Fluid in the ears and tubes? Questions.. (long)

[sidmand]

So, as part of DS's EI evaluation, they suggested a hearing test. We had the test today and they ruled out any major hearing loss, but DS wasn't responding to low tones and they weren't sure if it was because he was too busy playing or he really wasn't hearing them. She wanted to do a test that checked for fluid in the ears, but DS just screamed, so she had a doctor (audiologist?) check his ears. I had to hold his flailing hands and a nurse had to hold his legs (poor little guy!) and eventually, in the midst of DS's screaming, the doctor said that he does indeed have fluid in his ears.

As far as I know, he's never had an ear infection. We've taken him to the doctor before because he was pulling on his ears...a lot. But they always told us that his ears looked fine and clear. Although the doctor today said that if this was a typical reaction to checking his ears (it was) then he wasn't surprised that with a cursory examination everything looked fine.

I can't find much information on tubes without a history of ear infections. So I'm curious about that. DH also wonders why no one ever found fluid beforehand (DS has had at least two doctors as well as a number of nurse practitioners look at his ears), but I'm thinking that if it wasn't very obvious, what today's doctor said makes sense.

And not that this solves everything, but many of DS's "issues" could very well be explained by a hearing problem. Is it possible that this could "fix" a lot? He tested age appropriately for everything except expressive language and if he can't hear correctly, that would definitely affect that! The startling with loud noises would also seem to be affected. There are some other small things, but I'm thinking that many of the big things are covered by not hearing correctly.

We've though for awhile that although it was obvious DS was hearing many sounds, that if he wasn't hearing things quite correctly, it would make sense that he would be so startled by sudden noises (like coughing/sneezing) because if they were coming out of silence, they would be that more startling. I'm thinking fluid might also affect balance? DS does walk and run, but he's pretty wobbly.

We have a follow-up appointment in 4 weeks to see if the fluid resolves itself and then we're supposed to go the tube route. Just wondering if there is a good place to look for information? I did an Internet search, but haven't come up with quite the information I was looking for.

Some of DH's co-workers were shocked that we hadn't already had DS looked at for fluid in his ears with his speech delays, but since every time we took him to the doctors they said they were clear...was there something else I should have been looking out for?

Although we did especially start to wonder last week...the smoke detectors went off at 5:30 a.m. and we couldn't find anything and I looked for the red flashing light (this happened once before and that's what the fire department told me to do!). So we went around the house disconnecting all the detectors. I could still hear one beeping and realized it was coming from the baby monitor! It turned out that the defective detector was in DS's room and he slept through the whole thing. It had to have been about 15 minutes of ear-piecing beeping! At that point I thought that he couldn't possibly have slept through it if he could hear it and maybe he couldn't hear that frequency. Although DH is a very heavy sleeper, but even he woke up.

Anyone BTDT? Anywhere you can send me to do more research?

Debbie
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[Fairy]

So, we meet again.

Our EI went very much like yours. DS did really great in every area and was ahead in some -- other than Expressive Language, which was about a 10-month delay. The diff with us is that DS has had tons of ear infections and already has tubes. Still, I think there could be some low-grade hearing issues. If there are any, they're minor.

Now, on to you. I know alot about hearing and tubes. I had tubes, myself, and I remember the process and a difference afterward (tho it's a fleeting image of a memory, not a solid "and then the world opened up" kind). My first piece of advice for you is dump all this audiologist stuff via EI for now and go right to an Ear Nose Throad (ENT) specialist. They are the ones trained to know if the ear canal is an issue. Speech pathology will probably be the therapy of choice for the speaking, but you can definitely need tubes without ear infections. If his ear canals are narrow, it could be warranted. Personally, I'm glad he got the tubes, tho it hasn't seeme dot do all that much for the speech. In any event, check it out. Ask your ped for a referral, or barring that, ask your own doc for a referral. There are ped ENTs, but the general ENTs are fine, too (that's what we had, and I'm super picky about doctors due to my background -- don't ask).

Good luck!
-- Fairy

[juliasmom05]

DD had chronic fluid in her ears for many months, but in our case it was due to multiple ear infections. But, you can have fluid in the ears without infection. I think it is called "otitis media with effusion". Try googling that and you may come up with some information.

