Monday, April 4, 2011

In the span of 15 minutes the past ten years make so much more sense.

When T-Guy turned two years old we did the standard pediatric visit.  His doctor was concerned that he wasn't speaking much and sent us to see a speech pathologist.  Eventually we had a diagnosis of oral motor planning issues and dyspraxia.  At the time we were told his hearing was normal.

Six months later we hired a private speech language pathologist who looked at his reports and said his hearing wasn't normal, not for a child, and neither was the movement of his eardrums on the tympanogram.  But no one else considered it an issue and there wasn't anything we could do medically.  We continued with speech therapy for a year and then put T-Guy into preschool to work on his language skills in a more natural environment.

His teacher that year (which was only for two months) was concerned about his hearing.  We were too, so we started another round of doctor's appointments and assessments.  But those tests were done in summer and were again considered normal.

At four he had tubes out into his ears to help drain fluid, fluid that had been there intermittently since he was two months old.  A friend recommended a great ENT who saw T-Guy in the late fall/early winter and was willing to accept that this time of year he generally had fluid behind his ear drums.

Those tubes were in place for five and a half years.  Toward the end of that time T-Guy had more ear infections and showed some obvious hearing loss, and advocating for him we had him tested and found that the PE tubes were blocked.  At that time he tested as having mild-to-moderate hearing loss.  I also had concerns about the size of his adenoids (his tonsils had shrink some).  In the end we did surgery to remove the blocked tubes, repair his ear drums and remove his adenoids.  At his post-op hearing test he had regained most of his hearing function, and the minimal loss wasn't considered important as it was thought it would resolve with further healing.

Here we are nearly three years later.  In February T-Guy ruptured an eardrum even though he had no signs of infection and no pain.  All he had complained of was his ears feeling "clogged".  We had him seen and treated and discussed our options.  We couldn't do a tympanogram at that time because of the hole in his eardrum, but the doctor and I were both concerned that his eardrum might be weak and that he once again was harboring fluid in his ears.

When he was younger T-Guy had a mild milk allergy, and as he'd gotten older he no longer got eczema when he ate cheese so we had added it back into his diet in the past year.  But dairy was the only straw I could grasp at, so we decided to cut it out completely.  He wasn't happy, but the choice was to try diet or reinsert PE tubes, and none of us want that.  So we did six weeks dairy free to attempt to eliminate the fluid while his eardrum healed.

Today we saw the doctor and the audiologist.  For the first time in the past decade T-Guy was able to have a hearing test without PE tubes, without healing scar tissue (there was scar tissue but it wasn't considered new) and without fluid behind his eardrums.  That's right, he had a clean tympanogram!

Unfortunately, he has unilateral low frequency hearing loss in the minimal to mild range.  But we have an answer!  He has finally been diagnosed with hearing loss that isn't considered intermittent/transitory.

This is an incredible answer for us!  T-Guy doesn't have some of the behavioral issues that can be related to hearing loss, but he does have some social issues.  Hearing loss can make it hard for kids to pick up on subtle differences in speech that communicate meaning, and this can make it appear that the child is deficient in social skills.  Kids with hearing loss don't always pick up the nuances of speech.  But not being able to hear the differences and not understanding them are different things, and knowing the problems makes it easier to find answers.  Also, his speech issues most likely have more to do with hearing loss than oral motor planning or dyspraxia.

I'm just a mom, a mom who worried for years, especially about the social issues.  I'll admit that for a time I worried that he had mild autism or Asperger's disease, only so many pieces of the puzzle didn't fit.  He's an even kid, never prone to outburts or tantrums.  He understands humor, he's connected, he has a wide range of interests, he handles transitions well.  He's bright, he's funny, he has friends.  He just doesn't always hear that well.  That's okay, now that I'm in midlife neither do I!

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