Failed hearing test, fluid in middle ear, pushing tubes.... UGH!!!!!!!

[timneh_mom]

I think I just need some reassurance more than anything else.  I have been an RN for 19 years, so I well understand all the medical implications of this.  My son is 6 years old.  The health department did hearing tests at school this winter.  He failed two of them, it turns out the second one was done when he was recovering from strep throat and viral bronchitis.  The health department failed to tell me he even needed to be restested, and of course I had no idea they were going to retest when they did.  If I'd had some say in that, I could have brought him in when he was feeling better.

So they wanted us to see the doctor, which we did.  Normally she is very hands-off... try the simplest things first, then be more aggressive ONLY if needed.  I don't know what her issue was the day we went, but before even looking in his ears, she started asking me which ENT we needed because he might need tubes.

This is a child who has never, NEVER had an ear infection his entire life.  (He breastfed for 4 years.)  We do know that he can get fluid in his middle ear when he has a cold.  Doc has seen it.  He has had colds pretty much all winter as he started kindergarten this year and we have cold winters here.  They happened to test him when he was sick.  After me balking several times at the suggestion of tubes, she finally looked in his ears and said they looked normal.  She then finally said, "So, you want to try something simpler?"  And I said YES so she told me how to equalize pressure in ears (I am a scuba diver so very familiar with that) and suggested some mucinex. 

We are going back for a retest of hearing in 2 weeks.  The lady at the health department said his tympanogram looked like he had an infection, which he doesn't.  The nurse who did it is not known for being accurate with anything because she has weighed my kids with winter coats and boots on!!!  From what I understand it is easy to mess them up.

Again, I'm an RN for 19 years.  I know what I am seeing. 

He has not had ANY and I mean, ANY changes in quality of life.  He is a great student, hears fine in class, hears fine at home... he did say he couldn't hear well for a SHORT time this winter during a cold (like 1-2 days) but then it was better.  HE CAN HEAR.  WHY won't ANYONE understand ME when I say HE CAN HEAR??

I am frustrated, annoyed that people seem to want to push me to consider the option of cutting my kid's eardrums for a VERY INTERMITTENT problem that is not even causing a real problem? 

I am very confident in my decision not to consider tubes at this time, but just VERY sick of people being pushy and thinking they know better than I do!  It's making me mad... sigh.....

If anyone has had any similar experiences, please, I would love to talk to you... I totally think tubes are appropriate when a child has speech delays, does poorly in school because he truly cannot hear, is in pain, has lots of infections.... none of these apply to my son.

[libba]

I am going to answer with something you might not like.  I too am a nurse for 28 years but with profound hearing loss in one ear.  Due to the fact that I got tubes in my 20s.  I needed them in childhood because by the time I had them done my ear drum had little to no blood supply left due to repeated infections and the damage they caused. 

I NEVER complained of ear pain or ever acted sick as a child but would occasionally tell my mom that everyone sounded far away.  BINGO!  Ear infection!  They never hurt and still do not hurt at age almost 48!  I have had 76 ear surgeries after the first set of tubes.  The damage done to my ears during my childhood made it to where my ear would not heal normally and I finally had infection set in the mastoid bone behind my ear.  The bone has been removed and I have done well despite hearing loss but am faced with a final ear surgery to remove the bones of my middle ear ( they are corroded basically) and replace them with artificial ones and rebuild my ear drum.  I will also never be able to wear a normal hearing aid and will have to have one that is anchored in the bone of my skull.

All this to say  PLEASE get your baby tubes.  Have them take out the adenoids too which might contribute to fluid build up.  My daughter had this done at age two and was at the zoo the next day and hasn't had ear problems since!  Get a second opinion if you need to but just because he is never sick doesn't mean that his ear and hearing may not be getting damaged by the fluid.

OK - stepping off my soap box and thanks for reading if you did.

