Why Did I Release My Adult Tongue Tie?

I got my tongue tie released today.  Immediately upon stating that, I was bombarded with questions.  I felt like blogging would be the best method of answering them all.  If you have any questions remaining at the end of this blog, feel free to ask them in the comments.

Why did I get my tongue tie released at 30 years old?

My reasons for getting my tongue tie corrected are manyfold.  First, because there are many symptoms associated with tongue tie that I experience.  Frequent headaches, digestive issues, shoulder and neck tension, jaw pain.  All of these things are or have been a problem for me in the past.  There is no proof clipping an adult tongue tie will help with these issues, but I figured it was worth a shot.

Second, because I have gotten two of my children revised (each twice!) in the past, and I want to know what I put them through.

Third, because of needing to have each of my children revised twice, I wanted to experience the process of healing a revision without allowing it to heal restricted again.

And fourth, because I’m a dork and I wanted to know what it would be like to have normal movement with my tongue!

What was it like?

Shew.  It wasn’t terrible.  They checked my mouth and took a few “before” pictures, then put some analgesic cream on the lingual frenum (the tight bit under my tongue).  A few minutes later, I felt numb and he injected numbing medicine into the area under my tongue.  We chatted for another minute or two until I felt like I was sufficiently numbed, and he started.  I closed my eyes, and I knew he was using a tool to lift my tongue although I couldn’t feel it at all.  I wasn’t even sure when he started cutting, except that I immediately could smell hot, burning flesh… but I still couldn’t feel anything.  No pressure, no pulling, no burning.  I didn’t feel a thing.

He clipped for 40 seconds?  Maybe just a little bit more.  When he was done, he asked me to lift my tongue up and back like he had before, and my tongue TOUCHED the roof of my mouth.  It was honestly the ODDEST sensation.  That part of the roof of my mouth had never been touched by the tip of my tongue before.  I laughed a little maniacally.

He took a few after pictures, and we talked a little bit about the aftercare, and then I came home.

What do I think?

This one is hard to be objective.  It didn’t hurt for a good while after.  Then the numbing medicine wore off, and it began to ache.  Then I did my first set of stretches, and holy mackerel.  It hurt.  It hurt bad.  I began sucking on ice, and trying not to move my tongue as much as possible.  I finally broke down and took some Ibuprofen.  Currently, it hurts but not excruciating.  There was no bleeding.  No stitches.  I can swallow with LESS effort than before I had it released.  Talking is a little painful, but my speech hasn’t been affected at all.  I can stick my tongue out nearly twice as far as I could before.  I can lick my back molars.  There may be more that I don’t know I can do yet, as I’m being a little hesitant about playing with it!

I’ll try to update at the end of this blog as it heals.  But here are some before and after pictures!

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Pre on Left – Post on Right

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Actual incision size.

8 hours post-op:  My tongue feels swollen.  The area under my tongue feels swollen.  When I stretch it as hard as I can, it tears a little.  It is exquisitely tender.  I can chew, swallow and talk.  My breath is terrible.  The pain/aching is less.  All in all, still ambivalent about how I feel about this procedure.

 

Ketchup.

I have intended to sit down and write every single day since we got back from Albany.  I have lots to say.

First, our trip went flawlessly.  AFTER we got over the 2 hour delay in CLT on the tarmac, the rest of the trip was smooth as silk.  Dr. Kotlow and his whole staff were amazing, as usual.  They stuck around to wait for us because of our delay, and Ruby’s procedure was done in mere moment.  Ruby was un-phased and back to smiling within minutes!

Ruby with Dr Kotlow after the procedure.

Immediately after, Ruby and I had the immense pleasure of meeting one of my sweetest online friends for dinner.  I can’t even begin to describe how thrilled I was that Kimberly and her husband were willing to drive over two hours to get to Albany just to meet Ruby and I.  Have I mentioned before how much I love twitter??  We had such an amazing time.  Ruby and Kimberly’s sweet boy were angels during dinner, enjoying some food a la baby led weaning, and grinning at each other from their highchairs.  When the held hands?  I DIE.

