Episode 269: Trusting Your Mom Gut with Becky Birkenfeld MS-CCC, SLP

Hi and welcome to episode 269 of the Untethered Podcast. Today we have Becky Birkenfield joining us. Becky is a speech language pathologist and feeding therapist in Bergen County, New Jersey. She owns a home based private practice treating children in the comfort of their own homes and providing parents with hands on support throughout the process. Becky specializes in early language acquisition, treating children on the autism spectrum and extreme, extreme picky eating. 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, Hallie Vulcan. I'm a certified myofunctional therapist, feeding specialist, podcaster, business owner and mentor. This podcast is all about getting your questions answered in collaborating with colleagues to bring you the most up to date information in the orofacial myofunctional therapy, airway, tethered oral 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. Hello Becky. Welcome to the podcast.

Hello. Thank you so much for having me.

Ally, I'm excited to have you on here because I know you and I are like friends, like you know, online and outside of recording. And so it's always fun when we, when it comes full circle and I get to have somebody as a guest on, on the pod.

Yeah, for sure.

So I know we're going to talk about one of your little ones. You're going to share her whole journey and your whole journey with her today. But before we jump into that, I want you to share your background so everybody understands like who you are. So I'm going to turn it over to you and let you tell us a little bit about you and your, your professional background.

So I am a speech language pathologist. I am a feeding therapist. I specialize in kind of like the early intervention world. You know, I started out my career working at an early intervention center where I got my, my base. I worked with a lot of children on the autism spectrum and so I'm pretty well versed in that world and I just, I love, my favorite thing is getting a little one who doesn't talk. And getting them to start talking, it just. To me, there's no better feeling than giving parents that gift of being able to communicate with their children. And, you know, through that also, I started working in feeding a little bit, and it kind of became my. My niche. You know, I love to share this. And one of my. One of my little guys now eats lobster Mac and cheese. Like, that's one of his favorite foods now, you know, so it's really fun when you get a child who eats just the regular old kind of beige diet and they go to any, like, you know, I love giving parents the freedom of, we can go anywhere now. We can have a family trip. You know, we can go on vacation now, we can spend the day out, and we don't have to worry, you know, what is my kid gonna eat? I have to pack all their food, otherwise they're gonna starve. So just making parents lives in those respects for me is so rewarding and so important.

I love that. I feel like that mirrors where I started in my journey, where it was like, all I wanted to do is help children communicate and get their basic, like, wants and needs, like, communicated and, you know, get those needs met. And that shifted to me working with autistic children, which shifted to me going, why are these children always constipated? Why are they all eating beige diets? Like, I'm so fascinated by this. And then I fell into the feeding world, and the rest is history. And so I'm like, I just love that. I feel like we're like, you know, parallel journeys here.

So even more so, you know, when I was listening to your story about which one's your older one? Mia.

Lily. Lily.

So, I mean, the same thing happened with. With my older one with Gabby when she was, I think, like, her first week of life. I said, why is nursing harder than giving birth? It's not normal. And so that's. That's how I fell down the rabbit hole. I'm like, they didn't teach us this in grad school. And so I just. I would say up till like, 2, 3 o' clock in the morning, learning about ties, tongue ties, you know, tethered oral tissues, all. All of it. I became really good friends with Dr. Siegel. I was, you know, he had this really amazing symposium back then when I first fell into all of it, and I fell in love with that area. You know, I was like, why aren't people talking about this? Why is this not widely known? Why is it that I am an SLP who learned about it in grad school, but not. And it. You know, from there, I think it just. It just kind of catapulted. And I think during COVID one of the best things that came out of COVID for me was connecting with so many professionals and through you, finding all these airway accounts and, you know, learning more about that. And that's what. That's what this is going to be about today, because this is just a whole nother rabbit hole that I think needs to be well known. We'll get. We'll get more into that.

Yes, for sure. No, I. It's. You know, I. Every time I tell everyone, I'm like, I went to look for that podcast more. So for my own knowledge as a therapist who, yeah, was in this space, but also, I just wanted to listen to something on the go, like, Maya Tots airway. Like, give me all the good stuff. Right?

Yeah.

And it didn't exist in, like, summer of 2019 or spring of 2019. So I was like, oh, there we go. Clearly, I'm gonna have to create that and with the goal, information forward to everybody, because it should not be this hard to find information on two of our basic needs in life, eating and breathing. Like, where's all the info?

I mean, how many times have I DM'd you? Halle? Thank you, thank you, thank you, thank you. Like, I mean, you know, the fact. The fact that you put all of this out there, you don't gatekeep, you know, you. You really educate the public. I mean, you educate other professionals. I. I think it is there. It's really invaluable. And I. I wouldn't be where I am now if it weren't for you and pushing through all that and, you know, trying. What you always say, just because it's common doesn't mean it's normal. Is like, what is just on loop in my brain all the time, you know, and it. So let's. Let's jump in a little bit because. So how it all started was, you know, my little one, her name is Vivi, she's five and a half now, and last January, so a little over a year ago, you know, I was. I was getting really concerned. Every other word, she's like, what?

What, Mommy? What, Mommy?

