Episode 214: An update from a 7-year-olds perspective with Lily & Hallie Bulkin

Quick Disclaimer all information, content and material of this podcast are the opinions of the speakers and is for the informational purpose only and not intended to serve as a substitute for the consultation, diagnosis and or medical treatment of a qualified healthcare provider. Welcome to the Untethered Podcast. I am your host, Holly Balkan. I'm a certified myofunctional therapist, feeding specialist, podcaster, business owner and mentor. This podcast is all about getting your questions answered and collaborating with colleagues to to bring you the most up to date information in the orofacial myofunctional therapy, airway tether, dural tissue, and pediatric feeding therapy space. If you're new here, I challenge you to keep an open mind and join my mission to spread this message far and wide. If you've been around since June 2019, thanks for being a loyal listener. As we jump into today's episode, remember to listen with correct oral rest, posture, tongue up, lips closed, teeth apart, breathe through your nose.

Let's get started.

Foreign.

If you're listening to this the week of May 8th through 12th, 2023, the doors to Feed the Peds are now open. Go to feedthepeds.com and you can learn all about how you can join us in becoming a pediatric feeding therapist, SLPs and OTS. This is for you. Go to feedthepeds.com and as always, you can DM me at Hallie Vulcan on Instagram with any questions. We want to make sure that if this is for you, you join us. If you have questions about it, we answer them. So my inbox is open and I can't wait to see you all inside the course. Okay, Ms. Lily, welcome to the podcast. Oh, she's going to be shy now. Maybe I should say welcome back to the podcast. Right? You've been on the podcast before, haven't you?

If you wanted me to answer that question, it would be. I don't remember. Okay.

I was going to remind you that on a podcast you have to talk because people are listening.

You know, I know that.

Oh, perfect. Okay, let's get started then. So, Lily, I'm going to give them a little bit of a quick history just in case they're new to the podcast and they haven't listened before. Okay, so you guys can go back to like the very first episode and, and you know, go to untetherpodcast.com and put in, you know, Lily's put in Lily and her name will come up and you'll hear more about her journey and greater detail. But to make a long, long story short, Basically, Lily was born with a lip and tongue tie. We did not know that at the time. I didn't discover this until she was 24 months old when I came back for my first myo course. And at that point, we did have her. Her lip tie released. Right. We had a proneectomy done. But in infancy, breastfeeding was a struggle, Bottle feeding was a struggle, and we later learned that that was related to what was going on in her mouth. Right. So she had a narrow palate, high palate, tongue was low because of that tongue tie, kind of holding it down to the floor of her mouth. And so she really struggled to basically, you know, shape her tongue in the way that was necessary to feed as an infant. Transition to solids around six months went well, and she did really, really well with that. And then around 15 months or so, we started to cut foods out of our diet. And I'm going to let Lily tell us a little bit more about where she is today. So, Lily, before we talk about some of the other things, will you tell us, like, just tell us about foods and, like, do you like foods? What foods do you like? What foods do not like? Can you tell us a little bit about that? Okay, share that with us.

Oh, I used to be very picky, and I don't like chicken. To me, it's too dry, and it doesn't have enough flavor. And I also don't like the skin because sometimes it can be spicy. I love watermelon because it's juicy, flavorful, and my favorite color.

Well, what else do you. Can you tell us? Let's think about, like, proteins that you like to eat, because I feel like you love fruits, right? You love a lot of veggies. Do you want to share some of, like, the fruits and vegetables that you like first? Maybe? Okay, so tell everybody.

So I also like strawberries. I sometimes like to eat blueberries. And I also sometimes like the sour blueberries if, like, if they are sour. And I like pears if they're juicy and they don't taste too, like. Like, kind of like, like, sometimes to me, they. It feels like they don't have enough.

Flavor like the one you had this week. Yeah, it was like, everyone said, oh, they're really ripe, but they weren't like, super ripe and sweet. They were kind of like, a little harder. And, like, you're right. They didn't have a lot of flavor.

And I also like them when they're soft.

Mm, I agree.

And for vegetables, I like. I like little carrots that our dog eats.

Baby Carrots.

I like lettuce. I like broccoli, like when it's super juicy and fresh and warm.

But you also like it raw now.

Yeah. And I like raw cauliflower, but I don't like it cooked or baked or anything like that.

What about some other green things that you like?

I like green beans, but sometimes they have this weird taste. I had some this week that had that weird taste and I didn't eat them.