Ruby and her pal! Blurry ruby wouldn't stop moving. :)

Beautiful Kimberly and her sweet husband Joshua were so fantastic.  It’s hard to describe what it’s like to meet someone that you just know you’d be perfect friends with.  It’s even harder to realize that, if not for the distance, you could hang out every day.  Your families could grow up together.  You could get coffee, and go on walks, have barbecues, sleepovers.  You could cry together.  Laugh together.  It’s hard to realize that despite how the internet makes the world so small, it’s actually still just a little too big.

Ruby and I spent the night in a motel in Albany and flew home first thing Thursday morning.  I’ll gloss over the airport security woman that felt it necessary to tell me that breastfeeding is “gross” and fast forward to being HOME.  I had nursed Ruby exclusively the whole time we were gone, and I felt like she just kept getting better and better.  I feel like nursing without the use of ANY other feeding mechanism would be our fastest and best bet and nursing well.

Thursday night, I took another step in a wonderful direction; I took my first class on the road to becoming an IBCLC.  It was so perfect.  I felt like I absolutely was supposed to be there.  I am so, so, SO excited about it, and I find myself eagerly awaiting the next class – even more so, awaiting the start of clinicals!  I hung around after the class and was able to speak with Gretta, our instructor.  We talked a little about Ruby and our nursing journey.  She asked me a few questions.  I lamented that we’ve given up on professional help because we simply can’t afford to spend any more money on consultations and appointments that yield no results.  She told me, “Well… I think we’ll just have to make you our special project then.  We’ll get you and Ruby nursing.  I think we can.”

And then I cried.

I worked Friday, Saturday and Sunday, unable to get the chance to nurse Ruby for 3 days straight due to sleeping, pumping and eating schedules.  When I offered her the breast this morning, she bit me.  The first time she has ever, and I yelped.  It made her cry.  Two steps forward and a quick jog backwards.  This blog has gotten much longer than I had intended, so I’m signing out!  This is the current state of things, and thanks for letting me catch up!

A Last Hurrah.

Well, here we go.

I’m typing this from the airport. Ruby and I are headed back to Albany to have her tongue tie re-addressed.

A few weeks ago, I emailed Dr. Kotlow pictures of Ruby’s tongue, stating that I thought she ha re-adhered. He agreed and told me if we could make our way back out, he would divide the tie again with no charge.

It has taken me this long to get everything lined up and secure tickets, but now we’re on our way. We are flying stand-by and not returning until tomorrow morning. It’s going to be a long two days. Please keep your fingers crossed that there will be a seat for us.

As far as breastfeeding goes, I dont know that this will fix our problems… but it can’t make them worse, right? I feel like this is my final big effort to make things work. If it doesn’t, no one will ever be able to say I didn’t try hard enough. I won’t be able to say I didn’t try.

Wish us luck. I’m excited, nervous, a little scared… mostly hopeful.

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A Cry For Help.

Ok, internets.  I’m coming to you for help.

I know I said I was through, that I had given up.  But I truly haven’t.  I don’t know if I will ever allow myself to REALLY give up.

So I’m asking you… I’m begging you to help me.  All moms who have breastfed, all mommies who have tried to breastfeed, all lactation consultants and la leche league leaders, all women who have helped a friend, sister, daughter; anyone who knows anyone who knows something about breastfeeding – please help me.  Please pass this on, pass it forward, spread it around.  There has to be someone out there who went through exactly what I am going through, who has any idea, who can help.  I believe there has to be.

I have been blogging about all of our problems breastfeeding since the very beginning, but I’m going to chronicle them all out here, so it’s all in one place.  This is a little long, but I think knowing the whole history is important.

Ruby was born full term in a natural water-birth.  She was skin to skin immediately on my chest and not taken away for the first several hours.  She latched on within the first 30 minutes and began sucking.  She was evaluated for tongue tie and proclaimed “fine”.

Early on, I had glimmerings of an idea that something was wrong.  Ruby would break suction on nearly every suck.  She had huge (I mean MASSIVE) suck blisters all over her lips – but she was growing well and no one else was concerned.  I eventually took her to a lactation consultant to find out if there was something wrong with her latch.  I had a small amount of nipple pain, but it was tolerable.

