Wednesday, December 31, 2008

A Year in Hearing

Happy New Year to My Peeps!

It has been almost a year since Nolan received his hearing aids. So, here is a snapshot of his past year with full access to the world of sound!

January 9, 2008: A mild-moderate loss won't hinder this little guy. Nolan's first-ever hearing aid fitting! Sounds previously unheard by him (such as "p," "g," and "z") are now audible.
February 2008: Pilot caps discovered. These would prove highly useful in the not-so distant future.

April 2008: Babble. Never has "mamama" or "bababa" sounded so wonderful!

May 2008: Due to chronic fluid, we had the first set of PE tubes placed.

June 2008: Nolan stops pulling out his hearing aids. The pilot cap is GONE! Or so we thought!

July 2008: We discover the painful results of another toddler's curiosity. OUCH.

October 2008: The pilot cap returns, to thwart hearing aid removal attempts.

November 2008: A nasty virus necessitates tube insertion number two. The right ear takes a plunge into the severe range, fortunately a temporary loss.

December 2008: The most recent audiogram shows a bit of a drop from the initial ABR. His aids are more than capable of handling his level of loss, and his speech is taking off!

The blue line is Nolan's initial "eHL" from his ABR. The green lines are his current hearing level- his left ear being the better of the two.

Of course, the last day of the year doesn't lack for excitement in the hearing aid department. Nolan's left aid has ceased making the high-pitched sound of feedback. While no one really welcomes feedback, a lack of it hints at some sort of a problem. The batteries are fine, but the aid doesn't appear to be working well. Nolan won't leave it in and thus we are aid-less today.

I look forward to 2009- life with a toddler rather than a baby, a language explosion, and hopefully more compliance with leaving those hearing aids in!

Saturday, December 27, 2008

Merry Christmas!

OK, this blog post is a little late. We've been having far too much fun with all of the new toys and enjoying Daddy's time off from work.

The boys were up early on Christmas and Matthew really enjoyed tearing into the presents. Nolan was far more interested in a measuring cup that I received, and loved playing with the bows as a typical one year old is wont to do. Last year we were concerned with getting toys which stimulated language and auditory pathways, but this year we have relaxed and realized all toys present the opportunity for language growth. The language is not in the toy, but in how you play with it.

Of course, perhaps we should have invested in more pilot caps and fewer toys. The longest we managed to keep his aids in on Christmas was a 30 minute span of time. Plus, a pilot cap would help control static-hair in the ball pit.

Nolan is sixteen months old today, and I am looking forward to the language spurt that occurs somewhere around the age of eighteen months. We never had this with Matthew, but Nolan has normal language development. This time last year, I would never have guessed that my hard of hearing baby would have outstripped his brother in the language department! Three days ago he imitated the word "down" with a resonant "dau!" He has lacked the long "O" sound (pronouncing it as a long E instead), but with intense focus on that sound over the past few weeks, I am proud to announce that "uh-ee" is becomming "uh-oh." Watch out, /p/. You're next on our list!

Tuesday, December 23, 2008

Another Great Use for Pilot Caps

When you need a full-body bib, nothing else will do!

Note to self: In the future, avoid cakes with black frosting at all costs!

Happy Birthday, Matthew- I can't believe you're THREE years old!

Friday, December 19, 2008

Back to Moderate

We took a trip to the audiologist to re-check that right ear now that the fluid is gone. Good news- he's back to his August levels in that ear! I don't have the report yet, but I think he was 60dB at 500Hz and 1000Hz, 40dB at 2000Hz, and 50dB at 4000Hz. They tested his left ear again, too, and it was about 5-10dB better than the right ear. He does appear to have some fluctuation at the high frequencies, but at least he's staying in the moderate range.

I am very grateful that we listened to the audiologist and ENT, because with a blocked tube he had thresholds of 80dB in that ear! There is a HUGE difference between a 50dB threshold and an 80dB threshold (remember that decibels are logarithmic).

We are free from doctor appointments until January, when a trip to pick up earmolds is scheduled. Ahhh... blessed freedom!

Monday, December 15, 2008

15 Month Well Baby Visit

We took a little trip to the pediatrician for Nolan's 15 month well-baby visit today. I went in with a few concerns, including his persistent head lag, anemia, and low weight. The visit was a good one, and I walked out with one less worry!

Nolan's anemia is NOT iron deficient anemia. When they ran his CBC during the last bout of illness, the blood count showed a normal MCV (mean corpuscular volume) and a low hemoglobin count. This means there was anemia, but not due to iron deficiency. The pediatrician re-checked his blood counts today and everything was normal. The running theory is that the virus he had caused some acute anemia, which has since resolved. This is great, because we can stop the iron supplementation. No more rusty-nail flavored vitamins!

He still has the head lag, but the pediatrician isn't worried since he is walking, running, and doing everything else a 15 month old boy should be doing. I'll mention it to the ENT when we see her on the 14th, just to see what she thinks. It still bothers me a little, because it is something that shouldn't be there. It's probably just a quirk of Nolan's, but I want to make sure.

