Episode 219: Rapid Palatal Expansion for Airway Clearance and Mia’s Airway Journey

Hi and welcome to episode 219 of the Untethered Podcast. Today it is your host, Hallie and Mia. Mia Balkan here. And mia is my 5 year old.

And we're going to talk a little.

Bit about her most recent updates with her Airway journey.

She's going to answer some questions that.

May help other kids around the same age understand what it is like, right. To do mayo and have an appliance.

And you have a permanent retainer for a short period of time right now.

And you know, we'll be able to share that, right? All right, let's jump in. 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 health care 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 bring you the most up to date information in the orofacial myofunctional therapy, airway.

Tetheral 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, lip closed, teeth apart, breathe through your nose. Let's get started. Okay, Mia, so at the time of this video, this, this podcast episode, you are five years old, right? And you're making a bowl with your tongue, which is why you sounded funny when you said, showing everybody who's watching on YouTube how to make a bowl with their tongue. Huh? And Mia and I are recording this, but she's having a pajama day today, right? Me? Yes. If you're watching us, that is what you're going to see. And I'm just going to adjust the camera for those watching. So, Mia, I would love for everybody to hear about your airway journey. And what that means is where did this all start? Do you remember where we started? What we did first with you? When you were a baby and you were just born, you had a tongue tie release when you were five days old. Your tongue and your upper lip were released when you were five days old. Yeah. And you're feeding. Your breastfeeding went from being kind of hard for you. To do. And it didn't feel good on mama to being really enjoyable for both of us and very successful. And you were able to feed, and that was great. Right. But then, you know what happened Then you kept getting like, croup. And when you were four, you had it nine times. Maybe it was like three and a half to four and a half or so. Like over a 12 month period, you had it nine times. And so we had been on a lot of steroids and medications. And I was like, something has got to give. Right? So do you remember doing that, that scan?

What scan?

The scan that we did when the guy came to our driveway with a van. And you had to stand there and the thing circled around your head. Do you remember that?

I remember it staying in front of my head.

Oh, okay. So it actually kind of circled around your head, but you stood still. So you were looking straight at something. So what you saw probably didn't change much, Right? Kind of look the same to you. So that was pretty cool. They'd never seen that on, like, a traveling van before. And the guy came to our driveway here in Boca. That was crazy, right? So anyways, we did that. We discovered that we needed to do some expansion. And because of Mia's airway history. Right, Me, we had to pick between different options for expansion. Now, do you remember what your sister had? Her first expander? Well, she had spacers to put hers in. But do you remember when she was four years old, before we lived here, what did she do at the other place that we went to? Remember that? What that one was called the Al F. Appliance. I remember you. You kept asking me, you said, am I going to get the same thing as Lily? The same thing. Might get the same thing. But we didn't do the same thing then. Right. We gave you the same thing that she has now or that she had. Right. Remember that now? So tell everybody. What did you have.

One spacer?

Yeah. So you had the spacers first. We had to make a little bit of room real quick, right. For a couple days to fit that appliance in. Do you remember what the appliance was called? Or should I tell you? It was a rapid palatal expander.

I didn't know that.

You didn't know that? Yeah. And we chose the rapid one, which means fast, because we wanted to open up your airway because you kept getting sick. And we were like, enough is enough. We gotta let you breathe. Right? Yeah. So Dr. B and Mama decided that that would be the best route for you. So can you tell everybody if you do remember how it felt to get the spacers in? Hurt a little. Yeah. And how did it feel when the spacers came out?

Remember?

Don't remember. You think it hurt when they came out? After they were out? I remember you telling me that it felt good that they were out, but then we were able to put in your palate expander and.

But when they just came in, they heard.

Right? When you just had them put in, right? Yeah, yeah, yeah, yeah, exactly right.

And for the appliance.

And for the appliance. And so. And for your retainer.

Yeah.

So now we have a retainer in for just a short number of months. Right. Just to make sure everything holds while we confirm that where your. Your tongue is living, where it's supposed to be. And can you tell everybody where is your tongue supposed to live?

In your mouth, on the bottom.

What? Are you joking me? Your tongue's supposed to live on the bottom of your mouth.

The middle.

No. Did you top the top? Did you forget? Where do we have. What are we gonna have to do with you? We have to do more mile. I think we need to do more mile so you can remember where it needs to be. No. So I will tell you that whenever your nose is nice and patent, which means you can breathe air nicely through both sides of your. Your nostrils, your nares, you sleep with your mouth closed. And when I checked, your tongue is up on the top of your mouth. Is that cool? And you nasal breathe, you breathe through your nose, which is exactly what we.

Want right now, at night. And stick your finger in there.