You also like them sometimes you like the French green beans, but like, not if they're super stringy. Right. They're not like that.

Yeah, I don't like strings on them.

Yeah, yeah. So like, you do eat a good amount of like vegetables. You also like mushrooms and tomatoes and you like, sometimes you like the bell peppers, depending on the color. Right. And then if you're in the mood for them that day. So you'll, you'll eat a good amount of different, like, fruits and veggies. There's a whole bunch more, I think that you eat that we didn't even name.

Whoa, whoa, whoa, whoa, whoa, whoa, whoa. But I don't like mushrooms by their set.

Right.

I mean, I like them on pizza, but I don't really know if I like them on other things.

But you like them when they're cooked sometimes too? Yeah, yeah, yeah. So I'm trying to think of what else. So that's probably good for the veggies and the fruits. What about like some proteins you mentioned that you don't love like the grilled or baked chicken. Right. But you'll eat chicken nuggets.

I have my grandpa's eggs.

You like. See these eggs? Yeah. He makes them nice and fluffy and buttery. Yeah. Scrambled eggs. What else do you like? You like smoked salmon?

Yeah, but I don't like baked salmon or whatever it's called, like cooked salmon or that.

Yeah, you like it. Smoke and.

And was I going to say you've.

Had like corned beef, you've had bacon, you've had like, you like burgers now hamburgers, You.

Yeah, I love burger, fat burger.

I'm trying to think of what else you've been eating lately, protein wise, but you've been exploit. Oh, like you'll eat some deli meats like the turkey. Also we mentioned the corned beef. I think that you really like either like a hamburger or like the saltier types of meats because, like bacon and smoked salmon. Right. They're all kind of like salt. Yeah, you love salt. So, so we're, we have a good variety. Right. We try to cycle through those different. Those different foods. And so I wouldn't say that you're. You're super picky or anything, but you don't love, like, really spicy things, which is fine, right?

Me loves spice.

Your sister does, like, spicy things. That is true. That is true. So now that we covered that, what I want everybody to understand is that, like, Lily really transitioned into eating all kinds of foods and literally would eat anything we gave her until around, like, 15 months or so. And then it. You started to, like, cut some of the things out that you used to like, like chicken baked chicken baked fish, that kind of stuff. But over time, we've worked and helped you. One, we helped you with being able to chew your food. Right. Right. Two, we helped expand your palate. Right? You had expanders upper and lower at two different points, which we'll talk about, which with your tongue tie releases help give space for your tongue to live up in the top of your mouth. And do you feel like that helps you chew foods better or manage it better or, like, does it help you control where the food goes in your mouth at all or not? Like, what do you think?

Well, I. I don't really know because I don't pay attention to it.

That's okay. That's okay. So. So Lily has. So 24 months old is when you had your tongue tie released, right? And then now, like, you got. You've got a nice frenulum under there. It's stretchy, but we definitely can see it, right? So when you suction your tongue to the roof of your mouth, show everybody who's, like, watching on YouTube. So we can see that nice frenul under there. But it's nice and pliable, right? It's stretchy. And you can get the tongue nice, nice, and up into your mouth. I don't think that we need to, like, revise that or anything at this point point. So that looks good. The first thing that we did was with Dr. Tipograph, right. From Natural Dentist Associates in North Bethesda, and we went into an ALF appliance. When you were. Do you remember how old you were was right after your birthday when you turned five? Four. Four, yeah. So you turned four and you went into that appliance, right. And you had it for a year. Right. Do you remember anything about it? It's okay. We heard a knock, but you can keep going. Do you remember anything about it?

About the appliance?

I had the first one you had when we lived in Maryland. That was like, three and a half years ago. So, no, no. Should I share?

But. But I think it tasted bad when.

They put it in the glue.

Yeah. And also tasted bad for the one I'm wearing right now and the one before. The one I'm wearing right now.

Yeah. Yeah. Well, let's tell them a little bit really quick about, like, what you experienced that I remember. Can I share? Okay. So when you had that put in, you would just turn four. And I remember that you used to always get so sick, like, during cold and flu season, like, all the time, because a lot of kids do. But you would get, like, really congested, your nose be stuffy, and your tonsils, when we put it in, were, like, really big, almost touching the back of your mouth. And the ent didn't want to do anything. He was kind of just like, they're fine. Her mouth is closed, and she's breathing through her nose while she's sitting here. Because you knew you were supposed to do that. So you were sitting there with your mouth closed, like, while he was watching you. So you don't want to do anything. Right. And. But what we found out through your CBCT scan, which is that scan that, remember when you sat in the chair and that thing, like, went around your head, like, spun around your head, like. Yeah.

