Friday, August 29, 2008

Booth Test Results

Nolan cooperated really nicely for his booth test yesterday. With the exception of being very chatty (we had to shove his mouth full of cookies to get him to quiet down), he habituated quickly to the dancing puppy and koala and dutifully squealed with delight every time the animals lit up. We got great results as far as accuracy is concerned. As far as hearing level...

We've had a drop. A big one in the high frequencies. Twenty decibels gone in three months' time. We've gone from having a rising audiogram to a nearly flat audiogram, and now we have a "reverse cookie bite" audiogram. In the moderate to moderately severe range.

We're lucky that his hearing aids are more than capable of handling any configuration and almost any loss level (they are good all the way down to the severe range). We don't know why Nolan has his hearing loss, though our audi did ask if he had his eyes checked yet. That's the only test that hasn't been done yet (they can't really test for that particular syndrome until they're toddlers). Nolan's not at risk for type 1 Usher's, but there are two other variants that have moderate or progressive hearing losses associated. I doubt that's the case, and we'll probably just never know why his hair cells are dying.

Anyway, his last results (from May) were:

500Hz: 50dB


2000Hz: 35-40dB (depending on the ear)

4000Hz: 35dB

I don't have the official report yet, but I saw his audiogram in the office. Our results are now:

500Hz: 55-60dB

1000Hz: 50-55dB

2000Hz: 40-45dB

4000Hz: 55dB

I did have a moment of relief when I saw that his tymps were flat, but our audiologist quickly told me that he has tubes and they were looking to make sure one of the numbers was high enough to show the tubes were open. His tubes are open and functioning beautifully. So its a true loss and not anything complicated by a conductive component.

Nolan's aids were adjusted and he can hear those "f," "th," and "s" sounds again. We'll be going in every three months for hearing tests to monitor his levels. Hopefully he'll stabilize, but if he doesn't- at least we have a great audiologist who is really proactive and a great set of aids that can compensate for his current level of loss.

Thursday, August 28, 2008

Happy Birthday Nolan!

Well, day-after-your-birthday. I can't believe my little boy is one year old!

And boy, am I glad we removed his hearing aids before he got into his cake:

Wednesday, August 27, 2008

Showing Off

I finally got some video of Nolan saying "ball." It comes out as "da!" because our "B" sound has been on hiatus for a while.

I also have a video of Matt "reading" the Hungriest Caterpillar. His speech has come a tremendous way in the past two months!

Sunday, August 24, 2008

Using Our Library

I have been faithfully taking the boys to "story time" at the local library, and now that the session has ended I am still hitting the library every week for new books. Matthew likes the same book read 800 times in a row, so it is nice to know that it gets to go back to the library in a fairly short period of time. Anyway, this week we're reading:
  • Bus Stops by Taro Gomi. A bus stops at various locations, including a beach, a baseball park, a building site, and a hospital. This one is great for language opoportunities, but is better for the 2+ set since it has rather abstract pictures. Matthew LOVES this one, but Nolan would rather chew on it than look at it.
  • Ten Seeds by Ruth Brown. This one is great for both kids. Very short wording and great illustrations. A boy plants ten seeds and due to a sequence of events, only one seed remains to produce a flower... which produces 10 seeds! There are several animals and good plant based vocabulary that you can introduce (roots, seedlings, shoots). I can point-and-label with Nolan, and practice counting with Matthew.
  • The Very Hungry Caterpillar by Eric Carle (board book). Another great one for both kids. I should be ashamed that we don't own this one! Counting, days of the week, life cycle of the butterfly....this book is great!

I have to come up with three more books I want to check out for next week. I used to just browse and select books at random, but I've come home with some doozies. One day Matt was running amok and Nolan was crying, so I just grabbed three books that didn't have too much text and left. One was "A Fish In His Pocket" by Denys Cazet. About a bear who looks into a pond and drops his book into the pond on the way to school. When he gets to school he finds a dead fish in the book and carries it around in his pocket all day before giving it a fish funeral in a paper boat on the pond. Not exactly great material for a two year old! Let's just say I'll be consulting my Read Aloud Handbook before the next trip!

*Regarding Nolan's nose: the Rudolph look is because he fell on the playground by the library while chasing his brother. Proving that reading can, indeed, evolve into a contact sport!

Wednesday, August 20, 2008

Starting to Talk

Since my firstborn child refused to utter a single word until he was a full 2 years old, it seems amazing that my little one is already starting to talk! Talk about the power of early intervention- my hard of hearing little boy is talking a full year earlier than his hearing brother did. Nolan says two words consistently: "uh" for uh-oh, and "dah!" for ball. We have no "b" sounds at the moment, so "dah" is as close as we'll get for the time being. He asked for the ball several times today during speech therapy, to which I remarked:

"Isn't this kind of early for speech?"

Our speech therapist smiled and reminded me that average kids have a few words by one year. True, I know, but I wasn't really expecting anything for another year or so with Matthew's delayed speech. It looks like Nolan is going to fall in the normal range for speech development, which is cause for great relief (a 2 year old with no communication skills is a very frustrating situation- trust me)!

We are also doing some sign language with him (he signs "more" and "ball" in addition to his spoken words). It is a lot of fun to see how fast their brains grow at this age.