The first lactation appointment revealed that I had massive over-supply, that was thought to be the culprit of all of our problems.  The LC said that she had never seen anything like it before, because Ruby didn’t even have to suck, she basically just had to open her mouth and let the milk pour in.  After checking for and again ruling out tongue-tie, she recommended that we get my over supply under control, and the rest would fall in to place.  This was also around the time we began our first bout with yeast.

In order to correct my over-supply, I began block feeding. We started with 3 hour blocks and got all the way up to 8 hour blocks before I felt like my supply was under control.  There was no more heavy letdown, no engorged feelings between feedings, and Ruby was actually able to “comfort” suck at the end of a feeding.  But this “normal” amount of milk in my breasts brought on a whole new set of problems.  Over a month old now, Ruby had never had to find herself a good, deep latch; it became very apparent that she had no idea how to do it.

I went back to an LC and had her watch, offer suggestions, try to help.  She said that it was her opinion that Ruby looked fine and that the clicking and suction breaking was just her compensating for my oversupply.  (Oversupply?!  I didn’t HAVE oversupply, I finally had just the right supply!)  So I walked away feeling totally lost.  Nursing had suddenly started to hurt – badly.  Ruby was unhappy, fussy, angry; she would pull away and pinch and yell.

I began reading and trying everything I could think of.  Laid-back breastfeeding.  Only nursing lying down.  Nursing sitting up.  Anything and everything I could think of to get her to nurse comfortably and happy at the breast.  Her incredibly unhappy nursing behavior started right around the time that I returned to work and Ruby was introduced to the bottle.  It became immediately clear that she had severe nipple preference, and wasn’t interested in nursing.  I started pumping to protect my supply and offered her the breast before every single feeding.  It was a battle just to return her to NURSING position – she would scream as soon as I laid her back.  Through a lot of patience, determination and hard work, I got Ruby back to the breast, only not well.  Nursing had really, really taken a turn for the worse.

The pain from nursing had gotten so bad that I made another LC appointment.  I had purchased a nipple shield on the recommendation of many other mommas, and wanted to get some help.  During the appointment it was found that Ruby had zero milk transfer (with AND without the shield) and was happy as a clam as I pumped out 5 ounces of milk and it was offered in a bottle.  No real help or advice to offer me, the LC suggested she may have a weak suck.

Near the 2 month old mark, I read an article online aboutmaxillary labial frenum.”  I pulled back Ruby’s lip, and sure enough she appeared to have the most severe level of lip tie.  I knew immediately that I wanted to get something done about it, but didn’t really have the chance.  My husband and I began experimenting with bottle feeding; different bottles, different nipples, different flows.  We have tried every single bottle on the market that touts the ability to be used in conjunction with breastfeeding – to no avail.  Ruby would nurse if she were REALLY hungry, but not well, not happily, and JUST enough to tide her over until the next time she could get a bottle.

We continued like this for nearly a month when I finally decided it was time to have her lip tie divided.  I called Dr. Kotlow‘s office in Albany, NY because I knew if I was getting it done, I was going to have it done by the leading expert in the field.  We flew to Albany the next day and Dr. Kotlow pointed out to me without a doubt that not only was Ruby lip tied, she also had a very significant tongue tie.  I started crying on the spot, not because she was tongue tied, but really because it felt incredibly good to know that I wasn’t making things up – there really WAS something wrong with her mouth.

Dr. Kotlow clipped Ruby’s lip and tongue ties, and I saw an IMMEDIATE difference.  Her latch was better instantly – minutes after the procedure.  She seemed calmer, happier, more willing to nurse.  The pain I was feeling during all nursing sessions was gone.  She wasn’t clicking or losing suction.  She didn’t seem to be struggling to keep herself on the breast.  I thought we were cured.

And then a new behavior developed.  To my best ability to describe this, it appeared as though Ruby didn’t LIKE the feeling of her new, deep latch.  EVERY time she was offered the breast, she would latch on immediately (she seemed willing and excited to nurse, at least!) but she would bring both of her hands up, place them on either side of the breast, and pull back as far as she possibly could.  She would happily suck with just the tip of the nipple in her mouth, fists clenched deeply in to flesh, and remain that way as long as I could let her.  As you can probably imagine, this was excruciatingly painful and I couldn’t tolerate it for more than a few seconds.  But, if I pulled her hands away, held her closer to me, or did anything to change the position that she was attempting to nurse in, she would immediately begin crying, moaning, fussing, pinching and finally just refuse to nurse.