And doctor typographs.

Mm. Yeah. So with that, we saw that, like, your adenoids were big, your sinuses were full, your nose was really congested and kind of full, like, your nasal cavity in general. And there just wasn't a lot of room for you to breathe. And then we could also see your tonsils were enlarged right when you looked at your mouth. So when the alf appliance went in, within, like, three months, your tonsils went down to a healthy level. They, like, shrunk down from, like, almost, like, a three plus, which means they were almost touching to, like, a two. They didn't look inflamed or veiny or sick anymore, which was really cool. And you didn't get sick that winter. The tonsils are the big circular things. The back of your mouth, not the uvula that, like, hangs down, but the things that are on the side. I'll show you later. So anyway, so she went into that appliance, and we gained the expansion that we wanted right in, about, like, nine months or so. We left it until about a year because it was the middle of pandemic at that point. And then it came out around your fifth birthday. And when we moved here to south florida, we ended up deciding that you needed a little bit more expansion, and we Wanted to bring your lower jaw forward a bit. You want to tell us about that? I see your hand is raised. So does Everybody watching on YouTube. What would you like to tell us?

You said you were going to ask me questions.

I am. So now I'm asking you. Do you remember what happened next? When we came to Florida and we decided you needed more expansion, we went.

To this orthodontist place. It was, like, dark kind of, I think. And we went into this little room and I sat in a chair and this dentist, like, looked at my mouth and stuff. But she. But mama didn't like it, so she decided we had to go to a dentist all the way in Miami. When we live in Bob. Just two hours away.

No, it's like an hour, but an hour and a half in traffic.

More like two hours.

Okay. It is three hours in the car when we're doing a round trip, meaning their and back total is like three hours in the car plus the appointment. So it's like a half a day easily every time. Everyone can see your faces on YouTube. Love it. Okay, so you are correct. But the problem is that we went to this person, they said they were airway centric, and they did a really amazing evaluation. But what they didn't do was they basically said, oh, come back in, like, maybe six months. And then they also wanted to pull teeth out of your mouth. You don't remember that? So their evaluation was really good. It was really thorough, really great. I was very impressed. But the treatment plan did not seem to match the evaluation. I was like, we don't want to wait. She's a very compliant child. She's been an appliance before. Right. Like, we're ready now to help her airway. And I said. And your dentist had said. Right, Your dentist and Pocus said, no, no, we're not pulling those shark teeth because remember, you had two teeth behind your lower bottom teeth.

Yeah.

So those two teeth were called shark teeth because they, like, created their own row, their own space, because they didn't have room to come in. Hold on, let me finish explaining this real fast. And then that turned into your teeth actually eventually, like, did get pushed out and they did fall out. But you know why?

Why?

Because we started expansion at Dr. Barahil's office in North Miami. And when we started expansion with Dr. Miriam Barahil, it gave room for your teeth to start growing in, and then your teeth started falling out. And now you have teeth falling out of your head like, every day. Do you remember that? And you're not in your expander anymore, Right. You were only in your expander for, what, like, four or five months, and now it's in your mouth. What do you have in your mouth now?

A retainer.

Upper and lower or just upper?

Lower and upper.

So you have a upper and lower retainer, which is coming out in, like, two months. It's just in there for a little while to help hold things. But we don't want to leave anything fixed in your mouth because you need to be able to grow, right? Yeah. In case they're. In case you're watching Willie's showing you. If you're watching on YouTube. Yes, Lily, would you like to tell us now before I ask you more?

Remember when she said they wanted to pull my teeth out?

I think they remember they just heard that.

Yeah. Do you want my teeth to be pulling out, people?

No, they don't.

Doesn't sound fun.

It doesn't. And you know what? In the myofunctional therapy world, we don't like pulling teeth if we can avoid it. You know why? Do you know what happens when you pull teeth? You know what happens?

No.

So what happens is when you pull teeth out, sometimes your jaw gets smaller if there's nothing there to hold the space. And we don't want the jaw to get smaller. We want to grow the jaw if it's already. Your jaw was already small. Right. We wanted to make it bigger. Do you have enough room for your teeth to come in? Your permanent teeth, your adult teeth, right?

I already have four.

1, 2, 3, 4.

I just lost it on this one. This one? Yeah, I lost this one Sunday.