Wednesday, August 13, 2008

MRI Results

I'm not a patient person. I totally accept that about myself and decided to call the ENT to see if the MRI results were in, and if they'd let me know the results over the phone.

They called me right back and said the report was just faxed over and placed into Nolan's file today. The report indicates "no masses or lesions" in the inner auditory canal. Essentially, the MRI is normal. The ENT is going to review the images herself and with a team of other radiologists and ENT's on August 21, but I doubt they'll find anything that the initial radiologist didn't see.

Nolan's our little mystery (no cause whatsoever for his hearing loss), and it doesn't seem like anything else (syndromic) is involved.

Now we can get back to "real life" and just keep tabs on his hearing levels every so often. I'm glad to be done with the doctor appointments!

Monday, August 11, 2008

MRI Done

The last of the major diagnostic workups is now complete, thank goodness! Nolan's MRI went very smoothly, though he was a very cranky baby who was wondering where his lunch was!

The anesthesiologist was kind and allowed me to be there while Nolan was put under. Nolan's only real fear right now is separation from mommy, so it was nice to comfort him while he was still awake. An hour later they retrieved me from the waiting room and I was allowed to nurse him and calm him down (he was already awake and letting the nurse know about his displeasure)! He was certainly a tiny boy with all those EKG leads, the pulse-ox, and the IV line all tied to him.

They let us leave very shortly after the procedure, since Nolan was alert and keeping fluids down. He's doing really well now, though seems a little "drunk" when crawling around on the floor! He's a little too tipsy for walking at the moment.

I have no idea when I'll get the results. I don't expect any news, since his CT scan was clear. I do have an appointment with the ENT on September 3, but hopefully we'll have the results before then. I'm not very good at waiting when I know the doctors have the results in their hands!

Friday, August 8, 2008

My Brain No Longer Functions!

The good news? I actually got the correct date for our latest appointment. The bad news? I had the type of appointment wrong, so I made my wonderful husband take some time off work. I thought Nolan had a booth test scheduled for the 7th, but it turns out it was just an earmold impression appointment. Oh, well- we went out for dinner and toured the Galleria mall in Buffalo, so it wasn't a total waste!

Nolan's hearing test is on the 28th of August, the same day we'll pick up his earmolds. Our audiologist chuckled and told me they don't like to do impressions and hearing tests on the same day with toddlers, since they are often annoyed by the impression taking process.

We did have a brief scare when the audiologist thought she couldn't locate one of Nolan's PE tubes. He just had them placed in March, so they should stay put for a little while longer! We did finally locate it- what a relief! She also answered my question about the airshow. She said she'd probably leave his aids in and turn them off. She wasn't very concrete about it, though- his Unitrons have great noise suppression technology so his hearing should be protected by that, even when his aids are on. He does have very, very tiny vents (you can barely see them) due to his rising-slope loss (to keep the low frequencies from leaking back out). His loss isn't very "reverse slope" any more, though- it has been flattening out since his diagnosis. Our audi made a point of telling me to allow extra time after his hearing test for adjusting his aids. Hopefully we won't need to, but his loss has changed since his original diagnosis. I really hope he's stabilized, though.

He has lost his "B's" again. We have retained "M," "D," and "N." I'm not sure if this is a hearing thing, or if he's following in Matthew's get-it-and-lose-it speech development pattern. I do think we have our first spoken word: "DA!" That's "ball," but since we don't have b's, it comes out as "da!"

Now we're just gearing up for his MRI on Monday. I get to call and pre-register today. My friend has volunteered to watch Matthew, so at least we'll only have one cranky kid at the hospital. I think this is the last diagnostic test to cross off our list (other than ophthamology), and thank goodness for that!

Monday, August 4, 2008

Airshows and Hearing Aids

We went to our local airshow this weekend, which created a new question in my mind. Airshows are loud- is Nolan better off with his hearing aids on, or off? His aids should compress sounds that are too loud, so I left them on in the hopes they would act as protection for his residual hearing. This is definitely a question to ask our audiologist!

We have another hearing test on Thursday, which always creates a little anxiety on the mommy front. He seems to have lost a little hearing since his initial ABR, so I don't know if he'll be stable this time around or not. He seems to be responding to my voice at about the same level, so hopefully his audiogram hasn't changed. I still dread sitting in the sound booth, silently willing my little boy to look at the dancing puppy when those beeps and boops are played.

I also received Matt's official testing report. He is a full 3 standard deviations behind his peers in articulation. The good news is that our speech therapist thinks we can fix the consonant deletion issues fairly easily. The incorrect vowel sounds might be a tad harder to fix, though.

I have found a new (old) book series that Matthew LOVES. Richard Scarry's "Biggest Word Book Ever" and his "Cars and Trains and Things that Go" get Matthew talking like nothing else. I remember these books from my childhood, and Matthew is obsessed with them. The cars and trains one has a little yellow bug to find on each page, and Matt loves this activity. There are a ton of words that appear in these books that aren't in our everyday conversation, such as "smokestack," "squiggly," and "toll booth." I highly recommend these books to anyone with a 2-3 year old boy with a love of vehicles!