Thursday, January 20, 2011

To clip...or Not to Clip?

That is the question.


So poor Mr. Butters is tongue tied. Pretty severely. He has a heart shaped tongue because the frenulum is attached almost all the way to the tip. He had no trouble nursing or eating at all, but we knew he had it because it was so obvious. Our pediatrician brought up the possibility of it affecting his speech later in life, so she referred us to an ENT (the same guy who sculpted my beautiful nose 15 years ago...so I know hes good! Ha!) and he recommended we do the procedure to fix it.

Most cases, the connection is wispy thin, and they clip it in the office with a little local anesthetic. But When Dr. Garner peeked in Spenc's mouth he said it was thick an super short, so they would need to do a Z-plasty to lengthen it. Basically they split the frenulum down the center and make two more incisions in a z shape, superimpose the flaps, and stitch them into a new shape, thus untying the tongue. Slightly more complicated than the snip and go procedure I was envisioning. And the worst part was, we would have to put our little guy under anesthesia. Not to mention a sore mouth for 4 days with dissolvable stitches and a risk of infection.

Now im not so sure I want to go through with it! There is a chance that Spencer would have no speech problems at all, that the frenulum would naturally stretch to accomodate. But there is also a very real possibility that he might have a very prominent lisp. Which socially, is quite unacceptable and more detrimental than the surgery.

Brigitte was also tongue tied, but she severed the tie herself at some point because by 8 months it was broken. Since this is genetic, all our kids will probably have it - which means we need to know what to do about it!

My question is - would you do a medical procedure like this, when your child his normal and healthy - simply as a preemptive strike against a speech impairment that may or may not be a reality?

Of course I have heard conflicting advice. But I tend to fall a bit on the non-interventive side of medicine and would like anyone's opinion on this. Do you know anyone who has done the surgery? Opted out?

HELP! Butters is scheduled to go under the knife on Wednesday!

15 comments:

Anonymous said...

So, my cousin had this done to her second daughter. And they both left covered in blood and she got a slight infection. I think lisps are cute and so what if he's not "perfect" by our screwed up society's definition. Cindy Brady had a lisp and she didn't get the crap beaten out of her....Peter on the other hand....Anyway, why change something if it's not affecting life. If he gets older and asks if there's something to do about because he's miserable, then bring it up. Maybe he won't have a speech issue. Lexi still has trouble with some words, but I'm not rushing her to every speech therapist in the world. I figure she'll either grow out of it or she'll need help later in life. There'll still be a risk of infection 10 years from now, just like with any surgery. I vote wait and see. Why put both him and you under that kind of stress if it's a "well....it might happen". Personally, I think doctors jump the gun on way too many things anyway instead of letting people just live and maybe be different.

Emily said...

Christy,
I say keep you appointment and get it done. As parents we don't want to see our children suffer, be uncomfortable or in pain, but he's so little and in a few days he will fine. it's so much better to get things done when they are tiny- plus, you know that you did everything you could to give them the best start. have gabe give him & you a blessing and it will be great. It's awesome that he didn't have any nursing issues- you are lucky. My friend has had to clip all 3 of her girls. They are so much better afterwards even though it wasn't fun. You'll do great whatever you decide- but my vote is do it!

Julia said...

that is tough! Hmm.. I'm usually a 'let nature take it's course' kinda person.. put if I put myself in Spencer's position I think I'd be mad at my parents for NOT doing it when I was so little I wouldn't remember it... If it were my son (and my husband agree'd...) I would have the procedure done. Think back to the 'baby boy procedure' they do after birth that is 'not nessicary' but for the sake of society and apeal people have it done without thinking twice.



I say YES.

Anna Beal said...

Is there anyway that this will "go away" like big sister? I vote for the surgery if there is no way it will fix itself. Again he is so young and little. You could wait a year and see where he is at that point.

Krystle said...

DO IT!!!!!

My brother and I were both tongue tied and it didn't affect my speech but would always catch on my bottom teeth. But my brother did have a speech problem because of it.

SO at 7 and 11 we both went under the knife at the same time, so cute. Don't do this to "Butters" :) It was not a painful surgery, just milk shakes for a few days, but not fun. Do it when they can't remember it and will learn to talk normally in the first place!

My aunt on the other hand, was aware of this genetic malfunction, and when all 4 of her kids were brand new babes she snipped all their tongues. That's the way to go.