Yeah. Okay. So, yeah, you just lost three teeth recently. Before that, you lost another four. So basically, we were delayed in getting our teeth as a baby. We were. I think you didn't get your first teeth till you were, like, almost 11 months old or something. And after that, they started coming in, but then also with losing teeth, we didn't have room for them to come in. So the shark teeth poked through finally. And you didn't really lose any teeth until when. Do you remember when you lost your first tooth? Was it, like, were we in the other house or.

No.

Were we already in this house when you lost your first tooth? We're in this house.

No, we were in the rental house.

We were.

I lost my first tooth. Yeah.

Okay. So that could have been, like, a year ago. That could have been a year ago then. Or just like, a little. Maybe like, last May or something. But you were already in your appliance, right? Or not. Yet I think you are. I can't remember. Anyways, the point is that we now have space, and now it's very easy for your teeth to come in. So, Lily, let me ask you a question about losing teeth. Do you like when your teeth fall out? Yeah. Tell them about it.

The last time I, I. I put a huge blue bag under my pillow and opened it up, and I put a little. And I gave the tooth fairy two presents. I said, don't take my tooth. Take the presents. And I put. And for the. One of the presents, it was a little fairy keychain, and the other one was. Was a yellow smiley face. And so she took the presents, but not the tooth. And I put, like, little sticky notes on my bed that said, come in. Please don't take my tooth, but take the present and take the present.

Huh? And. And.

And. And for, like, little steps, like the sticky note.

Little steps, huh?

And when I woke up in the morning, the little. What's it called again? The bead. The bead smiley face.

Yeah.

And the fairy charm were gone, but the tooth was still there.

Is that what you wanted? Perfection. Awesome. So, Lily, when your tooth is loose, what do you do with it?

Just pull it out. And I have one list right now. He hates it.

I don't love when they're, like, super, super wiggly. You wiggle them in front of me. I don't know why I don't love it. She's torturing me right now. Okay, so. So anyway, so the bottom line is that now where's your tongue when you're. When you're, like, not talking or you're sleeping? Where it lives in where? And you're. She's sewing everybody in the roof of her mouth. Do you breathe through your mouth or your nose? Your nose. She's pointing. For those who are listening and not watching, are your teeth together when your mouth is closed, or are they, like, slightly apart? We're thinking. Not sure. Not one of the things that you're. You're, you know, planning on being asked today.

Like, I think so.

You think so what?

I think they're together.

Got it. All right, well, we'll pay attention to that. So. Excuse me. So in all of this, Lily also went through myofunctional therapy. Right? Lily not do that. Thank you. And she. You guys have to watch this on YouTube. This is hilarious. And in going through myofunctional therapy, she really worked on gaining control of her tongue and getting the tongue to rest up in the palate with the lips closed, breathing through Your nose. Right. And so with doing all of that, too, I think it's become easier for you to develop your chewing skills. And we noticed that with your expansion, with your airway opening, we feel like it's also been easier for you to explore more foods because I think you have better control over chewing them and where they land in your mouth. And so that might not make sense to you, but it makes sense to me because as your mom, you know, I've watched you do this for a while. It also used to be really hard for you to drink from, like, an open cup. When you were, like a little kid, like a baby, we were trying to get you to learn how to do that. You used to, like, dump it all over yourself until your tongue was really. And then you kind of figured it out. Do you want to tell us something before we wrap up? They're listening. So some people are not going to see what you're doing. So she's showing you how she drinks from a water bottle that semi resembles a large straw or open cup. But anywho, anything else you would like to share about your journey before we wrap up this episode today? Okay, go ahead. Any last thoughts?

I don't want my teeth pulling out, and I love losing them. I pull them out. It's actually not that bloody. And one of my friends say that they can see how much teeth are string. I mean, how many strings your teeth are on. And she also said when you're. When you pull out your tooth, when it's not bleeding, it hurts, but when it is bleeding, it doesn't hurt.

Do you agree with that?

Maybe.

Maybe. Okay.

I've been thinking about it in the past that. The past few months.

Yeah. Well, like a week ago or I guess whenever. It was five days ago when your tooth fell out. Was it last weekend?

It was on Sunday.

