When an infection lingers for six weeks, is resistant to amoxicillin and Ciprodex, and begins to threaten a child's residual hearing, something has to be done. The ENT's office stated we couldn't be seen until September 13, and I was reluctant to go back to our pediatric "random doctor of the day" clinic.
Instead, I called the ENT's office and plead our case: a child with pre-existing hearing loss, persistent infection, and antibiotics that aren't doing any good. While our ENT is out of town for an extended period of time, they could get me in today to visit with a physician's assistant (PA). I leaped at the opportunity. Could we be there by one o'clock? Sure!
I looked at my watch: 10:50am. We have to leave by 11:00 to make it by 1:00- I threw the kids in the car, added a few Capri Suns and a diaper bag, and headed out. Of course, this sudden journey meant that lunch was catch-as-catch-can. I'm pretty sure I won't be winning "Mother of the Year" for their lunch today (some breakfast bars, 'Nilla Wafers, and string cheese). Oh, well. We'll make up for it with an especially nutritious dinner.
The PA took a look at Nolan's ear, and decided to culture the nastiness within. Nolan was quite good and sat patiently while the PA looked for "Spiderman." Thank you, John Tracy: he never cringes from the otoscope because of the hope of a lurking Spiderman. That little trick has served us well over the past few weeks! The culture was quick and painless, and we should get the results from that test in a few days. It will be interesting to see if Nolan is infected with an antibiotic-resistant strain of bacteria.
In the meantime, the PA decided to suction out the gunk from Nolan's ear. The ear vacuum is Nolan's least favorite invention on the face of the planet Earth. We tried to do it without papoosing him, but we resorted to the full body restraint and a nurse assist. He proved to be tiny but mighty- but we got the job done. The little guy hates the Big Scary Ear Sucker, and I don't blame him. It's loud, it is poking into an infected and tender area, and he has to be held down against his will. It is also (unfortunately) necessary and the antibiotic ear drops will be able to reach his middle ear now.
We are to continue the Ciprodex, in addition to a new antibiotic ear drop (Tobramycin). Aminoglycosides always make me nervous because of the whole ototoxicity thing, but the persistent infection isn't great for his hearing, either. Technically, Tobramycin is an eye drop, but the germs in his ear don't know that (it hits gram-negative bacteria that are resistant to Ciprodex). Nolan hates ear drops, and now he gets two different kinds every day. If the infection doesn't clear up after this round of medication, we have to come back.
We still have our appointment on the 13th to discuss the whole shifting hearing levels thing, so any remaining infection can be dealt with by our trusty ENT. I really, really hope the infection is gone by then!