I can't hear you, Mommy. And I was like, you know, I don't. She can't hear us. She can't hear us. She passed her hearing screening at birth, so I knew there wasn't anything, you know, and during COVID she had no issues. I know she could hear us. She started school that September was. Yeah, I think it was that September she started preschool, and she had gotten, like, a handful of ear infections. And I was like, okay, we have to go see the ent. We need to see what's going on. I mean, I wasn't even in the chair for 60 seconds, and the doctor had told me that she had to get her adenoids out. It hadn't even been 60 seconds, which.

You know, is, like, pretty serious, because they're pretty conservative about those sometimes on kids. Yeah, yeah.

He's like, they need to come out. And that. That was even before he, like, went over the hearing test. And I panicked. I'm like, you know, and my husband would yell at me. He's like, has a therapist. Like, you would yell at the parents to, you know, go and get this taken care of asap. And I'm like, I know, but I know there's more to the story. I know there is more, and, you know, it. It pains me to say that it's taken this long to get to this point, but it was like I was exhausting all of my resources. I was. I would try something, and I would. It was. You know, I would wait for a dead end. Basically. I was just waiting and waiting. So from there, we saw a craniosacral therapist who is phenomenal, you know, and all these other people, they helped in other capacities, but it wasn't getting to the root issue. So, you know, we saw the craniosacral. We worked with a homeopath. We. I saw an airway dentist initially, but at the time, you know, they were like, well, she could maybe use a little bit of expansion, but it's. It wasn't like a clear yes or no. And it was like, you know, things weren't getting better. Her hearing wasn't improving. And this was over the course of maybe, like, a couple of months. But finally I'm like, you know what? If nothing else, we have to get tubes in. So we did the tubes. Thank God she started hearing okay, you know, and it was just. Everywhere I turned was. It wasn't giving me the answer. And I was just. I was losing it a little bit until finally, you know, this year, we met with an Airway dentist, Dr. Barry Rayfield. And I'm like, I'm so. I'm so grateful that he is so close to me in proximity. I would travel. I would travel so far for this man, but, you know, he's. He's probably, like, 20 minutes from my house, and he is Just so much on the same page as me and you and everything that, you know, we've been learning about and preaching kind of. And it feels validating that, you know, we're. We're working in the right direction now. Yeah, it's just. It's. I mean, I took her to a salt cave. I had her get a lymphatic drainage massage. You know, you do it.

All the things this childhood, it's like, you think about. You're like, can I do this for myself, too, while we're at it? Like, please?

Well, to be fair, I actually started doing all those. I had a hard time nasal breathing, and I started doing all of these things, and I'm like, literally, I realized about a month ago that I started breathing through my nose so much better. And so that's when I was like, oh, let me take her to the salt cave. Let me get her a lymphatic drainage massage. You know, next on my list is gluten. Am I cutting gluten out for her? And before I do that, that's more of, like. I feel like that's going to be a hard one because it's like, what am I going to feed her?

Hi.

That.

That was me last summer. We cut gluten out the end of summer. I let her go all the way through summer. And then finally, like, I was like, okay, we're starting a school year where I'm gonna make her lunches, which I usually make her lunches anyways, but it was like, we're gonna just get hit reset. Like, she's not in a day camp where they're giving her lunch or something. So, like, it's easier to control at this point because my kids, like, love getting the lunches at the camp that they go to. And it's so nice to have a summer off. But now I'm like, no more of that as we roll back into summer. But I will tell you, like, she. Not only did she have a growth spurt, so there's definitely that, but just within, like a week or so, the inflammation in her body just went completely gone. Like, she would have a little tiny gut at the end of the day or after she ate. Like, she doesn't really get that anymore unless, like, I know she's had some contaminant, like, some. She's had a little gluten by accident or. And you can see. Or she's sick. Like, sometimes she gets sick and then there's some inflammation because of that. But overall, she is like this skinny little thing now. Whereas before, she was, like, puffy. It was probably the best way I could describe it. She was, like, puffy, and, like, her tummy would, like, kind of a little. Like, she'd be, like, have, like, a.

Little belly, like, distended. Right?

Yeah. Yeah.

So, you know, I've noticed that a little bit, too. And so when we saw Dr. Dr. Barry, he. He had a great recommendation. He's like, you know, before we do anything, I want you to go see a functional medicine doctor and rule out any sort of, like, infections, parasites, mold, anything that could be in her body that could be, you know, causing the inflammation. So, of course, we went, and lo and behold, she has an infection. You know, the way that the doctor explained it to me was we don't know how long she's had it for, but she doesn't. She hasn't had any outward symptoms. So I'm thinking it's been there for a while now. We don't know. We don't know how long. So that was kind of like, you know, there's an answer. We have a little bit of an answer. It's. It's just. Why doesn't anyone tell us these things?

It's a lot. And I feel like the more that I read, the more that I, like, learn and understand. I feel like going to a functional medicine doctor was like, the doctor 100 years ago. Do you know what I mean? Like, they were more integrative. They used homeopathic medicines as, like, a first resort instead of, like, a weird, crunchy side thing, you know? Yeah. You know, I just feel like things have evolved so much. There's so many toxins in our environment that I feel like it's hard to get away from them. And so if, like, what I'm learning from. I just had Katie Green on the podcast. I don't know.

I just listen. I just listened to the podcast.

