Tuesday, January 10, 2012

Ears and Adenoids and ENTS, oh my!

Medical stuff - I took Monday off to take my daughter to a new ENT, since I never reached a happy place with the last guy. Other than the little corner of hell known as the pediatric specialist's waiting room at 8am, it went swimmingly.  The first guy wanted to operate immediately, because all kids with Down syndrome end up getting tubes (and adenoidectomies).  Nevermind MY daughter's stunning lack of ear infections.  He shrugged off my query for the ABR (auditory brainstem response), stating it should only be done after the tubes were in (so that they drain first, which admittedly makes sense IF the fluid was the problem).  Granted, she was getting over one of her long string of colds that day, so it's quite possible she did have fluid in her ear but no one else had ever seen any before (triggering some unfair thoughts about my beloved pediatrician's abilities) so I wasn't sure what to think (though I very much appreciated y'alls comments).  I don't expect all our MDs to be warm and fuzzy but basically I didn't like the guy that much and if we're going to get tubes, why not just drop in this other office over here first and see if there's somebody else I'd rather pay? 

Besides, the new ENT is at Hospital #2 which has better landscaping and parking than Hospital#1.  You can see I'm a fully informed & empowered patient's mommy. 

Hospital #2 is also the same place they re-read the AAI xray from Hospital#1.  And it (#1) is where her first opthamologist was - she was all of 6 or 7 months old when she saw him, i.e. with a newly fixed heart, and it was the middle of winter, i.e. flu & pneumonia season.  The guy sneezed into his hands and then reached for her.  Time slowed down like in a horror movie - nnnoooooo!  We didn't go back.  Damn #1 & their proximity.   Hospital #2 is sooo far away but this last month just sealed the deal and I'm always game for lovely morning drives. 

Anyway, the new folks actually tested her hearing.  Such shocking thoroughness!  They tried a behavioral hearing test first (the VRA on the link.  By the way, kudos to whoever dreamed up those light boxes - pure, inspired genius) and then a tympanometry.

We had inconsistent results- they'd expect the tympanogram to be flat if she had fluid in her ears and/or because of those little ear canals all kids with Ds have.  Except the new ENT thought her ear canals were lovely, as in not small, and she saw NO fluid.  So she wasn't sure why the tympanogram was flat.  She had to look as I held down my wailing, thrashing daughter so she hedged her answer a bit but no glaringly obvious wells of, um, yuckiness.

And although she technically passed her VRA (lookit me with all the new acronyms!), the audiologist thought the results were unclear since she was only "fairly" cooperative.  Turns out "fair" really means "wild child - good luck with THAT one".

So we're scheduling an ABR.  Which is what I wanted 'lo these many moons ago.  While the girl's sedated, if our new ENT sees fluid, she'll put in tubes, but not before evaluating what the heck is going on in there.  AND she wants the results of next week's sleep study, so she can decide if an adenoidectomy is appropriate.  Wow!  A thoughtful rational approach to an individual patient!  You'd think we're in the 21st Century or something.


Daily Boulder:
The teacher's aide in my son's class who not only had encouraged a new friendship between my son and a very nice new kid (he came over to play during Christmas break), she also promised to talk to someone about the mean kid the kid in aftercare who's still learning how to play nicely with others, and maybe encourage some different and better friendships since the nice new kid gets picked up right after school because his mommy loves him and isn't around to play with in aftercare.


  1. So glad you had a good experience this time... curious to see how the ABR results go and if they do tubes. Mostly because I'm just curious like that. :o)

  2. You are totally right to abandon doctors who are irritating human beings and go with doctors who give you a good vibe. I truly think the good vibe is something that as a parent your body is tuned into.

    Okay, and I don't know what an ABR is (although there's a good chance Maybelle had one done in November, when she got tubes in her ears and the sedated tympanogram). I googled: American Board of Radiology? American Bicycle Racing? Advanced Bio-Mechanical Rehabilitation (this would be if your daughter were the Bionic Woman).

  3. I updated the post w/the ABR link but then couldn't comment here for a couple days (on my own blog!). Adding this now just for the hell of it. Auditory brainstem response. How cool is that?