No, I don't stick my finger in there, silly. So sometimes I'll just take. I'll just take a peek and I'll look and I'll see your mouth is closed. Other times I might go like this. And when I gently move your. Your chin down, your tongue, I can see your tongue is suctioned to the top. So even though you don't realize it now, it is right. Good stuff, huh? I know you can do such a good lingual palatal suction, that tongue suction to the roof of your mouth because now you have enough space. Right. And so in a matter of months, we were able to take you from like 28 millimeters behind your back molars to like 35 millimeters behind your back molars, which was really great because you were four, right? You were four at the time that we were doing this. And how old are you now?

Five.

Five.

When.

Do you remember when your birthday was?

February 18th.

February 18th. Right. And this is now May. So about three months later, she's five years and three months old. And soon, when we get back from our trip, you are going to go and get the retainer taken out. Do you know why they don't want the retainer to stay in? Because if you have a permanent retainer stay in and you're still growing, it'll lock up your jaws and your teeth, and they won't be able to continue to move and grow the way that they need to. So we just did it for a little bit to make sure that we held the growth that you got and it didn't collapse back.

Is my sister gonna do the same on the same day?

I think so. I think she is. We'll confirm with Dr. Barahil. So, Mia, you mentioned that when you got your appliance and you had to eat soft foods because it was kind of uncomfortable. What do you mean by that? What kind of foods did you eat? Do you remember? I think, like, soup and maybe mashed potatoes or applesauce.

The fig bars.

Do some fig bars, maybe. Can you think of anything else, or you don't really remember? I think maybe you had some pasta, maybe applesauce. Yeah, I think you might have had a little bit of applesauce at first. And you look like chicken soup. So I think we gave you some chicken soup, and we had some, like, roasted potatoes that we were like. They were really small, but also we made some mashed ones. You showing everybody your exercises, huh? You look like you're doing Maya with a tongue bowl and your lateralizing the tip of your tongue left and right to the corners of your mouth. And your jaw is nice and stable and not moving. Good job. That's what we want to see. So somebody had a question for you. When I recorded with your sister, we were talking about how they wanted to pull out some teeth from her mouth, and she thought that was crazy. And she was asking everybody that was listening, they thought that was crazy that they wanted to pull teeth out of her mouth. What do you think about pulling teeth out of your mouth? No. You want to share any words about it? Want to say anything about it?

Almost every time my sister would bleed. What?

What do you mean? Oh, when her tooth comes out. Oh, yeah. Well, when her loose tooth falls out. Yeah, most of the time. Yeah.

But I mean, like, two wiggly teeth at the bottom.

You have two wiggly teeth on the bottom? Yeah. It's exciting, right? The dentist said that your teeth are getting a little wiggly. We have some wiggly Teeth. But my question is, what if the dentist pulled your teeth out? What do you think about that? Would you like that or not really? Lily was like, nobody is pulling teeth out of my mouth. And you know what? In the airway world, the work that mama does, we don't like when teeth are pulled out like healthy teeth, because we would rather do expansion like what you had, you and Lily, so that, guess what? You don't know. So that there's enough space for the teeth. We give the teeth enough space, then they can grow in. Right. And then the baby teeth. What happens with baby teeth then?

They get wiggly. They get wiggly and they fall out, and then they grow into big teeth, adult teeth.

And then what happens? What happens if you do know what happens if you don't have enough space?

They don't grow in.

They don't grow in. Or they grow in crooked.

Yeah.

So you know what mama did when I was creating a. A presentation in December, and I found some information that said that if we use a palette expander like we did for you, that we could use a slow one or a fast one. And they were both just as good.

At.

Growing the bone, causing both skeletal and dental alveolar transverse expansion, which I know means. Means nothing to you. Right? Right. But so you're. If we can anchor those appliances to the baby teeth, like, to your molars. Right. Just like we did, and like you have now with your permanent retainer, then that actually was most helpful in getting the expansion we want, and it didn't damage the teeth. But the research, they found that the rapid expansion actually produced more growth forward. And did you know that you and your sister needed some forward growth for your maxilla for your jaw up here? That means we were trying to bring this part forward a little bit, like. Exactly, Exactly. You're so silly. You're so silly. You are silly. And you know what happens when we do that? We can open the airway more and make it easier to breathe. And guess what you needed help with?

What?

Opening your airway and making it easier to breathe.

Crazy.