Okay. So I love her. I followed her forever. Like, it took us forever to coordinate our schedules and get her on the podcast. But, like, she just makes. She's such a good balance for me between, like, healthy, holistic, and, like, real life. Because I feel like there's so many accounts out there where it's like, you got to do these 57 things, and if you do one wrong, you're screwed, and you might as well not do any of it. And I'm like, well, that's not realistic.

And then you become anxious, and then you can't. Oh, my God. It's a whole circle, Right?

Whereas she's kind of like, okay, if you do, like, at least some of these things, like, your body should be able to live and manage these toxins that we're exposed to on a regular basis. And so it was such a mindset shift where I was like, okay, we're exposed to toxins. We know that, like, no one has to be okay with it, but, like, okay, how do we get our body to some, like, homeostasis where no matter what toxins are thrown our way, we can manage it, like, kind of get back to, you know, our homeostasis and continue forward. Right. And so that's where, like, these functional medicine doctors, I think, can be so helpful and that I've turned to, like, osteopathic medicine and homeopathy and Chinese medicine. And I mean, I believe in Eastern and Western, like, I use all the. But I've just seen especially, like, with me, I feel like Mia is like a version of me. And I feel like as an adult, I need to go back to the functional medicine doctor. And I need to figure out what's going on, too, to get back to my own homeostasis.

I mean, look, at the end of the day, if we try all of this and we go through the expansion process, and at the end of the day, her tonsils and her adenoids are still enlarged. I'm obviously going to take them out. I'm going to go through with it. It's not like I'm totally opposed to it, and it's not like I'm saying that's the wrong answer. But to me, it's like what I always tell my husband. We can take them out, we can't put them back in. So I don't have.

It's also part of your immune system.

Yeah.

So there's that.

Right. Like they say, what is it? Like, they're the gatekeepers of. Of your body.

Yeah. And they can. They will grow back to. If you don't always address the root cause. Like, there's so many kids where they're removed, but somehow, three years later, the adenoids are back, like, and worse than before, and the tonsils grow back. And, you know, and I think part of it is, especially with kids, at least I've learned from some surgeons, is like, they don't always take out all the tissue because of, like, bleeding risk or because of, you know, it is part of your immune system or that's more invasive than just leaving a little tissue. Well, if you leave a little bit of the tissue, you have a higher risk of it growing back. And the chances of that happening, you Know, not that we don't want it to be there at all, but, like, if your immune system is compromised and, you know, airway is an issue and you have this inflammation going on, like, hi, you're gonna pop back up.

Well, so that's what I love so much about Dr. Barry, is that, you know, it's not just about the expansion. Like, he. He has us working with a breathing coach. He has us, you know, we're. We're using the myo brace for a short time just to see how she responds to it. We haven't. We haven't done sleeping with it yet just because, you know, I'm nervous. But I have to say so after we found out about the infection, she's been on this, like, herbal supplement the past week. Her snoring has reduced this week, so.

The inflammation's probably going down, too. So.

It's going down. So it's like I. I feel like the pieces are starting to fall into place a little bit.

Amazing.

It's. It's exhausting.

It is. But.

So. So you brought up Katie Green, and I was listening to that podcast this morning, actually, and one thing that I. Well, I took away a lot of things, but one thing that really stuck out for me was who do we listen to and who do we trust?

Right, Right.

So, you know, you have to listen to yourself. That's. I think, you know, I tell moms a lot of. You know, when I work with my students, I tell the moms, you have to trust your gut. You have to trust your instinct. And sometimes it's hard to apply it to yourself. But, you know, I. I mean, thankfully, you know, Alex, my husband, he's very supportive, and he's on board with whatever. Whatever crazy idea I come up with next. He's like, yeah, whatever.

You think that's what my husband does, too. He's like, you're gonna do it anyway. So, I mean, what is it? He's like, all right, what? He's like, what is this gonna cost me? And I'm like, I'll pay for that. You know, it's like, I got this. Don't worry. It's all good. I mean, not that it matters, but at the same time, that's one of the other things, too, is I feel like having the resources, because a lot of these things are not covered by insurance. Right. And so it's not even just having the knowledge, but having one, the providers in your area, to even having the money to do it or figuring out how to access resources to help you. You Know, it's. It's not mainstream. And that. That's what kind of breaks my heart a little bit, because I'm like, I know I can give this to my kids, but I know this is not something I can recommend for every single patient that, like, I can recommend it, but not everybody's going to follow it, you know.

Right. So. Okay, so maybe let's talk about that a little bit because, you know, that is. I think that's a big roadblock is that a lot of this is out of pocket. You know, we might get reimbursement for X or Y, but what can. What can most people do to kind of mitigate the costs and, you know, work around it because, you know, insurance does not cover a lot of this kind of stuff.

Yeah, yeah. No, I think, you know, one of the things that you've talked about that's so beautiful is like, the behavioral side of things, like, what can we do before we go right into. For a surgery? Right. Because I think for some people, if surgery is covered, that might be their go to, because it just seems like path of least resistance monetarily. Yeah, path of least resistance to maybe fix their kid, you know, And. And look, if somebody's choosing to do that, I'm passing zero judgment like you do you. You know, I don't think there's anything wrong with that. But when we have these conversations and we share information and we give these other, you know, avenues, right? And then you have parents coming to you going, like, who do you know that does that? That takes insurance. And I'm like, well, I don't know. It's okay. I'm like, I don't know many insurances that cover, you know, a lot of airway dentistry or like, I know Barry is an orthodontist, so maybe you can use some of, like, if you have a dental plan or think ortho. Orthodontist.

