Friday, May 15, 2009

ENT Visit

We headed up to Buffalo for a routine ENT check-up. Kids with hearing loss see an ENT on a regular basis to make sure the middle ear is as healthy as it can be, since fluid or ear infections can make a sensorineural hearing loss worse.

The left ear has a patent tube and looks great- no fluid, no wax, no infection.She took a look in Nolan's ear and confirmed the right PE tube was out, and that there was a lot of wax in that ear. She did a tympanogram on the right ear and the eardrum is a little stiff. After further investigation, the stiffness is not caused by fluid. I'm guessing the bad infection/perforation and two sets of PE tubes may have caused some scar tissue- hopefully the "stiffness" isn't enough to affect the hearing in that ear. Still, I'm thrilled because no fluid means no third tube and no adenoidectomy.

I did mention the possible PUV's and scheduled cystoscopy to the doctor and nurse, and that I was still concerned about his lack of appreciable weight gain. She entered the information into her computer and did the usual "mm-hmm" response.

Then she went to clean out his right ear (this involves a papoose board and all sorts of unpleasant metal funnels in the ear). After doing this, she checked his records again and saw that the ENT office hasn't taken an official weight since October 2007. She told the nurse to get a weight on him, then set us up for a 4 month appointment.

The nurse took his weight, furrowed her brows, then sent us back to the exam room. The ENT came back in, took one look at his growth chart, then proceeded to freak out. In a very professional, medical manner, of course. Apparently, seeing a drop from the 60th% to the 3rd% line makes more of an impact than the mom telling the doctor that he's only 21 pounds at 21 months of age.


A yummy cookie. If only he'd actually eat the whole thing!

After asking us if the pediatrician had started up a fail-to-thrive evaluation (um, nope!) and having me fill out another symptomology sheet, she set us up for a feeding evaluation at children's and a scintiscan to check for gastric reflux. Apparently, pulling food out of your mouth, refusing food after the first two bites, spitting up occasionally at the age of 21 months, and being very texture sensitive are indicative of a feeding disorder.

They're sort of treating it as an emergency and have us in for the feeding evaluation on Tuesday. There is a part of me that finds this rather ironic- he's been technically in the "failure to thrive" camp for EIGHT months. I have mentioned the weight issues like, um, Every. Single. Time.

The ENT is a tad concerned that this bizarre constellation of symptoms might be indicative of a syndrome. We've been there, done that before. It's more likely just a bizarre constellation of symptoms. .

For now, we have a bazillion appointments at Children's for the reflux evaluation, feeding evaluation, and cystoscopy. Hopefully it is just reflux and a little Zantac will help him put on the weight.


Ericka said...

Miles is the same way! Except he will eat good at a meal, but if he coughs or gets upset after he gets full, he vomits. And it's not a little spit up either. He's been doing it since he was born. I've told the doctors many times but they are not concerned unless he does it more than once a week. Miles is on the small side for weight. He weighs about 23lbs and is almost 24months old. I've always felt he probably has reflux. Definitely something I'm going to bring up at his next checkup. Hopefully thats all your little guy has too! :)

Lucas'Mommy said...

I hope everything works out with his weight gain. Sometimes the professionals need it to strike them in the face to realize it, huh? How frustrating!

Mandie said...

I plan on talking to our ENT at our next appointment about Carter and acid reflux. He has a very husky hoarse voice, he's always grouchy, he refuses food after a few bites and he was constantly spitting up as a baby. Our pedi never worried about it, but I am. Especially since his hoarse voice could indicate pollops or vocal damage.

tammy said...

Wow Leah. You have just been going round and round with all this and my heart goes out to you. Don't you just want to scream out "Why didn't you listen the first (and second and third ..)time?!?" UGH! I feel your frustration girl!

Good to hear there isn't any fluid though! Just one thing to check off the list for now. I'm sending good vibes that all this is just reflux and they figure it out real quick!

MB said...

Sorry to hear about all the new doctor's appointments coming your way, but glad you at least found a dr that would listen!

Val said...

gage weighed 21 at 21. he's now 8 and weighs about 46. He eats like a horse too, he's just never still.
This is the first year (2nd grade) that kids are actually outgrowing him by six inches or so.....they must hit some growth spurt in second grade, we missed it!

Herding Grasshoppers said...

Oh man... the doctor must've realized you were going to get 10 consecutive minutes of leisure time and thought, "Whoa. We can't let that happen..."


I'll be praying for him... and you!


kkohler said...

Sometimes it's as if we go to so many specialists that none of them want to take ownership of Courtney. One says the other one will take care of x and the other one says the first one will... I am so sorry it is yet another hurdle. Thankfully he has an amazing mom!

Kristen@nosmallthing said...

I remember having conversations with the pediatrician, telling him NOTHING was wrong with my daughter, while he insisted there might be, because she was very thin. I guess it has to do less with the actual weight of the child, than the trend of weight gain/loss. So while having a 21 pound 21 month old is not a problem, having a child that goes from 60% to 3% is a problem...

In any case, I hope you get some answers. It's all very troubling for us moms, isn't it?! Good luck!