It was on Sunday. So when that happened, you literally stood in front of the. The, you know, the mirror for, like, 30 minutes, wiggling your tooth until it's ready to come out. Whereas, like, most people probably would have let it stay in their mouth for, like, a week until it was, like, ready to come out on its own. Lily was like, oh, no, you are wiggly and you're close to coming out. Like, we are getting you out tonight. Right? You were, like, determined. Oh, Lily. Anyways, so. So, yeah, so this is kind of interesting because one of the things that I teach inside feed the peds is part of this journey. Having a baby who has, you know, feeding struggles, tongue tie, high, you know, narrow palate, Airway issues. And I'm talking more upper airway, not lower. And that's why I teach the tether, oral tissue and myo modules and how that applies to, like, the birth to 4, 5 population in feed the peds, because I lived it with my own child, actually, with both my kids. So I know, Lilly, you want to add one thing, so just hold on one second. But Lily's journey has been one that is really. Has really inspired me, educating others on what to do when we have a child who struggles to feed as an infant, who may transition okay, or maybe they don't transition okay, to solids, who may become more selective eater, who cuts foods down and trying to get them to be more experimental, and then also dealing with those airway issues so that we address the expansion needs. We address the airway, address that palate, right, and that tongue before you're seven or nine years old, which is more traditional for orthodontics. We want to get in early. And if your child's already older than that, it's okay because it's never too late. It becomes harder and longer and can be a more expensive process. I'm not going to sugarcoat that. But the earlier that you start doing this and making the space, the better the jaws can grow, the better the skull grows, the better they're able to nasal breathe, the healthier they typically are. Because what we saw through your CBCT that we did after your first round of expansion with that ALF appliance with Dr. Typograph was that not only did your. And I think this is like, actually two years after we started the ALF that we did the scan, and I have to go back and look at the exact dates, but your sinuses were clear, your adenoids were healthy, your tonsils are healthy, your nasal cavity was completely clear. And so she was able to fully breathe where she didn't have that before. And no course of medication was fixing that. It was sort of like the cyclical thing that she had experienced throughout every single spring with allergies, you know, fall and winter with cold and flu season. And so it's really cool to me that we've been able to get you on a healthy trajectory through expansion, tongue tie release feeding therapy, and myofunctional therapy. So that's all I'm gonna say. And like I said, I do teach this stuff in. In module 7, 8 of feed the P. So doors are open right now. Go to FeedThePedes.com if you want to learn more. And Lily, before we wrap up, because really, we're about to wrap up. Tell us one last thing.

I have a question.

Oh, you've got a question? Yes, ma'.

Am. Was I a messy eater when I was a baby?

Were you a messy eater when you were a baby? So that's actually a very funny question because it's not so much that babies are messy, and we want babies to be messy when they're, like, learning how to eat, because it's a sensory experience and getting food on your face and on your hands and your arms and all over you. It's part of the experience that your body needs to learn about those foods. And then most kids will start to become less messy over time as you get better using, like, a spoon or fork or the baby utensils that you're using or putting foods in your mouth. But Papa used to take a napkin or a wet paper towel and wipe your face between bites. And I always used to tell him, don't do that, because you're going to cause a problem. And he does not like a mess. So he was constantly playing you up, and I was constantly telling him to let you be messy. But you're not really a messy eater now. Aside from dropping crumbs all over the floor, but go ahead.

I knew I would be hilarious. I knew I would be hilarious.

Or divorced. Can you use your normal voice so they can hear you?

I knew I would be hilarious. I knew I would be hilarious. That's what I was saying. I'll do our big.

Are you done yet? All right, we're gonna start to wrap up this episode. Lily, thank you so much for being hilarious and bringing your full on personality today. Everyone's gonna love this as much as they love your faces that you're making. It'll be all over YouTube. We're making this on Take youe Child to Work day. So Lily has been working with me all day today, right?

Yeah.

And we only got, like, half the things on our list done. Don't read it off, please. Nobody wants to hear about it. And some of it is private. Don't show them the list. Okay. Hi, Lily. Anyways, we're gonna wrap this up.

So we were using.

That is the pen that we were using. Thank you so much, Lily, for your time and for joining me on Take youe Child to Work Day. This episode will be out in a couple weeks. When people hear it. High five.

In a couple weeks.

All right, well, welcome to Living with Lily. I hope everybody has an awesome day. Go to feedthepeas.com if you want to join us in there. This is Lily and I signing off.

Remember, you love me.

Bye everyone.

Thanks for listening to this podcast. If you found value in this episode and want to hear more of these Myotots, Airway and Feeding related episodes, be sure to leave a review on Apple Podcasts and share this episode on your social media platform. You can access free resources and all I offer@halibalkin.com or pop over to hollybulcan on Instagram to get all the latest updates.