Friday, March 09, 2007

Tubular

Barak can't hear that well. I've been noticing this for a long time, and took him in to the doctor for it last fall sometime. He said, yeah, there's fluid in his ears. Bring him back in six weeks and we'll see if it's cleared. When we came back nothing had changed, so I asked for a referral to an ENT.

We went last Friday, and she was absolutely decisive. "He needs tubes. And he needs his adenoids out." Ten minutes later, she was gone and I was holding the phone number of the surgery coordinator.

On Wednesday, I took Iyyar for his ten-month checkup and Barak in for a preoperative (choke) physical. My pediatrician seemed to have nothing at all to say on the subject of tubes. I asked him what he thought. He said, "I hate to put tubes in a kid in March. It's only been four months. It'll probably clear in the summer. Why not wait?" Would he do it if it were his kid? "Probably not. If he still has fluid in June, sure. But right at the end of cold season? The surgeons who do tubes talk about it like it's nothing and there are no risks, but that's not true. You can get..." and he reeled off a whole list of scary-sounding things. "I'm not saying I'd never do it. I'm just saying it seems worthwhile to wait until the weather warms up."

I called the ENT back. She was just as sure as she'd been. "He meets all the criteria. He's probably hearing at 40 decibels. You'd want to do something about that if it were your ears, wouldn't you> It's a very, very low-risk procedure, and it will help so much. He'll sleep better, he'll breathe better, he'll hear better. Don't you want to take care of that? Why would you wait?"

Why indeed. Um, because he's my baby and I don't want anyone to operate on my baby if it isn't absolutely necessary? How about that for a reason?

Don't I want to take care of it? Of course I do.

There is, by the way, no question that he can't hear very much, and I know the adenoids will have to come out sooner or later. So why not just do it all at once?

Argh.

Did you have tubes? Did your kids have tubes? Do you have any wisdom to share?

4 comments:

AidelMaidel said...

Listen to your gut. I had chronic ear infections and my tubes were replaced more than once as a child. I'm sure the procedure has improved in the last 30 years, but I have permanent damage to the inner ear mechanisim which regulates balance due to a mishap during surgery for tubes. Not the end of the world - I can't ride a bike but I can ride a roller coaster without getting sick, but still, I would go with your gut and your pediatrician. Don't let the ENT push you around. And when surgery is involved, it's always good to get a second opinion (and most insurance covers a second opinion).

Miriam said...

I had chronic ear infections as a kid too, and speech issues to go with them... and either my doc never offered tubes of my mother flat out told him no. Turned out I had a milk allergy, and as soon as I cut back on milk, my ears and speech cleared right up. To this day, I still get a runny nose from drinking milk or eating cheese. (Note that I haven't completely avoided dairy, just cut way back on it.)

My niece just got tubes -- although my mother gave my sister h*ll for even considering it, insisting that they just don't work for anyone, which is why I think she may have nixed it when I was a kid -- and I haven't yet heard how it went.

Another friend got her little girl tubes last year, and her speech cleared up considerably. She had barely been talking at all, and her spoken vocabulary just exploded overnight.

So I would explore other options/reasons for fluid in his ears first, (like allergies, etc.) but don't just discount the potential benefits of tubes. Oh, one thought is to use mullein-garlic-olive oil drops in his ears, probably available at your local health food store. (In a small brown dropper bottle with an orange label.)

Deborah said...

Sorry, have not been there or done that. Had a nephew who did--he would get infections from swimming in the pond in the summer. No complications that I ever heard and he did have far fewer infections. He was older though--maybe nine when it was done. He had suffered in his speech for years before that--always sounded plugged up.

Yasmin said...

Well, you've heard about Robbie already. Once he started at daycare around 2, he got regular, almost monthly ear infections. Got to the point we didn't have to take him to the pediatrician any more: we'd call her, she'd ask if anything was different, and put in the prescription for antibiotics to be picked up right away.

I'm not crazy about constant antibiotic use, especially in small children, and when the Amoxicillin ceased to be effective and we had to bump up to Augmentin, I got more concerned. And Robbie had a hearing test, and the nice lady told us he's basically hearing like he's underwater.

We talked it over with our wonderful pediatrician, who is very much into doing the minimum of invasive procedures on small children (we really had to work on her to have his blood drawn for typing, because it hadn't been done at birth and we wanted to know, in case he needed a transfusion in an accident or something, for instance). Even she felt that tubes were a good idea.

And, you know, they were. We felt awful when he got all scared and when he came out of the anaesthetic bawling because his throat hurt, but Curious George and a popsicle helped a lot, and very soon we could tell his hearing had improved a lot, his speech development picked up, and he has only had one ear infection since. And he just turned 9.

(Nine! Yikes!)

So I think that yes, they probably don't work for everyone, and surgery should never be your first solution in a non-emergency situation, but they can be a Very Good Thing for some children. Including mine.