He's 31 inches long, which is great! He's growing well (in height) and his head circumference is fine. He is still below the 3rd percentile for weight, at 19 pounds, 5 ounces. He's almost sixteen months old, so he's a little guy! The lack of catch-up growth is also attributed to the recent virus.

As Nolan doesn't tolerate illnesses well (Matthew's cold was severe bronchitis to Nolan), we opted for the flu shot. If we can head off any more infections, I'm all for it. He also got his scheduled chicken pox injection and MMR. Our little guy has two sore arms and one sore leg today!

We don't see the pediatrician again until March, so pending illness our doctor visits should decrease over the winter. That makes me one happy mama!

Sunday, December 14, 2008

I Love Libraries

No, Nolan isn't really blue. I just need to adjust the camera settings.

I was at our local library and found they have entire activity packets available for check-out. The activities are rated by age, so I checked out a packet for the 1-2 year old age group and one for the 3-5 year old age group.

Nolan's packet came with the book "Ride, Baby, Ride" (he didn't care for it) and a felt board (which he likes- a little too much)! Matt's came with with the book "One Red Sun" and several laminated suns to count out while reading the book.. These things are great because:

1. They come with instructions. People like me need instructions to get by in life.
2. They tell you what your kid is learning.
3. They come with all needed materials.
4. They are totally free. I'm cheap. It's a match made in heaven.

I guess I could come up with some brilliant ideas on my own, but let's face it- I'm lazy. Letting the library do the work for me is worth the $0.50 the parking meter eats. I highly suggest investigating the children's room at your local library.

Saturday, December 13, 2008

Twas Brillig and the Slithy Toves...

We have a new development on the speech front- Nolan has finally developed "jargon!" This is a variegated form of babbling which resembles the intonation and inflection of adult speech. Since we never had this with Matt (he said almost nothing until he hit 2 1/2), it is really neat to watch. Last night Nolan came up to me and informed me, "Ba! Dabawa! Inda!"

I'm fairly sure he was "tattling" on his brother.

This is cool.

Monday, December 8, 2008

IEP Meeting

We had our IEP meeting for Matthew today, which I considered great practice for when we have Nolan's in a year and a half or so. Matt only qualifies on the basis of articulation at this point in time, so we weren't too worried about the quantity of therapy sessions when we went in. On the other hand, we wanted to see exactly what we could get, since we'll be going through this again in a while and will be requesting expensive equipment (no, a sound field is not enough. We want that expensive FM system, thank you very much)!

IEP meetings are quite different than the cozy IFSP meetings we've had through early intervention. First off, the meeting is held at the middle school of our school district. Walking through the cafeteria-scented hallways with my little ones gave me a glimpse of our future- slouching adolescent boys with mullets. Yes, mullets. Have those become cool again? I shudder to think so.

There were about seven people in the room, including the school secretary. Everything was recorded and there were several forms to fill out. They had all of Matt's paperwork and his cognitive evaluation set out on the table. They say he has "superior" intelligence. Really? I mean, he does this and this . I'm just sayin'.

After talking about his history and test results, we had to come up with therapy recommendations. Once children transition to the school district, they typically get less speech therapy time (the typical is 30 minutes per week). We asked for 2 days per week, 45 minutes per session. They didn't blink an eye and granted our request- I think Nolan's recently soiled diaper may have persuaded them to make a quick decision.

He will stay in EI until December 31, then transition to the school district for services. We will have a lapse in service because the school board doesn't meet until January 13, but a 2 week break will be good for all of us. Except our wonderful speech therapist, of course- who doesn't get paid when she's not working.

Most things will stay the same as when we were in EI, but there are some important differences:
  • Matt now follows the school calendar. That means if therapy falls on a holiday, he gets no services. This also means no services over the summer, during winter break, or spring break.
  • Our speech therapist now gets paid less, even though she's doing the same thing.
  • We have annual reviews rather than semi-annual.

Matt will probably graduate from CPSE services in the spring, just in time for us to start the process with Nolan.

Friday, December 5, 2008

10 Books Per Day

Reading is important for all kids, and is absolutely vital for hearing impaired kids. We have a goal of ten books per day for Nolan (this is a self set goal- sometimes we meet it, sometimes we don't)!

Finding books that keep an active 15 month old engaged isn't always easy, so we read during lunch, we read during breakfast, we read before nap, in the car.. everywhere! Since Nolan is hard of hearing and can hear in close range when his aids are off, I even read to him in the bathtub. Here's a selection of ten of our favorite books in the 12-18 month range:

Five Little Monkeys by Eileen Christelow. Why we like it? Counting, repetition, the ability to do an accompanying finger play, and the inclusion of words we don't encounter every day (picnic, snooze, river, scold). Nolan would like to add that his favorite part is the "SNAP" when the crocodile goes after the monkeys.