Surgery is for sure worth it! Trust me :)

Shawn AND Chelsey said...

i would do the surgery. but i am a speech therapist and have seen first hand how traumatizing it is for kids that have speech disorders. i am 100% sure that he will be made fun of ...and kids are so cruel to each other at that age. if you don't do the surgery now you will probably have to do it later or have him in speech therapy....or both. and it's sad, but kids even get teased for having to be pulled out of their class to go to speech therapy. really, i think it would be so much easier on you and him if you just did the surgery... and on the chance that he cant correct his speech disorders through therapy, he is going to have a hard time in job interviews, dating, etc.....
wouldn't you have wanted your parents to correct it for you if you were tongue tied when you were a baby? imagine how different your life would be if you talked funny. he won't even remember the surgery but he will remember being teased.....

it is a tough one, but that is my recommendation.

Maren said...

Hey christy!
As you know, I am also a speech therapist and I've had a fair amount of experience with short frenulums. Here's my advice: 1) has Spencer met all his communication milestones so far? If yes, it probably isn't impacting him. 2)what I have learned by working with a craniofacial specialist is that if a child didn't have trouble nursing with it he most likely won't have speech problems because of it. 3)can he touch behind his front teeth on his upper jaw(or where those would be)? If he can move the tongue side to side and touch the alveolar ridge then he has enough movement for speech.

Of course, this is just my opinion but I can tell you that the most current standard of care that I've seen and use is that tongue-ties only need to be severed for speech reasons if the tongue is really tethered very tight. Maybe there are other reasons to clip also, such as appearance or annoyance (as krystle mentioned) so you have to consider those.


Whatever you decide to do it will be fine!

Whitney said...

If I were you I would do it now while he won't remember it. My niece was tongue tied and they didn't do anything about it until she was wanting to sing around age 9. She had a beautiful voice but couldn't sing as well as she would have liked because of a lisp, so they did it at age nine. It wasn't a huge deal, but I think my sister wished she would have done it when she was younger and couldn't remember it all. It think the older you get the more traumatic it can be. But this is a hard decision don't do it because of us that say yes, only do it if you feel good about it!!!I have never personally been in this situation so I am not sure all the details, this is just what I have learned from my sister. Hope all goes well.

Jessie and Taylor Miller said...

i think my lisp is endearing;)
surgery is so scary! we had to put brody under to get his tubes for his ears, it was the best decision, but more traumatic for me than him.
good luck deciding!

Erin said...

oooooo that is a hard one. My thoughts aren't totally validated by the school board BUT I am in the the classroom enough to have some what an opinion. Speech problems are cute up to kindergarten BUT come 4th grade...not so cute. You feel bad for them because they cant pronounce the sounds the letters make. They think they are saying it right...With the wrong sounds come the wrong words, therefore they cant read correctly. I would take care of it now and he wont remember it. good luck.

Mitzi said...

That's a tough one. You know which one you feel better about. Just trust your decision whatever it is and be at peace with it. It sounds like your decision is surgery and that sounds like a smart choice. It is scary though. Good luck and pray a lot. Poor butters, really he will be just fine in a few days.

Jami said...

My Spencer was very tongue tied, similiar to yours, but we did nothing about it until he was 4. It never really did affect his speech at all, his L a little but you would have never known. The only reason we did was because he had to have some dental work done and the dentist did it. It was pretty painful, and I was glad he could tell me when it hurt. It healed within about 5 days. If you could push it off until he is older I would wait it out a little.

C. Alvarez said...

If you do this, it is far better to do it while they are young because there will be no trauma or memory of it later.

Heather and Dave said...

My little 10 month old Kate has the same thing - but she can stick it out and touch her bottom lip, so they thought it would be ok. One day while she was crying, it even tore a little on it's own and bled a little bit. My bro-in law actually cut his on his teeth when he was 5 and severed it himself. It may be similar to an episiotemy or naturally tearing....gross to think about, and I'm sure the mouth is way different...but Mama knows best :) I hope you'll both be ok and at least you know he's an awesome doc ;)

jayna said...

Well I see you have had some great sounding out about this! Having just survived a putting-under of my baby, it is traumatizing to the parent, but that office is AMAZING and EFFICIENT. Lila was out all of 15 minutes for ear tubes and adenoids! So I'm sure it wouldn't be bad. If I were you I would maybe wait until after he's 1, and not drinking bottles so much. That seems easier. Poor Butters!