Ruby and I continued with this nursing battle for nearly 3 weeks before I couldn’t take it any more.  Every single nursing session reduced me to tears.  I would get so hot, and hurt and angry that I couldn’t even look at her.  One day, I finally decided that she NEEDED to eat, so I went and got some frozen pumped milk, put it in a bottle, and I fed her.  I cried, and I cried but I decided we were done.  Nursing her wasn’t working for either of us and it was just causing more heartache than good.  From that day forward, I have exclusively pumped, and Ruby has been bottle fed.

About two weeks ago, I took Ruby to see a speech therapist.  She did a suck evaluation, and tried Ruby on about 5 different types of nipples, with different types of flows.  She determined that Ruby has an uncoordinated suck, in that she doesn’t take any breaks.  She just sucks and sucks and sucks and sucks, with little time to swallow or breathe.  This causes her to have a very urgent, demanding feeling to her feeding.  We began paced bottle feeding and have seen an improvement in her demeanor while she is bottle fed, but there has been very little change in her nursing behavior.  She doesn’t nurse like a normal baby, who will suck, suck, suck, suck, swallow, breathe, rest.  She doesn’t rest.

And this is sort of where I stand.  Ruby wants to nurse, and I will attempt to allow her to occasionally.  She hurts me terribly the entire time.  I have cuts and claw marks on my chest and nipples.  She squirms and kicks and rears her head back.  She PINCHES.  There is nothing I can do to ease her discomfort or get her to relax.  I say I have given up, but I really haven’t; I want her to nurse.  I so desperately, deeply, fully want her to enjoy nursing, for it to become a nursing relationship that makes us both happy.  I want to nurse Ruby until she doesn’t need the milk any more.

I want to nurse.

Please help.  Please send this to anyone who might be able to help.  Please give me all of your ideas and suggestions and advice.  Please tell me even if you think I’ve already tried it.

Ruby is 5 months old.  I’m not finished.  It’s not over yet.  Please.  I need help.

 

 

 

Maxillary Labial Frenum and Tongue Tie

When I think of a ‘whirlwind vacation’, I imagine jetting off to Paris for a romantic weekend.

Jetting off ANYWHERE is not relaxing or romantic at all.

I flew with Ruby to Albany, New York yesterday… and here’s why:

Ruby and I have had nursing troubles for ages, and there didn’t seem to be any real solution beyond just muscling through. She had been ‘checked’ for tongue tie at birth and I was told she was fine. She was ‘checked’ again by a lactation consultant and again by my pediatrician who all pronounced her ‘normal’. Several weeks ago, I read an article on “maxillary labial frenum” tie on Facebook, and it got my wheels turning. I checked Ruby’s upper lip. It looked like this:

Ruby's Maxillary Labial Frenum

I was sure the moment I saw it that it was tied. My little wheels kept right on squeaking. I tweeted about it. I had a bunch of responses, but one person in particular (and I can’t remember who) sent me to www.kiddsteeth.com, where I started reading article after article. I knew it, this was our problem, and Ruby need to be ‘fixed’.

I began talking with Brock about getting Ruby’s lip tie separated, and brought it up with our pediatrician. I knew many people flew to Albany, NY to see Dr. Kotlow because of his experience and his methods of laser separation WITHOUT the use of anesthesia, and we were prepared to do so as well. My pediatrician talked me into getting a consult with a plastic surgeon before I considered flying. When they called to schedule my appointment, the earliest they could get us in for a consult was June 22nd. I called Dr. Kotlow’s office and asked how soon they could get us in – to see if it would be worth our time going that route. I was asked, “Would you like to come in tomorrow?”

That sort of cemented it for me. I looked into flights to Albany, and there was a non-stop option. Brock’s dad, Ted, help me plan out the flights, the tickets were bought… and it all happened to work out. We were going. The very next day.