I think it's like you get like a 1 lifetime usage of it.

Exactly. Right. So it's like Alex is like, let's.

Hope she doesn't need braces down.

Right? I know, I know. Oh, my God. To name is Social Security number. Joking.

Yeah, but like you said also. Well, no, I'll go back to that later, but continue.

No, I was going to say, like, I called a functional medicine doctor here in Boca, and I should have put us on the wait list because we probably would be going, like, now. But I was like, oh, I don't know when they're going to come available and Lily's going to Sleepaway camp. So I'm not going to like start something in the summer with her. It was like a three month wait list and I, I don't remember what the consult fee was, but I think I was looking at a couple thousand dollars for the three of us to just go for a consult. And I was like, okay, I need to be. It wasn't that I can't pay for it, but I was like, I'm not going to invest the money until like, I'm really serious and ready to like, you know. And I don't know I'm gonna be in three months. Right. So now I'm like, oh, I probably should have done that. But here we are. So one of the things that I do like recommend to families is see what you can do. Like, can you get a sleep study? Because sometimes if you have a sleep study, if your child has like obstructive sleep apnea, for example, it may be worth getting the sleep study because then you can argue with insurance to cover like an oral appliance. They are now covering certain appliances for sleep apnea in adults and I believe it's trickling down to kids now. Like the vivo cna, for example, is a covered. I had it a long time ago before it was covered, so no benefit to me. But I believe that's a covered appliance. They have like a certain like MRNA appliance or something that's covered. And so I feel like once insurance starts to accept certain appliance types, then that can arguably expand to other companies. Appliances, oral appliances that maybe serve the same need. Right. It's opening their way. And so I think we're moving in a direction where we could potentially be getting more things covered. But you have to have a diagnosis. Right. And so if you have a kid with like sleep disordered breathing or like a more mild airway issue, which we still know is a huge problem and not mild, but we'll just go, you know, go with that term for now. I do think it's still going to be pretty hard. There was a mom a long time ago who was on the podcast who was on Medicaid and she did get Medicaid to cover her child's cranial sacral therapy. His oral clients, his. Yeah, she got like them to cover everything. And I think she was going to Lenny Kundal in Connecticut.

Yeah.

So I think the child may have had an alpha appliance and tongue tie release and craniosacral like all the therapists she was. But it is a full time job Right. Full time job, arguing with insurance. Right. So at the end of the day, can you get things covered? Sure. But you have to know one, how and two, you got to have all the time in the day to go back and forth.

It's a hot tip though.

I mean, hey, hey, you know, so I feel like, is it possible? Yes.

It'll wear you down, but it'll save you some money.

Exhausted at the end of it, you'll need like a massage.

But no. I've spent countless hours on the phone with insurance, you know, for my clients and I'm just there. It is, it is exhausting. And then they transfer you like 15 times and you're like, ah, just explained my whole story.

Yeah. I mean we're out of network. Right. Like we don't take any insurance, but even so, we still have to write letters of medical necessity. We still have paperwork sometimes that comes our way that families will partially fill out. We have to complete and then we fax it in for them because it has to come from the provider. We don't have access to the provider line or a provider portal because we're out of network. But they treat us as if we should, the insurance companies. So the whole thing is just, it's such a racket. And this is really, you know, for those listening, this is the United States. Like it's different outside of the United States.

Yeah.

But in the U.S. it's just, they make it very hard. The squeaky wheel sometimes though does win. So be a squeaky wheel if nothing else.

No, that, that's really, that's good to know because I mean it's a lot, it's a lot.

You know, like myotherapy, feeding therapy, that stuff should be covered.

Yeah.

So if you're going to an SLP or an ot, if you're going to a non SLP or non ot, like someone who does not have feeding therapy and can't bill the codes, the diagnostic codes and the cpt, the procedural codes.

Right.

Then, then don't count on it. Like there are people giving super bills out there who are not licensed to do the work that are on the super bills. So if someone gives you a super bill and they're not a speech language pathologist or an occupational therapist or a physical therapist, they cannot bill the same codes that we can.

Right.

And so I think that's another tip is like, I'm not saying don't see other people, but if you want insurance reimbursement, make sure you're going to somebody that has the SLP OT or PT credentials.

Right.

So that your super bill can be argued otherwise, you have no. Nothing to base it on, nothing to go back on.

No, I think that's very important. I think that's really, that's really good to know because, you know, I've, I've, I've had a lot of people kind of ask me about this and you know, when I say, you know, the downside is it is out of pocket. It's a big commitment. It's a time commitment. It's, you know, I mean every day I'm administering like medications and breathing exercise and it's a full time job.

It's a lot.

I feel like I've been underwater a little bit, you know, the past couple of months, just trying to sort this all out. But you know, a lot of people are like, oh, I'm not paying, it's out of pocket, I'm not doing it.

So then you know what's also really interesting? I've had some families who get better reimbursement out of pocket than they get going in network.

Interesting.