Yeah. Because the research showed that the rapid pal expansion and the maxilla on that upper jaw was better for, like, children like you. Right. That had a respiratory dysfunction or that had crowding in the front teeth. And so that was why we picked what we picked. You are so silly. Super, super silly. So while the slow. It was kind of a debate because while the slow expansion gives us a little bit more control of the teeth, the movement of the teeth, the rapid one, opened the airway and that's what we needed super duper fast for you especially, because. Do you remember we went to an ent. You don't remember going to the doctor's office here in Florida to the entire. And he, like, kind of looked up your nose and looked in your mouth, and then he said to use some, like, nose spray. And you use the same nose spray that I use when I have my nose surgery. The flonase senso mist. Do you remember that we're spraying stuff up your nose a little bit.

The kids one for, like, spray spray. Whoa, Whoa. Spray spray.

Well, you kind of got, you know, it's kind of sniffed it in. Right.

Then blow down.

Yeah, but that was like. That was like over a year ago, so maybe you don't remember, but that's really all he thought we needed to do. He said, everything looked okay with you.

And I was like, that's called exelier.

Well, we also use the X layer, the clear spray in the past. Right. This one was different than that, but it's the same idea. Same idea. What do you think about nose rinses? They're good.

Are you gonna tea better?

You like it better than the nasal spray? So tell them. What do you do? Do you do nose rinses? Yeah. When?

In the morning.

In the morning? We're doing silly voice now. Your sister did the same thing. Okay, so we're. We're gonna wrap up in a minute, but tell them real quick about your nose rinsing so they can understand how we do what we call, like, nasal hygiene, which means we keep the nose healthy. Other than breathing through your nose and keeping that tongue up and your lips closed, what else do we do?

How you make it is you put the water you drink in it first. Then you put the salt packet, then you put the cap on. Then you shake up, then until the salt's out to the bottom. Then you put it. Then you square up one side by the sink, and then the other side, then the other side, then the other side, and then blow your nose.

Yeah.

Or you can blow your nose each time you do it.

Yeah. Do you remember what we call it when we don't stop to blow our nose in the middle? What do you call that? Do you remember?

Beast mode?

Beast mode. Right. Activate beast mode. So we used to stop and blow our nose halfway through, and then one day you were like, I'm just gonna do the whole thing without stopping to blow my nose. And we started calling that beast mode. And now you just do that all the time. Right.

But not all the time.

Well, you don't. Oh, you stop the blow sometimes in the middle. Oh, okay. And what does it help do? What does it take out of your nose? It's not the snot. And I think you and your sister think it's really funny, disgusting, and cool to see your snot on the bottom of the sink, right? Yeah.

Yeah.

You guys like to do it in the sulfur sink so that you can see it just sitting, right? Oh, my gosh. It's okay. We can still do it. And so when you told people that we. You. We use the water that we drink, we have a special type of water at our sink, so we can use distilled water, which we sometimes use, but we also, at our sink, have water that it goes through a process of reverse. It's filtered, goes through reverse osmosis, and then it has remineralization as well. And that drinking water. And that is a safe water to use for the nose rinse, just like distilled water is as well. So we may not be drinking, like, distilled water or something all the time, but we often drink that water. And when we're traveling, do you know what water Mama has found when we can't find distilled water? Because that was really hard when we were in California. You know what I got? I got smart water, because smart water works also when you're. When you're in a pinch. Otherwise, it's kind of an expensive water to rinse your nose with. But hey, hey, you got to do, right? You're making funny faces and sounds. All right, Mia, is there anything else that you want to share with us about your nose breathing, about our nasal rinsing, about all our healthy habits like tongue living on top of our mouth and our mouth closed and our nose breathing, like you're doing right now, even though you forgot your tongue is supposed to live up there, which is okay. What do you think? Anything else or. No.

If you don't breathe, you can't live.

If you don't breathe, you can't live. In the words of Mia Balkan, if you don't breathe, you can't live. That's right. High five. I love it. Now, will you smile for them so they can see all the beautiful spaces between your teeth? Put your teeth together. Normal bite. Normal bite. So whenever we tell Mia to smile, we kind of jut. Or. No, no. Other way. Other way. Behind. There we go. We kind of jut our lower jaw forward sometimes, and so she's had a deep bite. But what we've been doing is working on building that bite up with her expansion and with Planus tracks, where Dr. Berryhill put some material on the back of your teeth. Right. And that way when you're. When you did have things like croup or congestion and you were grinding, grinding, grinding, we were grinding down the planus tracks instead of grinding down your teeth like this. Yeah, but don't do that. It's not good for you anyways. But now we have beautiful spacing and enough room for our adult teeth to start coming in as our baby teeth start to fall out of your head. Amazing. All right, Mia, anything else you want to tell us?

Oh, remember, you love me.

Remember, we love you. Okay. We love you. Bloom kisses, Holly and Mia signing off.

Bye.

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 platforms. You can access free resources and all I offer@halibalkin.com or pop over to hollybulcin on Instagram to get all the latest updates.