Monday, December 7, 2009

Buffalo: Round 1 (ENT)

We headed up to the ENT this afternoon to determine if there was any fluid lurking behind the wax in Nolan's ears. With a flat tympanogram in the right ear, we thought some hidden fluid might be the culprit behind the latest loss of hearing.

The ENT looked in his ears, weighed him, and then took him back to clean out the wax. This is a very miserable process, involving a papoose board, a microscope, metal instruments, and some bleeding from Nolan's ears. I won't go into detail, but let's just say that it ranks pretty high on the "least favorite thing to do" list. His left PE tube had just fallen out of the eardrum, so she removed that, too.

His ears are clear, and there is no fluid. We're free to go to BHSC for the repeat hearing test on the 15th, confident that there is no cause for a conductive problem remaining in his ears. They did run a tympanogram, which showed a perforation in the left eardrum (from the recently removed PE tube- it is too small to see and should heal completely by the time of the hearing test). The right ear does show negative pressure, but they just "wait and watch" with negative pressure. Sometimes it means a fluid build-up is imminent, sometimes it just disappears on its own.

Of course, no ENT visit is complete without finding some new thing to be concerned about. Our ENT is concerned that Nolan's anti-reflux medication isn't quite handling his reflux. He's eating less, pulling at his neck more, screaming a lot. Also, he never sleeps (reflux parents, you know what I'm talking about). He's also snoring again and his tonsils are big.

The big tonsils and reflux/snoring issues worry our ENT a bit, because all of this can affect growth. We have managed to get his weight back to 24 pounds, 3 ounces with a lot of DuoCal, but we're not seeing an improvement of symptoms. Our ENT has ordered a sleep study to be done on Nolan, and if obstructive sleep apnea is found, a tonsillectomy and adenoidectomy will be recommended. I get to set up the "polysomnogram*" at my convenience, and we'll see the ENT again on March 1 for a follow-up. If his tonsils have decreased in size and his sleep study looks good, we can ditch the whole tonsillectomy idea. I really want to ditch the whole tonsillectomy idea.

She also sent a note to our GI doctor requesting a possible increase in anti-reflux medication. We see our GI doctor tomorrow, so this may happen fairly quickly. Now I'm preparing for Buffalo: Round 2 (GI). Time to charge that portable DVD player!

*I learned a new word today.


MB said...

You can call the polysomnogram a "PSG" if you want to impress the sleep docs and technicians.

I am all to familiar with that term. My next one is Dec 15!

Julia said...

Oy, poor kid. Well, say hi to Michelle for us when you see her on the 15th. We saw her today -- booth test, CI mapping, earmold impression. We started to hit some snow when we got to the Skyway, and on the way home, it was absolutely terrible from Buffalo almost to Silver Creek. On the plus side, we had dinner at India Gate on Elmwood. I hope the appointment(s) on Tuesday go well; safe travels to you.

And congrats on being a listenup moderator! Everyone has had very nice things to say about you all day, and I couldn't agree more!

rouchi said...

My goodness, I am so sorry about this.I think all this affects the kid so much. The mothers too feel the pain equally and the nagging sinking feeling before you visit the doc and before he gives the diagnosis is most horrible and familiar to all mothers.I hope his entire tonsillitis thing too gets sorted out soon. Take care.

tammy said...

You've taught me MANY new words over the last six months, so thanks for another one! LOL. My goodness. Here you go again, but hopefully this time things will work more in Nolan's favor and he won't have to get his tonsils removed and the increase in reflux meds works out for him! Poor little man! Hope your travels are uneventful and the weather is nice!

Megan said...

Poor guy!