Josh Thompson     about     blog     projects

Tongue Ties: What, So What, What To Do

Article Table of Contents

“tongue tied” (my first time hearing the word, my newborn’s experience) #

‘tongue tie’ was something I’d heard discussed (the little bit of fiber under a tongue) as the child we now know as Eden was incubating inside of Kristi’s womb. I didn’t think much of it then.

Cut forward to 5 days post Eden’s birth, we get our first at-home lactation consultant visit, from a lactation consultant affiliated with The Mama’ hood. She was amazing. Eden was at the minimum threshold for how much weight is normal for babies to lose after being born.

I didn’t know until then that whatever weight a baby is born at, it’ll lose 10% as it’s diet and nutrition and metabolism cut over from ‘being fed via umbilical cord from mom’ to ‘being ved via milk and digesting and eliminating waste’. It’s fascinating, but I totally get why weight would be lost but it’s not good to lose too much.

The hospital lactation consultant had checked in on Kristi and Eden and pronounced all as fine. The at-home lactation consultant said:

I’m technically not allowed to make a formal diagnoses, but by my estimate, Eden has a severe tongue tie, and probably a lip tie, and it’s interfering with her ability to generate suction, which means Kristi’s milk isn’t going to come in, because her body doesn’t know anyone’s requesting milk.

That’s something of an emergency state, as you could imagine. Kristi and Eden began “triple feedings”, where:

  1. Eden and Kristi, nursing as usual
  2. After eden would finish a defined few minutes of nursing, I’d feed her breast milk from other mothers with extra milk, obtained via friend networks and online mothers-supporting-mothers groups
  3. Kristi’s milk needed the stimulus of nursing to come in, so using a electric pump, she’d pump. We’d freeze it to later give to Eden.

And all of this happens every two hours, start-to-start. We’d spend an hour feeding, rest a bit, and then another hour would pass and we’d start it all over again.

We tracked everything to the nearest 5 or 10 ml, at the very beginning. After a weekend of this, and a weigh-in at the pediatrician’s office, we could see that Eden was gaining weight, and we all collectively breathed a sigh of relief.

I said something about the proposed tongue tie to the pediatrician, he said:

Yeah, maybe, no biggie either way. As long as her weight is going up, all good. If not, she’ll need to go on formula. We’ll re-weigh her in a week.

This was basically an emergency situation.

author’s note, I just for the first time ever lost a bunch of the text I’d written! I had this whole story typed out, saved it, gone. I’m sorta not willing to re-do the whole thing now, pardon the brevity…

We wanted Eden to be able to eat herself, from Kristi, ended up visiting our local dentist who referred us to their favorite pediatric dentist. We spent a morning driving around and talking to doctors, but by the end, had what we wanted and what eden needed.

Her lips opened up so much more, she was able to finally generate an obvious and proper seal.

Her mouth opened so much more than it was before. Her cry was different, stronger, throatier. Everyone commented on it. Her tongue could move up and around, in a normal way, but I hadn’t even realized how restricted it was before.

The procedure was simple, the pediatric dentist removed her upper lip tie, lower lip tie, and tongue tie - it wasn’t just the fiber visible inside her mouth, but it was actually removing quite a lot of material from the mid-line of her tongue, into an area that looked (and in hindsight obviously had to be) deep in her throat.

I watched the whole procedure from over his shoulder, looking at her mouth or the camera he sometimes used that sent video to a monitor. As soon as he was done, I was saying to myself “why was this not instantly diagnosed in the hospital as soon as she was born?”

It was sooooo obvious.

Tongue Tied (the book, and my adult experience) #

Skip forward a few years. Other than the story of how inadequate the American medial system is, I didn’t think about the tongue tie thing for a year or so. then I remembered, in the conversations, people saying “it’s heritable”, and then I looked up a functional test for myself, and failed it, hard.

Here’s an example self-assessment youtube video. Also google tongue tie self-assessment and hunt around. There’s different ways the tongue and lips can have extra tissue hanging out, and as you explore you’ll find those ways.

Tongue Tie Test: Quick Self-Test to see if you are secretly Tongue Tied! (FOR SINGERS)

I obviously had one, next read Tongue-Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More.

After reading that, I was fully committed to the procedure, just needed to line up the details. It’s not trivial, but not difficult or complicated.

