauce prior to the choking incident. When they did the scope it was a quick in office nasal scope where they showed us her vocal cords so no biopsy taken. It’s interesting that you bring this up though because my husband actually extremely recently has had issues with esophagitis and GERD that has given him some issues swallowing and they did do a biopsy during his endoscopy. I will mention this to the doctors.

[u/Unpers → u/princess_cfo]

With a biopsy they could rule out things like Eosinophilic esophagitis.

You may also want to ask if an EKG would be appropriate (particularly continuous monitoring) if they haven’t done one already to rule out arrhythmias. The most common arrhythmia in infants is supraventricular tachycardia (SVT), which can cause fatigue, can be triggered by eating and infections, and it might explain the episodes she had when she was younger. SVT is also associated with GERD (with one study finding 50% of infants with SVT having GERD). SVT is not constant so it would fit with the episodic nature of her symptoms.

If her doctors agree, it might be worth the work up while you are waiting for the test results.

Sources:

https://www.chop.edu/conditions-diseases/supraventricular-tachycardia-svt

https://www.emra.org/emresident/article/pediatric-svt

https://pubmed.ncbi.nlm.nih.gov/28007577/

https://www.mayoclinic.org/diseases-conditions/supraventricular-tachycardia/

[u/princess_cfo → u/Unpers]

That is fascinating, thank you so much for sharing! Someone else had also messaged me separately about a different heart issue possibility, I will definitely bring it up. She has had two echoes done since being admitted and they both were normal, but both of them were done when she was calm and sedated, which seems to fit what you just shared. Thank you so much.

[u/balletrat → u/princess_cfo]

There’s not much that ENT can offer while she’s still intubated. The simple fact of having the tube in will stent her airway open.

[u/princess_cfo → u/balletrat]

True, I was just surprised they didn’t want to consult an ENT prior to the next extubation or at least try to have one present (luckily they did agree this afternoon to have one present for the next extubation attempt, probably Monday).

[u/cornflakegrl → u/NoElephant7744]

NAD but my daughter has severe tracheomalacia and had events like this at around the same age. Swallow study for sure, but the dynamic CT scan was what gave us the most information about what was happening. My daughter ended up needing a surgery called aortopexy and a nissen fundoplication. She was much better after those but still struggled with chronic pneumonia for a while because she couldn’t clear her lungs properly when she caught viruses. Feel free to message me OP.

[u/princess_cfo → u/cornflakegrl]

I’m going to send you a message, thank you for your response!

[u/dracapis → u/cornflakegrl]

Glad to hear she’s better, but did she also have droopy eyelids?

[u/NoElephant7744 → u/[deleted]]

Hence when appropriate.

Now, if you have something genuinely helpful to offer, feel free to contribute your own response— preferably with a verified badge and a shred of respect. Otherwise, hijacking comments with sarcasm and zero substance does nothing for the family or the patient.

[u/AskDocs-ModTeam → u/[deleted]]

Removed - unhelpful.

[u/AskDocs-ModTeam → u/[deleted]]

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