Monday, January 18, 2010

Biscuit, part 1

Our oldest son, Biscuit, has had trouble with his ears since he was small. He had round after round of ear infections, with round after round of antibiotics. Our first set of ear tubes made a huge difference! He was still 2, I think, at the time, but he was more cooperative, and less frustrated about things, and the number of ear infections was dramatically reduced, so we were happy that things were going well.

They came and went as they were supposed to, and his ears being what they are, we ended up with a second set. We felt good about them, too, until they fell out after being in for less than 6 months.

Then we began to notice that he was having more difficulty hearing. Our nurse practitioner recommended a new ENT, who removed his adenoids and introduced us to t-tubes. The standard tube used for myringotomy (ear tube surgery) is a small, straight tube. However, after you've had straight tubes, or have had trouble keeping them in, your next option is a tube that is shaped more like a "T". They stay in for an average 2-3 years vs. the 8-12 months span of the straight tube. Because they stay in longer, they also carry a higher risk (about 20%) of "perforation", which is when the tube leaves a lasting hole in the eardrum. He also had an appointment with the audiologist at this point, during which we were told that already had some mild hearing loss due to the scarring on his eardrums from the repeated infections and the previous sets of tubes. It seemed important to not have to KEEP repeating the regular tubes, so we agreed that it was time for the t-tubes. And for almost 2 years, he had VERY few ear infections (for him!), and no real problems, ear-wise. Yippee!

Then his eardrums began to reject the tubes. With ever-widening holes in his eardrums, and tubes that were about to fall out, our ENT had no choice but to go in and remove the tubes, and "clean up" the edges of the holes, in the hopes that they would repair themselves. It wasn't very long before we were BACK in surgery to put in paper patches to help close the holes. They appeared to be working, and things were looking good. But, this summer, he had ear infections that pretty much just blew everything out and now the holes are larger than ever before. And then he failed the routine hearing screening at school.

So back we went to the audiologist, who classified him this time as having moderate hearing loss, and the ENT, who suggested hearing aids and tympanoplasty. Tympanoplasty involves making an incision behind the ear, lifting the ear forward (basically flipping it over, like turning the page), and then repairing the hole in the eardrum with a graft of skin. This seems like a much bigger deal to me than simple tubes, so, as you can imagine, I'm not in any hurry to do this unless it is absolutely necessary! And also, we have no "hearing aid coverage" according to our insurance company (like we just didn't have the forsight to include this in our policy!), and those things aren't cheap!

Thankfully, someone we know recommended her daughter's ENT, and we went this past week for a second opinion. Not because we have a problem with our other doctor, or because we didn't want to take her advice, but just because this seemed like something we needed to be really sure about. And I'm really glad that we did.

His advice, after seeing Biscuit's records, and looking at him (and BEFORE hearing our opinions on the matter) was that he doesn't believe Biscuit to be a good candidate for surgery right now.

SO... hearing aids here we come.

Anyone wanna rob a bank hire me to do some odd jobs?

Jean

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