I called around American dentists, to see if they did it, and wasn’t inspired to confidence. Eventually I found the Colorado Tongue Tie center and was instantly onboard. They’re trustworhty, you can read the reviews. They said:

we don’t do the procedure until it’s recommended by the myofunctional therapist you’re working with. here’s some we recommend…

I ended up calling and working with megan dewalt, who is exceptional. If all you do is read this blog post, read the book, and then set up a intake/evaluation call with her, and do what she tells you, and you have a tongue tie, your life is about to be transformed. :)

contacted a past dentist to see if they agreed, in case I needed a referral, and they said

We agree that the patient might have a tongue tie that might benefit from release, obviously up to the wisdom of the involved medical professional.

Good enough.

My personal life is full of stories of things like:

  • signs of sleep apnea
  • night time teeth grinding
  • braces (and pallet expanders) as a kid
  • adhd? sleep issues, for sure, in various ways.
  • sometimes sounding like I’m choking in my sleep (I don’t remember these episodes the next day)
  • obviously limited tongue mobility

BuuUUuut… I also “seemed fine”. I can eat, I can talk, I sleep, blah blah blah…

I spent time in Thailand and Indonesia and thought about getting the procedure done there, but thankfully my sister convinced me to consider myofunctional therapy before just getting the release done.

The reasoning makes tons of sense, as soon as she says it:

Your oral anatomy has been constrained, massively, so you’ve learned compensatory movement patterns. If your tongue gets unstuck from the bottom of the mouth, and you don’t know what new movements to do with it, you’ll only partially benefit from the new options.

(My words, not hers)

Right she was. I made it back to colorado, found Colorado Tongue Tie Center (I just live in google maps, so here’s their listing/the reviews)

✨ My Post-surgery experience ✨ #

As the procedure was happening, I giggled to myself the first time I noticed my tongue touch the top of my mouth while my mouth was side open. I’d never felt that before, I had been looking forward to that moment for a while, and I finally got it, though my mouth was full of local anesthesia, so ‘feel’ it might be the wrong word.

even sitting in the chair afterwards, I noticed that my head turned better. It makes sense, turns out my tongue was incorrectly stuck to my hyoid bone. (If you can look straight up and swallow without pain or tight pulling from your throat to your sternum, congrats! No tongue tie for you!)

My throat (‘hyoid bone’) had been turning when my head would turn to full extension - because it was uncomfortable, my head either wouldn’t turn farther, or it would hurt.

Post-op, no pain. It was amazing.

Next I noticed indeed that my head sat a bit higher/differently on my neck. The tongue tie (in my mind) caused a bit of tugging on the top of my spine, so to keep things comfortable I was compensating in posture. This was plainly visible to the therapist/doctor, but I’d never noticed and couldn’t really see it, until after the procedure.

i felt differences in my sternum, diagram. shoulders. neck. throat. voice. swallowing became less burdensome.

And this was all still while my tongue and mouth was in quite a bit of pain, because it had just gotten rather er… opened up.

So, I did what any normal person would do and drove to Rifle for three days, where I proceeded to have a LOVELY trip, climbed a bunch of moderates, and did (and sent!) harder-for-me things.

My climbing #

My climbing is different.

Turns out my head couldn’t rotate freely on the end of my neck, so, because one spends a lot of time looking up the wall while rock climbing, I was changing the posture of my contact with the rock, often enough, to accommodate the needs of looking up/around. With better mobility/de-linked neck/head rotation, my movement is different. I’ve always been able to climb smoothly, and I don’t know if this difference is visible from an observer’s perspective, but I can easily feel a difference in comfort, just looking around and finding various positions relative to holds.

My posture #

I stand differently, and I’ve had a HORRIBLE lingering back issue for a while, that was exacerbated by my head being incorrectly tilted forward. I’d compensate in my shoulders somehow, and then compensate again in my lower back. Now, everything ‘stacks’ nicely, and I can stand vertically without effort. I would have said I could stand without effort before, but I was wrong. Now I know, it was very effortful.

My tongue #

After six weeks of tongue strengthening and stretching, I’m very aware of my own mouth. I spend SO MUCH time now exploring the inside of my own mouth with my tongue, or exploring the movement of my throat, soft pallet, throat/hyoid bone, and tongue, all in relation to each other. I notice that I can open my throat in a different way, that is much more comfortable.

Driving and scooting #

My head sits differently on top of my spine, and I can turn my head easily, farther, as I mentioned. This manifests in more ease while driving and scooting. I can easily tell the difference. A helmet is heavy, so a slight correction to head posture lets the weight of the helmet be more easily carried on top of my spine. It’s comfy. I can quickly turn my head far too the side to check blind spots, as needed.

