Thursday, April 16, 2009

The One Millionth Post About My Kid's Ears

I haven't mentioned this before, but in the last few weeks Charlie's been doing some weird things in physical therapy. He is actively trying to pull to a stand, but then he promptly falls down. When sitting in his Rifton chair, he sways back and forth like a person's who's had too many cocktails.

At first I thought it was just me, but then the PT noticed it too. Physically he seems stronger, but he can barely hold the standing position these days. Normally, I'd assume that he's doing one of those things where one skill regresses in favor of another, but he seems genuinely interested in getting himself up, so that's doesn't seem to be the issue.

So I made a list like they do on House of all the things that could be causing these symptoms and came up with three possibilities:

  1. He's having drainage issues with his shunt and that's affecting his balance.
  2. He's having a growth spurt and his muscles aren't able to keep up with the demand.
  3. He's having problems with his ears and that's affecting his balance.

Anyone else cringe when they have to use the word affect/effect in a sentence? Hate that.

Anyway, we started with the ENT because that was a fairly easy appointment to get. We went in yesterday, I gave them the digest version of Charlie's medical history including his recent falling down, and held Charlie in a wrestling move while he took a good, long look in Charlie's ears. He also checked out his nose and throat.

After giving these parts a good, long look his professional opinion is that Charlie probably needs tubes in his ears and possibly an adenoidectomy. Neither ear drum is the right color and his left one is showing signs of scarring and is graying. This means that he probably has a chronic problem with fluid behind the ears. His tonsils are enlarged and that means that there's a good chance his adenoids are as well. Add that to the fact that he's got a lot of signs of mouth-breathing, and that means there's a good chance that he would have enhanced breathing and drainage if his adenoids were removed. They can't know for certain about the adenoids without looking at them, but he said the standard procedure is to schedule the adenoidectomy at the same time as the ear tubes and if the adenoids end up looking OK then they don't remove them.

He also said, however, that Charlie is a complicated case and that he wouldn't do any kind of surgery until his neurosurgeon and his cardiologist signed off on it. I've googled shunt and ear infections, but I can't find any literature on whether or not you can have ear tube put in when you have a shunt. In case you didn't know, shunt tubing runs behind Charlie's right ear, which may complicate things. I'm hoping he could get a tube in his left ear at least, which is the worse one of the two. Cardiology isn't an issue since we've been released, so I'm not too worried about that.

There was one funny moment where the doctor warned me that if we took out his adenoids then he would probably have to be intubated for the procedures. I smiled and said that Charlie always did well with anesthesia and he chuckled and said that I probably wasn't going to be one of those moms who needed a Valium to get through ear tube surgery.

He did also say that whatever needs to be done to keep Charlie safe is fine with him. That means that Charlie may end up getting the procedure done at the hospital where he sees his other doctors, so everyone can be on hand if their are any problems.

I'm not happy about the idea of yet another surgery, but my understanding is that this is a pretty run-of-the-mill procedure and I'm completely interested in safe-guarding Charlie's hearing.

Ahhh. . . . kids. . . it's always something, isn't it?