I can't tell you why I don't know enough about their. And these are people with like BCBS, UnitedHealthcare, Aetna. What's another big one? I'm like, there's a couple like, anyways, I'm like, there's another one that's like on the tip of my tongue that's not coming to me. But cigna. Yep. I've had family and some of these insurances make it really, really hard. And like in our, even like our EMR that we use, right. We'll write like 50 minute or 30 minute or 25 minute or whatever. However long like that code is being billed for, which we're not. We don't have timed codes. Right. But we do it on our back end so we know how to bill the right fee for the patient. But then it shows up like 50 minutes speech language session or 50 minute feeding session or whatever. Shows up on the bill, right?

Yeah.

And this is still happening. It just happened last week. These insurances come back and they're like, what is this Dash 50 modifier? We're like, it's not even in the same column, you morons. Like, and we have to manually change our super bills so that, that 50 doesn't show up because their system is so dumb or the person processing it doesn't get it. That number is, it's in a separate column. It's attached to some words. This is not a, this is not written Like a normal modifier here. Hello. Like, look at the super bill. But there's always something. There's always something. And again, the squeaky wheel. The person who is persistent enough, like, we help a lot of our. I will say, like, probably 95% of our patients that want to submit and get reimbursed, get reimbursed. And we guide them on how to do it. And we basically. If they come back and say it's not, you know, it's not approved, we go challenge it. Call and find out what. What is the. How many different ways can we challenge it? Because if you go right to an appeal, you're done. You're done if you lose the appeal. But if you challenge it in a different way first and that doesn't work, then you still have the opportunity to appeal. Right? So how many different, like, steps, like, go the route that gives you the most opportunities to essentially appeal, but don't go right into the appeal. Right. So we've learned a lot of information that being out of network on how to kind of play the insurance game. But our families do typically get reimbursement, obviously, at varying degrees, based on their plan.

Right.

But I'm, like, very. It's like, something I'm very passionate about because I'm like, you pay a ton of money to insure. It's like, yeah, the kid needs this. We're not doing this for fun, right? Like, we're doing this because the kid needs it. Right. Meanwhile, Lily says to me yesterday, she goes. She actually was, like, singing some song that she heard at Hebrew school and, like, just came home, like, randomly singing songs. She's never sang songs from Hebrew school, like, prayers and stuff yesterday. And I was like, this is so fascinating. She's like, oh, this is my favorite one. And she starts going. And I was like, her tongue is moving with her jaw. It's not dissociating. And I look at her. I'm like, lily, try this. I'm like, la, la, la. I'm like, showing her, like, move that tongue separate. And so she starts doing it. I'm like, oh, good. And then she goes, yeah, mama. You know, my tongue is coming between my teeth for us. And I was like, oh, it's just like, I thought we fixed that. No, the fact that, like, at almost 8 years old, she. Or no, she is 8 years old, almost 9 years old in August. Right? She, like, recognized that and said that to me. I was like, oh, now we have to address it. Thank you.

Oh, man.

As I'm writing myself a Note here. I'm like, s, L, circle Lily. Get her on the therapy with one of my team members.

I mean, it's also such a fine line. I've always been like, I don't want to, like, over therapize my own kids. Like, I don't want to look at them with my therapy eyes, but it's hard. And. Oh, yeah, yeah, yeah. You know, even, like, with the tongue tie release, like, so back, you know, when Vivi was born. At the time, I feel like standard practice was, like, getting craniosacral and, you know, like, all that afterwards. So we didn't. We didn't do body work before. And, you know, I. I called Dr. Siegel. Like, literally, I was in the hospital. I'm like, oh, yeah, I'm pretty sure this kid has a tongue tie. Even before, when I was pregnant with her, she had, like, hiccups in my belly all the time. Like, this kid, I know he has a tongue tied. I mean, she came out and I called Dr. Siegel. I'm like, I need. We need to come see you. And so, you know, like, I went to go see him almost like she was maybe a week old.

Mia was five days, and we did not do pre op anything, so I feel you. And that was my second kid.

Yeah.

It's like, keeps me up at night.

It keeps me up at night. Yeah, we did. We saw. I don't know if you know Lee Miro by us here.

I know the name, but I don't know her.

She is, like, the best human on planet Earth. I mean, I love her so much, and, you know, she did so much. We've all been to her, my whole family. My parents have got. She's amazing.

I feel like I need to talk to her now. You'll have to send me her name later.

Oh. Oh, you will love her. Yes. All of my people have to come under your.

Yes. Send them all. I mean, Scott's been. I feel like Scott's been on. He's gotten the membership. Like, love, Scott. Yeah, but this is. It just sounds so familiar. Like, I was, like, laying in the hospital bed and texting my oral surgeon, and I was like, she's got a tongue tie and we're gonna. I, like, we'll probably be home tomorrow. And he's like, all right, when do you want to come in?

But honestly, like, now. I know. You know, I always thought, like, it seems like there's still a little bit there, or maybe I didn't do. I don't know. But I always knew in the Back of my head, like, she didn't have a full release for whatever reason. I'm pretty sure it's because we didn't do body work before. And I was like, you know what? Like, I'm just gonna leave it alone because I. I can't. I can't. It'll give me anxiety if I start, like, thinking about what I need to do. And I was like, you know, if. Until. Unless it becomes an issue down the line, I'm not. I'm not gonna do anything right now. And here we are, 100. But, you know, it's like, do I. Do I revise it? At this point, she has.