My emotional state #

Pete Walker says, basically,

emotional flashbacks tend to happen when we assign emotional meaning to physical sensations. Stopping the flashback is to first engage in thought-stopping behaviors, then try to localize where/what the physical sensation is in the body, and hold space/honor/work through that physical thing.

I now know in a way that is clearest once the ‘strings have been cut’ that I carried substantial tension (think… muscle tension, fascia tension, whatever) in my throat, connecting my tongue, the top of my spine, my hyoid bone, and more. That physical knotted-up-ness would contribute to a turbulent emotional state, AND would limit my rest-and-digest systems from fully getting online.

If my sleep is compromised, I’m getting less restored, and if I’m less restored, things seem incrementally harder and more dim, rinse and repeat.

I could say more but this was written in a single session, and i lost a bunch of what I’d had due to minor computer errors. I’m a write-it-now kind of person.

I’ve gone all the way around with depression, need to do an update to that post, but would posit that an emotional state and inner physical tension can have a relationship. I prefer the version of my body post-tongue-tie-release than pre.

My climbing partner was subjected to near endless exclamations to myself about my own mouth. “I love my new mouth!” “I love taking my new mouth rock climbing!” “wow, that thing I said earlier about breathing and my diagram applies to breathing while climbing, too! Amazing!”

I could say more.

How I proceeded to the tongue tie release, 5 days ago #

I’m writing this whole damn post because I want to write down the profound and many differences I feel, inside my own body, often in shocking and beautiful ways. If you have a tongue tie, and can get the work done (myofunctional therapy, tongue tie release, more myofunctional therapy, and body work) you might find your body a drastically friendlier space to inhabit.

Colorado Tongue Tie Center #

The procedure was done by Dr. Chad, he was exceptional, it was chill, easy, pain was non-existent (during the procedure) and minimal during the post-procedure repair time. (I ended up with six sutures after the procedure, so went heavy on ibuprofen and tylenol for a few days, and took a light dose of narcotics the first night to sleep, drank TONS of salty broth)

It’s ~$1500 on a credit card, some health insurance agencies will reimburse you, and if the health insurance company won’t, the dental insurance company might. Or no one might.

Megan Dewalt, OMT #

Megan was (is) my guide through the whole process. We did a few pre-procedure meetings, a few weeks apart, where I’d get exercises to build tongue strength and proprioception so I can know where my tongue is/isn’t. To make sure I mouth breath, etc. Then I did the procedure, she’d given me notes ahead of time with the stretches to do throughout the rehab. (super light immediately after, light/medium until sutures dissolve, then go hard after)

Dr. Chad at the Tongue Tie Center said it was easy to do my procedure, as it’s always easy to do the procedures for Megan’s clients, because I had plenty of musculature in my tongue, which made it easy for him to find the tissue to remove, vs. the tissue to not remove.

I spent ~$1k on the pre-op prep, and about $1k on the post-op rehab, spread across six weeks each, with 2-4x/daily strength building exercises, paid/scheduled right after the intake call.

The obvious book, Tongue Tied #

Tongue-Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More. Get it, read it.

Bodywork from Daniel Lopez #

Daniel Lopez, DO very useful bodywork, bc turns out the tongue/hyoid bone/top of the spine all can be incorrectly bound together, and when the tongue is released, there’s so much new movement potential. Dr. Lopez did grand work on me, from the cranium through the sternum (and even worked on a back injury that is now dramatically better, bc my head sits on my spine differently, so i don’t have to compensate/over-compensate elsewhere in the spinal column)

I did my first appointment ($300) the day after my release. I kept having nearly tears in my eyes as I could feel the ‘unclenching’ of various portions of my body and musculature, in the days following the release.

Nasal Breathing #

A big part of a tongue tie is it’s contribution to things like sleep apnea. A big part of sleep apnea is snoring. It’s ‘super unhealthy’ to breath through the mouth exclusively, or majority, or much at all. Oops, RIP my entire childhood. Tongue ties also relate to teeth grinding, which I did, so I wore a mouth guard, which pushed my mouth open even more, so I was 100% mouth breathing when I slept, even though when awake I’m aware of how dry the air in denver is and would close my mouth.

Fixed it all with tape. A little strip of athletic tape, across the lips, and I instantly was sleeping better, waking up with the inside of my mouth feeling rested instead of dried out.

Consider reading Breath: The New Science of a Lost Art by James Nestor. It’s sorta pop-sciencey, but if it gets you to start taping your mouth at night and nasal breathing when awake, good enough.

Misc Sources #

Here’s some internet rabbit trails to follow:

💬 Comments

Post comment