That night, I slept well but woke at 6am and couldn’t go back to sleep. I got up and showered, got dressed and myself all ready. I re-packed the diaper bag and picked out an outfit for Ruby. I cleaned. I ate. I changed the car seats so Brock would have a seat for Ronan while I was gone. I sat. I tweeted. I got really, really bored. It was 9am and NO ONE else was awake. I finally woke Brock up so I would have some company.

Ruby eventually woke a little after 9:30, and I bathed her and dressed her. She was in a great mood and I was excited for our day. We loaded into the car – me, Ruby, and my trusty Ergo – and it was off to the airport. After parking and checking in, we were really on our way.

Mommy and Ruby - Ready to GO!

Security took us mere seconds to get through. In the Charlotte airport, I wasn’t asked to take Ruby out of the Ergo, but instead was given a quick pat-down. We arrived at our gate and patiently waited. Ruby was handing out smiles left and right! I stood near the counter so I could be sure to hear if they called my name, and I could see on the monitor how many passengers had checked in, how many seats were left. We were flying stand-by, and all we needed was ONE seat to get on the plane! I watched as person after person walked down the jet-way, and I felt myself getting more and more nervous. My hands started shaking, and I was a little sweaty. There were at least 4 other people still ‘sitting’, so I assumed they were also stand-by. By my counting, there was only going to be one extra seat. After the last person boarded, I nervously walked up to the counter and said who I was, and that we were waiting for a seat on the plane. I had mentally prepared my sob story, and how I was taking my poor, sweet baby for surgery… but the gate agent picked up a boarding pass that was sitting next to him, scanned it, smiled at me and said, “Enjoy your flight!”

We were on the plane!

Nursing... on a plane!

While on the plane, I began chatting with the lady sitting beside me. I told her I was planning on nursing Ruby while on the flight, and she was very pleased! She told me that she had breastfed all three of her children, the youngest of which is now 47. We had a lovely conversation about breastfeeding and how it would be wonderful to see more women doing so, more normality and less derision. Ruby smiled and smiled at her. I think it made her day. She became Ruby’s honorary airplane grandma, and held her so I could have a bathroom break.

Ruby and her new friend.

After landing in Albany, I hopped in a cab that was waiting curb-side at the terminal. I told the driver the address, and we were on our way. Nerves had really started to to kick in, and I was starting to feel scared about putting my tiny, sweet baby through surgery. We arrived at the dentist’s office, and it looked like a repurposed house. I wish I had taken a picture of it. But as soon as we walked in, it became apparent that this place was in the business of kids. There were sweet, lovely, colorful signs every where… there was even a carousel in the waiting room! Dr. Kotlow has been a pediatric dentist for so many years, his patients are referred to as “Kotlow’s Kids.”

Kotlow's Kids - 20 minutes early!

I filled out mountains of paperwork, and Dr. Kotlow came in and introduced himself. He asked to examine Ruby, and laid her down between us with her bottom in my lap, and her head on his knees. The man is incredibly professional, and incredibly proficient. He pulled Ruby’s lip up harder than I ever have, and it immediately became apparent how tied her lip really was. He then forced his fingers and thumbs in her mouth and pulled her tongue up as far as he could, and showed me how tight her lingual frenulum was. I had no idea how significantly tongue tied she was, but he described it as a “very severe tie”. Ruby wasn’t bothered in the least by all of this, and he handed her back to me so I could watch a video about the procedure. While the video was very informative, and showed exactly how the procedure is done (using clips of actual procedures) my heart was racing. I wasn’t sure I wanted to go through with it.

Dr. Kotlow came back, asked me if I had any questions, and said, “Ok! Let’s get this done!”

He held his hands out to Ruby, and I hesitantly placed her in his arms. With very confident, assured hands, he carried her away.

I was suddenly very alone with her paci and my tears.

Seeing this picture still makes me cry.

I strained and strained my ears to hear her screams of torture. I convinced myself that it was awful, and my poor baby was going to be scarred for life. I prepared myself to sit in suspense for the duration of this exhaustive procedure. Moments later, and I am not exaggerating, but mere MINUTES later, I heard her whimpers coming back down the hall. My shock was washed away with relief at seeing my baby with tears down both cheeks, but quite obviously fine. He said the procedure went smoothly, and commented that she was a VERY good yeller. He showed me her incisions, and it didn’t seem to bother Ruby at all. I suspected that she was crying simply because she had been restrained and not at all because she was in pain. He said he would leave the room and allow me to nurse to see if I noticed a difference.