I would definitely take him to an ENT and have his ears checked. You will still have the same issues with the hearing tests and the test for fluid, but if you go the route of ear tubes you will have to see an ENT anyway, and they will be probably be more informative. DD had hearing issues as well, although like you said, I was never sure whether she couldn't hear some of the sounds or whether you she was too busy taking off her shoes to be bothered to respond to the sounds ;).

We never had any concerns that DD couldn't hear. She always responded to sounds, but were told because of the fluid that everything was muffled and that would affect her speech. She also got scared of loud and sudden noises, like DH sneezing. We were told that a lot of times, speech dramatically improves after ear tubes. Like pp, this didn't happen with DD. So we were very glad that we started EI instead of waiting to see whether the ear tubes would help with her speech.

If you guys go the route of ear tubes, it was really a simple procedure. It was done by the time I got back to the waiting room and sat down. Harder on me, than her.

Good luck.

Marci

Mom to Julia 4/05

[sidmand]

Thanks for the advice ladies, but I misspoke a bit (not in familiar territory at all and used the wrong words!). We did see an ENT. He wasn't a pediatric ENT and I wasn't so thrilled with his bedside manner, but he was indeed an ENT referred by our pediatrician and in the same facility.

I definitely think EI is still a good route, and at the very least he's going to need some speech help since he is still far behind even if the tubes help. I do think there are other issues not involving his hearing, but I think a lot of the issues CAN be attributed to his hearing and that would definitely help a lot if that was the case.

Marci, it's interesting because DS does the same thing—startles (cries) at sudden noises like sneezing (mine, though—it is loud:(). And we didn't have any concerns that he couldn't hear because he did respond to things like that, but after time we realized it's quite possible that it's muffled and he's just not hearing things as they are.

They put them under general anesthesia for this? Or they're asleep? DS just doesn't even like getting his haircut and I can't imagine this is going to go well unless he's not aware of what they're doing!

Debbie
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[juliasmom05]

They put DD under with general anesthesia. My DD is what I would call a fighter. Hates to be restrained, hates the doctors touching her, hates to have her temperature taken. I cannot even imagine what it would be like to try to get her hair cut :-).

The surgical staff was very good, and it was very quick. They put her on the table and almost immediately put the mask on her to put her under. It was difficult, because DD fought it. So, I really had to restrain her. But, it was quick. She was out almost immediately. Then before you know it, it was over. I really think it only took about 5 minutes. She was already awake by the time I got to see her. She was not a happy camper, but I was able to nurse her within 5 or 10 minutes. They wanted her to have clear liquids like water first, but I was able to convince them to allow me to nurse her. I would say, she was not happy for around 30 to 40 minutes, but after that she was fine. You couldn't even tell that she had had it done. Unlike others I have heard about, DD didn't take an extended nap afterwords either.

It was a little scary for me, while they were putting her under, but really it was a very simple procedure.

ETA a couple of things. They are usually pretty good about scheduling kid's surgery for first thing in the morning, but really insist on this. It was hard to tell DD that she could't eat or nurse that morning, so the earlier the surgery, the better.

Also, talk to the surgeon, and make sure that you can go into the operating room with him. For us, this was no problem. I also wanted to be in the recovery room before she woke up, but they wouldn't let me, but they let me in just as she was waking up. I didn't want her to wake up frightened and disoriented without me around.

Marci

Mom to Julia 4/05

[lilycat88]

DD is 28 months old and is on her 3rd set of tubes. Her first was at 11 months, 2nd at 18 months and her third was just placed last month when she had her adenoids removed.

Just a couple of comments. DDs fluid was related to many many ear infections. The infections were treated with antibiotics but we still had issues with fluid. We were SURE that DD wasn't having any issues with hearing before the first set. She wasn't talking yet but we noticed a fairly significant increase in vocalizing after she had the first set put in. So, perhaps there was some "muffling".

As far as the actual tube placement, it's more difficult on the parents than it is on the child. DD did fabulously with all of them. For this last one, it was harder because she had the adenoids removed as well. For her first set, she came home and took a long nap and was fine. For her second set, she ate a sausage biscuit from McDonalds on the way home and was at Kindermusik that night (she was climbing the walls she was so bored). For the first 2 sets, by the time we figured out the TV in the waiting room, the doctor was coming out to see us. Depending on the facility, you might be able to accompany your DS into the operating room. We did for her last surgery.