I feel like if you're gonna do expansion, right? Like, at this point, I like to wait and see, like, what happens. Because it's my opinion that if you release a tongue to a palate that needs expansion, then the tongue heals to the palate that needs expansion. And in some cases, not saying this is gonna happen for every case. And it's totally, like, my theory based on, like, working with patients. But if it's not, like, emergent, and it's kind of just like a. Hey, this might be adding to the symptoms, but, like, it. It doesn't need to be done. Like, right now. Yeah, I would rather, like, expand and then release the tongue so it can heal to the proper palate. Because that. Then I feel like you're less likely going to need, like, another revision or you'll at least know that. Okay. The environment to which we release that tongue was, like, the perfect environment, was like, a healthy environment otherwise. Right. So, you know, I don't know. I'm always like, path of least resistance. And I feel like, especially because it sounded like she. You weren't sure if she even needed expansion. So initially. Right. It was sort of like, oh, maybe, maybe not. Does she. And I don't know if that was a different provider. But, like, at this point, I'm curious, like, is she high and narrow? Another person basically said she wasn't. Or is she kind of, like, borderline and needs a little expansion?

I think she's kind of borderline, but she's on the smaller side. And, you know, I asked Dr. Barry, you know, the one thing that I really, really appreciate about Dr. Barry is he spent like, a half hour on the phone with me one day. You know, I was just like, are you sure we need to do this? What do you think? And one of my questions was, enlarged adenoids and tonsils aside, structurally, does she need it? And he says, yeah, you know, she does. She has a little bit of a tooth rotation already that I've always notice. And again, it was one of those things that I kept. Okay. Like a mental note that's she's going to need expansion. But, you know, this kid, she's. She's also been in Mayo also for six to eight months, maybe with Michelle Burrito. I don't know if you know her around here yet. So we've got everybody on board.

You're doing all the things. That's the good news is, like, you've already got everything. Everything going. So at the end of the day, you know, it's like something should just kind of fall into place. Right. Like, at some point, I'll just click.

Yeah.

But it may be. I often see that expansion is part of that clicking process, if that makes sense. Like, we. We can make progress, but like, to what extent? Right. Doesn't fit in the palate, or we're noticing that, like, okay, they're borderline, but we're seeing some teeth turning a little bit. That tells us, like, okay, maybe there isn't actually enough room for all the adult teeth to, like, grow in, you know, upright themselves properly. And it was fascinating, too, because with both my kids with expansion, that's when they started to lose teeth. Like, they were late to get teeth. Interesting. Lose teeth. And that tends to be. People say, oh, my kid's gonna, like, lose teeth late because they got teeth late. Why did they get teeth late? What does their palate look like? And so that was really interesting. And here's the. You'll like this too. So Lily had shark teeth, right. And so we. She was in an ALF appliance. She got some expansion, but when her teeth started to grow in, she still needed, like, a little bit more expense expansion, especially on the bottom, which doesn't expand nearly as easily as the maxilla, Right. So she gets a second row of teeth, her little shark teeth, you know, growing in behind her lower central incisors. And the dentist, who. I do love him, but, like, he was like, it's fine. Those teeth will fall out. Like, one's kind of like seeming like it might get a little wiggly. Like, they weren't really wiggly. I think he was just trying to, like, you know, encourage her to, like, start wiggling it or something.

Yeah.

He's like. And then her tongue will push them forward. And I was like, ah, oh, no. Meanwhile, I go to the orthodontist next door that's connected to him, like, literally a week later for a consult, thinking, like, let's get her in some early expansion. And he did a beautiful airway assessment, but then the treatment plan did not match. And he said all these, like, really concerning things. And actually, to the point where I was so combative that I think they came and, like, got him at some point because they were like, you need to end this consult. And he called me at the end of his day to be like, are we good? Like, I just want to make sure we're, like, on this. I'm like, yeah, we're good. That's your number. But I had.

I had another. I had a second opinion who I went to.

Oh, my gosh. But no, but this guy was like, oh, we should pull those teeth. And I was like, wait. Your buddy across the hall, like that you guys, like, refer to each other, just said, give it six, six months. And, like, let's not pull those teeth. Like, let's see what happens. Sure enough, we didn't need to pull them.

Yeah.

I ended up going to another provider an hour away, drove a little further because this provider was like, let's put her into rapid palatal expansion and get things moving again. She's totally like, you have the most compliant kids. Like, why would we wait? And I was like, thank you. That's what I'm saying. Like, wait. Like, let's help them breathe and not be sick all the time. But, yeah, as soon as that expansion started, boom. Like, out came those front two teeth move. She did. She did use her tongue and push those teeth forward. So I have to say, that's why I'm like, the dentist was not wrong. But also, if you see the kid's tongue is on the floor of the mouth. Can we have a different conversation, please? All right. I. I love him, though. He's great otherwise. No, but, you know, same thing happened with Mia, who is, you know, six years old as of this past February. It wasn't until she had expansion that her teeth started to, like, wiggle and she started to lose teeth, and her expansion was done at the point of her first tooth coming out, which was like, maybe, like, fourth quarter of last year or, like, fall of last year or so. I don't even remember, honestly. Maybe it was earlier this year. I don't know what month we're in anymore, but she's. Yeah, it was very, very interesting. And I was like, oh, it kind of makes sense, because the teeth coming in, right? They have to. They have to resorb, I guess, is the term the root of that tooth. It's almost like it eats the root of the tooth and, like, kills off that tooth. It becomes wiggly and starts to fall out. So that can take over space, which is why we need baby teeth, because these teeth are also bigger, so they don't fit. Everything starts to turn a little bit, right, and you get things growing in crooked and pushing baby teeth funky ways. And I will say, like, for the most part, their teeth are all coming in straight now because they've got room. And I'm like, all right, that's wild.