That's Not My Kitten by Fiona Watt and Rachel Wells. Why we like it? It is touch-and-feel and gives descriptions of fuzzy, smooth, shiny, rough, and fluffy. There is a repeating mouse character on each page. Nolan likes this one because he has a thing for cats.

Hug by Jez Alborough. Why we like it? While there are few words (primarly "hug") the pictures offer many discussion points for emotions. The baby monkey watches mother/baby pairs throughout the jungle exchanging hugs and longs for his own love. We use words like sad, lonely, friend, help, kindness, happy, and grateful when talking about the baby and mommy monkey.

Good Night Gorilla by Peggy Rathmann. Why we like it? There are many zoo animals, with the recurring theme of "good night (animal)." It is short enough to hold Nolan's attention, and has an element of humor as all the animals end up in the zookeeper's bedroom. This book also has a recurring mouse with a banana on each page.

Goodnight Moon by Margaret Wise Brown. Why we like it? Oh, come on. What kid DOESN'T like this book? There are a ton of household objects named, it rhymes, it has repetition, yadda yadda yadda. I think I can recite this one from memory.

Good Night Baby , a DK book. Why we like it? Real life photographs of the evening routine. I like this one because this time of day is frequently one where Nolan has no aids in. While he can hear without his aids within close range, he is probably not hearing everything correctly. Reviewing this language in a book is a good way for him to acquire words for things like towel, bubbles, bath, soap, undress, pajamas, etc.

Moo, Baa, Lalala by Sandra Boynton. Why we like it? Farm animals and their accompanying sounds, it is short, funny, and you can really ham it up. We have several Boynton books and enjoy all of them, but this one in particular is great for the 12-18 month age range.

Brown Bear, Brown Bear, What Do You See? by Eric Carle. Why we like it? Colors, animals, repetition, the last set of pictures on the last page reinforces left-to-right labeling (for future reading), etc. All of Eric Carle's books are great.

Winter Friends by Carl R. Sams II and Jean Stoick. Why we like it? Real life photographs of a winter woodland, similar to our own backyard. The snowman provides food for several woodland animals. This is a shorter board book version of Stranger in the Woods.

B is for Bear by Roger Priddy. Why we like it? The alphabet, touch-and-feel, rhymes, and real-life photographs of 26 objects.

I'd also like to mention Matthew Van Fleet and his books. We used to have "Tails" and "Dogs" and loved both of them. They're touch and feel/lift the flap and have several interactive elements. Unfortunately, ours have been loved to death and we have to repurchase Tails.

Thursday, December 4, 2008

Tubular Day

I really, really hope this is the last sedation for a long time. Nolan is quite perky and happy now, but the food deprivation separation from mommy was not a recipe for toddler happiness.

We were up at 4:00am to load the car and get everything ready for our trip up to Buffalo Children's. The car ride takes about two hours and we had a 7:00am registration time, so a pre-dawn departure was necessary.

Nolan didn't mind the early trip, but once up on the 9th floor for the same-day surgery, he started to get uneasy. He's been there before, and I don't know if he remembers it or not. He definitely was less playful the second the nurse came to get us. They had to return the toddler sized gown they brought out and find an infant sized one (at 19 pounds, he's very small for a 15 month old). Normally PE tubes are done in the special procedures unit on the fourth floor, but since he was squeezed in as an "emergency" case, it had to be done in the main operating room.

The nurse took him from me and he screamed from that point until they knocked him out with gas. When he woke up, he screamed until we were finally released and opened the door to leave the hospital. This was definitely stressful for him- not so much for the procedure, but for the separation from mommy.

The real negative of all the ear infections and Dr. visits is that he is becoming very shy about his ears. Any time an otoscope comes within 3 feet of him, he totally wigs out. I feel sorry for our audiologist at his next appointment for impressions...

I have my fingers crossed that this set of tubes will remain in place and functional for as long as possible!

Tuesday, December 2, 2008

Going Under

There are times I really, really wish our ENT was a little closer to our house. We were sent to the office in Depew yesterday to discuss the whole 80dB mixed hearing loss in the right ear thing. I learned some really valuable lessons on the way:

  1. Transit Road in Buffalo is NOT the same as Transit Road in Depew.
  2. My GPS system is out to get me.
  3. Calling 411 for the phone number to the ENT will not help you when the ENT's office dumps you into their voicemail system.
  4. You will need a pen to write down alternative phone numbers offered by the voicemail system, and there will be none in the car.
  5. Mobile gas stations do not carry pens.
  6. Three hours in a car does not make 1 and 3 year old boys happy.

We did eventually make it to the ENT, which was good considering the looming lake effect snow warning. She looked in Nolan's ears and made the proclamation that he had lots of middle ear fluid in his right ear. She scheduled us for a replacement PE tube this Thursday, and will check the positioning of the left PE tube at the same time. She also considered taking his adenoids, but then relented and said that the adenoids will come out with the third set of tubes.

I'm really hoping that we can avoid a third set of tubes, but having 2 sets in his tender 15 months of life doesn't set a very promising record. Off we go for sedation number 4!