Boy, did I notice a difference.

It was as though I was nursing a different baby. It was as though our problems had melted away. It was as though she was nursing the way she was meant to all along. I cried, and I cried – happy tears. I felt justified, vindicated… but most of all, just thankful. My fears of picking up and flying across several states for a problem that may have been all in my head just melted away.

Dr. Kotlow returned and could tell from my face that things had improved. I thanked him profusely and we went over our “discharge” instructions. He showed me how to stretch her incisions so that they wouldn’t heal back together. We discussed what normal healing would look like. He pointed out potential problems to look for and gave me his cell phone number. He told me I could call or email him any time with any questions or concerns. He then apologized that we came such a very long way for such a very short visit, and I assured him that it was incredibly, unbelievably worth it.

Happy it's all over.

We cabbed our way back to the airport and over-exhausted Ruby fell asleep as I was waiting in line to check-in. I walked to security, and put my things on the conveyor belt, assuming that I would be allowed through with Ruby in the Ergo as I was in Charlotte.

Wrong.

They insisted I take her out of the Ergo and put in on the conveyor to go through the x-ray. I questioned it, told them I hadn’t been required to take her out at our previous airport, and was informed that it was “regulations” and that the rules were the same everywhere. Let me just say this – airport security, and all your pompous crap is just power tripping. Anyways.

I had lunch at a cute little salad bar, and watched as leagues and leagues of people went to McDonalds next door instead of opting for soup, salad or sandwhich. I laughed and moved on to our gate. We waited almost two hours for our flight home, and I was given a seat before we even started boarding. The flight wasn’t even close to full, and my last anxiety faded away. We had survived the trip, we simply had to survive the flight and we’d be home free.

Ruby was fussy on the flight, and unable to fall asleep. She comfort nursed more on that single airplane ride than she ever had before, and I think both of us found it relaxing. I can already tell that she finds nursing to be less frustrating than ever before. Near Charlotte, when we started making our descent for landing, I strapped Ruby in the Ergo and she became very upset. She was screaming and didn’t want to be strapped in, but I felt that it was necessary to have some extra security when taking off and landing. I whipped out mah boobage and nursed her in the Ergo and it calmed her instantly. BECAUSE she was in the Ergo, it was nearly impossible to tell that I was breastfeeding her. However, when the flight attendant walked by, she stared intently at what we were doing, and when she figured it out, she gave me the most heinous stink-eye I’ve ever seen. I laughed it off, and said to my seat-mate, “Did you see that look? I’m entirely impressed,” to which she responded, “You’d think she’d just be glad the baby isn’t crying.”

Landed, traversed the airport, and a short car ride later we were HOME. Brock immediately noticed how mobile her tongue was – it’s incredible to watch her experiment with her new-found mobility. I nursed her again and put her to sleep around 9:30pm, and she slept until 7 this morning. She’s my hero.

Here is a before and after comparison of Ruby’s lip.

Maxillary Labial Frenum - Before and After

Since photo-blogging our journey yesterday, I have had several people ask me questions about the lip-tie, the procedure, and what to do. Here’s how I feel about it – it was so easy, so fast, and quite obviously doesn’t bother Ruby a bit. (I have done the stretching exercises several times since we’ve been home, and she smiles immediately afterwards.) My only question is – Why not? If there is a chance it could improve your nursing relationship, or improve your child’s chance of not having speaking/eating/etc problems in the future… what really is there to lose? I read an entire thread of people on Facebook yesterday who opted not to have tongue or lip tie clipped as an infant and ALL of them had it done at a much later time, suggesting it be done earlier because it’s easier and heals faster.

Check out the link (again, it’s www.kiddsteeth.com) and see what Dr. Kotlow has to say about it. I am SO thankful I decided to go through with this, and could not be happier with the result. If you have a question or a concern, consult a pediatric dentist or ENT – and find someone that can do it without general anesthesia, because it isn’t necessary. And good luck. :D