So did both of your girls have expansion on the bottom also?

Yes. Yes. So Lily had the ALF appliance upper and lower when she was 4 to 5. That was during COVID And. And so we didn't do any body work. Everything was shut down. And honestly, like, we probably would have stopped it around nine months because she got, like, phase one of what we were looking to do was basically accomplish them. Because of COVID we just kind of left it in, but then we took them out because we were moving. So when we moved down here, I was presenting her case, and a colleague was like, hey, she needs a little more expansion and forward growth. And I was like, all right, like, fine. Like, you know, I think a lot of providers who use ALF will typically leave it in longer and follow the child's growth a bit more than what we did. But because we were moving and we felt like she got, like, really good growth and her tonsils shrunk down to nothing within three months, I was like, I'm good. I'm good with this for now. Like, we're good. You can take it out. So when we came down here, the provider down here put both girls and Mia, she wanted to start on a mile brace first. But when she realized that Mia had croup nine times in one year and had been on steroids nonstop, she was like, oh, we're kind of in an emergent airway situation. Like, let's shift the treatment plan, and we'll use my O brace on the back end to help continue to guide growth. But, like, let's put her straight into the rapid paddle expander with a forward growth, like, component that was custom made for both of them. And then they both went into upper and lower. I don't think they went into them at the same time. I think we started with upper, and then we may have, like, quickly followed with lower.

Okay.

I. At least for one of them, if not both, but because it was a lot of freaking appointments, driving back and forth with two kids who are on two different schedules with uppers. And lowers. And like, here's the fun part. We had a spacers put in. So you literally go to. I'm like, can I do this myself? Like, I drive an hour to have spacers put in for 30 seconds to drive back home, to come back two days later to then have the appliance put in. I was like, you guys are killing me. But no, it was totally worth it. I mean, again, no. No joke, because they're in North Miami Beach. I, like, in the beginning, I was like, can I make my appointments on Fridays and I'll just get a hotel room and, like, we'll stay for the night. Yeah, no, they're closed on Fridays, so I couldn't justify them missing two days of school every single appointment to, like, you know, stay in my North Miami Beach. But it's all good.

So funny. I mean, you know, they say it's not hereditary, and that has nothing to do with it. But, like, I 100% should have had expansion, and I still probably need expansion. And my husband. I mean, same thing, you know, based.

On both of our tooth journey, like, totally epigenetics. I don't know why they say.

I feel like I. Yeah, I mean, I've. One of the. One of the people who I've spoken to, I was like, you know, I think we need expansion. Like, nah. I was like, well, like, I had teeth issues, and my husband. I had braces for seven years, and it's. Oh, don't you.

I think I knew that. Or maybe I did.

I got them put back on.

That was me, like, before my bat mitzvah. I was like, take my braces off. I don't want them on in photos. Like, I'm. So.

I had them all for my bat mitzvah. Also had them. I had them forever. Yeah, but, you know, and my husband had teeth pulled, and he always says, you know, I don't have enough room in my mouth. I'm like, I think. I think we all need an expansion right now if we can get covered by insurance.

Oh, my gosh. There is a girl who I know from a girl now mom, like, who I know from, like, back home, like, growing up, who lives down in South Florida. And she texted me the other day, and she was like, Like, I like, do you have a recommendation for me and my child or for my child? And I gave her the record. She goes, oh, I'm actually going to that person for me. I didn't realize she did pediatrics. She's like, I had teeth pulled as a kid. And, like, she's not in our space at all. Right. Like, so, like, I had teeth pulled as a kid, and I'm having, like, airway issues, and I'm gonna go for expansion and get, like, you know, like, something put in place basically to fix my. I was like, I love this party. It was like, this is the best text I could ever get all day.

Well, that's bad, actually, how I found Dr. Barry, also one of my really good friends, she posted. She actually posted a picture, I think, on Instagram that both of her kids had their tonsils and adenoids taken out. And we were just talking. She's like, you know, we're working with this. With this amazing doctor, and we just got to talking, and so, you know, that's. That's how I found. Oh, my God, my alarm is beeping. Hold on, wait, we're gonna have to edit this out.

That, like, of course it is all good.

Okay, back.

You're back.

I actually. I'm going to have to run in a few minutes also. Okay.

We can wrap up.

Yeah, but, you know, I was talking to one of my friends who. She's not a therapist. You know, she's not in this world. But. But she actually. She used to work on Broadway, and she's like, I've been working on my airway and my endurance, and when I exercise has been so much better, and when she sings, she has so much more, you know, breath support. And we were just talking, and she's the one who actually brought me to Dr. Barry.

So amazing.

You know, the word is getting out there. Yes, Word is getting out there. So I love that.

Well, and when you were saying, like, the whole common not normal thing, I was, like, thinking in my head, I've been seeing so many more, like, Instagram posts, right. Of, like, common, not normal, and people talking about this around the airway, myo feeding, you know, all kinds of issues related to these topics.

And I'm like, can you make merch with that on it?

Right. Common, not normal. Yeah, we should, like, have a shirt.

That says, I mean, same thing with, like, colic. Right? And, you know, all the colic is not a symptom. But, like, you know, when. When Gabby was a baby, my older one, obviously, they told me she's colicky, and there's no other explanation.

It was a diagnosis. Right? Yeah.

And I went back to the doctor who was, like, 85 years old, you know, and I'm like, I just want you to know, you know, this is what we're working with, and he's like, Totally, totally brushed me off. And, you know, it's hard to. It's hard to almost, like, trust professionals, like medical professionals who've kind of been doing this for years. And, you know, it's like the new research in the new way, it sometimes could work, too.

Yeah. I mean. And thankfully, there is research now that shows expansion. Like, so many millimeters of expansion does lead to a certain volume, like, percentage and increased volume in the airway. Like, there's definite, like, numbers. And I think that was Audrey Yoon whose research demonstrates that. And so I'm like, more, please. Like, all of this research coming out, I'm like, obviously we know it works. Like, we see this work firsthand. But I'm like, it's very cool when there's published, like, even if they're case studies, but, like, just published documentation where we can say, hey, read this. Like, it's not just coming from my mouth. Like, what we're seeing is actually being validated and published. So I know we're behind there in terms of publishing things, but. And I also am not one to, like, solely rely on the data because high humans are not number data points. But that's another conversation for another day.

So, anyways, you just, you know, just the first. The second that Gabby started nursing after her procedure with Dr. Siegel, I was like, oh, that's what that's supposed to feel like?

That was me.

I mean, within seconds.

Yeah. Yes, immediately. And our nursing journey was so much better. Even though she was going to pt and then we went to. And her neck was tight on one side a little, and she was crawling with dragging a leg and, like, we had other things we were dealing with. Nursing was so much easier with her compared to Lily.

You want to hear one really cool thing? So when I had brought Vivi as an infant to see Lee for the craniosacral, I had to bring Gabby with me, who at the time was 2. And she's like, you know, running around Lee's office and whatever. And Lee takes a look at her. And I had known, again, one of those things that I was like, I'm going to deal with it somehow. Gabby's foot used to turn inward. And Lee took one look at her and she goes, I can fix that. One appointment. She comes out, and she was two. She's seven and a half now. It has never been, like, a thought on my mind ever since then. I mean, it was tension and, you know, one tiny release, and she fixed a whole issue. You know, I mean, this stuff works.

The stuff works. I always Say, I can't explain it, but it works. I've experienced it firsthand with myself, with my kids. Like, it works. It works.

Well, when I say that, Lee yells at me. She's like, no, there is an explanation. She's like, no, I. I release the tension in the pattern of the body. Yeah.

No. And I'm. Well, that's. That's right. I'm always like, talk to them. Like, talking to the people doing it, because they can explain it. I'm like, I can't explain it. I know there's a reason. Right? But. But it is really cool to feel, too, because, like, I've been able to feel, like, pulsating, like, in my body, where it's like, things feel like they're flowing better. Like, it's almost like you can feel the blood or the lymphatic fluids, like, actually, like, flowing differently. And apparently only, like, 30% of people or so can actually feel this when you're getting certain types of body work, per the guy who I used to go to in Maryland, Manny Kemp. But it was incredible. I would leave there feeling like a different human. And that's why I used to say, like, I don't know how it works. I just know it does, but I know it. Like, he would tell me. Like, I'm like, please, talk to me. Tell me everything you're doing and why it's. Why what's happening is happening and how it's working. And he just explains things so beautifully, but I can't replicate his. Well.

Lee would ask me. She's like, there it is. Did you feel it? And I'm like, yeah, but. But I did walk out of there like a jellyfish. I was like, I don't know what is going on right now, but I feel like a complete. Even with Vivi, when she did it the first time with her, you know, I had, like, a newborn baby, and she was like this tense little ball, and she gave her back to me when she was finished. She was like a sack of potatoes, just, like, open and relaxed and calm. I mean, it's really wild. It's really wild, and it really works. And I've sent. Probably, like, my entire caseload goes to her, because, you know, I'm like, you will see a change. And the craziest is when, you know, they start talking after seeing Lee. You know, she unlocks something in their brain. It's. It's really so, you know, I think it's. It is really cool to kind of see these other professions that are kind of like, under the radar. And, you know, I feel like moms on Facebook always know. They, they, they know who to go to. You gotta find the name that comes up the most. And, you know, like, when you really find that person who knows what they're doing, it's.

It's a game changer for sure. Well, I want you to come back at some point and update us on Vivi's case. Let us know how things are going after you've gone through a couple. I know this will be like a year from now, right? A couple of these, like, steps that you're. You guys are going through right now. But thank you so much for sharing her with me. Tell us where everybody can find you.

So you can find me on Instagram. My handle is Lets Gab Speech. People always think my name is Gabby, but it's because of my daughter that I called it that. But it's let's Gab Speech. And My website is LetsGabSpeech.com Amazing.

Thank you so much, Becky.

Thank you, Hallie. Thanks for having me.

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