[californiajenn]

Originally Posted by libba 

I am going to answer with something you might not like.  I too am a nurse for 28 years but with profound hearing loss in one ear.  Due to the fact that I got tubes in my 20s.  I needed them in childhood because by the time I had them done my ear drum had little to no blood supply left due to repeated infections and the damage they caused. 

I NEVER complained of ear pain or ever acted sick as a child but would occasionally tell my mom that everyone sounded far away.  BINGO!  Ear infection!  They never hurt and still do not hurt at age almost 48!  I have had 76 ear surgeries after the first set of tubes.  The damage done to my ears during my childhood made it to where my ear would not heal normally and I finally had infection set in the mastoid bone behind my ear.  The bone has been removed and I have done well despite hearing loss but am faced with a final ear surgery to remove the bones of my middle ear ( they are corroded basically) and replace them with artificial ones and rebuild my ear drum.  I will also never be able to wear a normal hearing aid and will have to have one that is anchored in the bone of my skull.

All this to say  PLEASE get your baby tubes.  Have them take out the adenoids too which might contribute to fluid build up.  My daughter had this done at age two and was at the zoo the next day and hasn't had ear problems since!  Get a second opinion if you need to but just because he is never sick doesn't mean that his ear and hearing may not be getting damaged by the fluid.

OK - stepping off my soap box and thanks for reading if you did.

I'd say a blanket statement of definitely get tubes AND cut out parts of his body based on one post is entirely too drastic.

OP - As there is a history of fluid, I would highly recommend dietary changes, such as removing mucus forming foods like dairy and inflammatory foods like industrial seed oil and grains. This will give you the best chance of him "passing" the hearing exam. If he does not pass again, there are other dietary changes you can make. If those don't work, then tubes might be in order.

Good luck!

[timneh_mom]

I was pretty frustrated last week when I wrote this, and since then, we have decided that if he doesn't pass another hearing test, we will see an Audiologist for their opinion.  The test was given by a health department technician and I would like to get a good solid assessment of his hearing before proceeding. 

The next step will then be to see an ENT, for ALL our options.  We can explore allergy options as well. 

Libba, I am so very sorry you have gone through so much with your ears and hearing.  My son will get a paper cut and scream for an hour over it... so I trust he would tell me if he was in pain.  Another thing to consider... back in the day when we were kids... 60's and 70's... did they really pay much attention to kids' hearing back then?  I think I remember getting screened a couple of times in grade school (76-78 or thereabouts) but that was it.

I just cannot see cutting eardrums/removing parts of the body due to a problem caused by a cold or too much of a certain food, or maybe even environmental allergies.  You can trust that I am not going to bury my head in the sand and refuse the surgery if (IF) it is clearly necessary.  I am also not willing to kill a fly with a sledgehammer.

[Owen'nZoe]

My son has had issues with chronic fluid in his ears. He went for about 9 months straight with fluid, unable to hear, before we settled on tube surgery. He did have a few speech delays because of fluid. For us, the surgery was necessary, but our situation is very different from yours.

What I learned as we went through the process of deciding what to do, though, was this:

1) According to our pediatrician and the pediatric ENT we worked with, it is actually rare for chronic fluid issues to lead to long term hearing loss. And libba, I am so, so sorry that that was the case for you. But I think taking a little more time to decide in the OPs case is not a bad idea.

2) We also learned (and this is something you as a health professional probably already know) to get advice from more than one doctor. My son's surgery was eventually done by a wonderful ENT. I have nothing but the best to say about the surgery, and other doctors who have examined DS's ears since have commented on what a skillful job he did. BUT he was very gung-ho on surgery, and didn't agree with using it as a treatment of last resort. Since it was needed in the end, I'm sure he felt we should have just gotten it over with months before when he first recommended it, but we knew there was a chance the issue would clear up without surgery, and I'm glad we waited. Our second opinion was from a wonderful pediatric ENT, who actually recommended waiting. When he (and our ped, who was very reluctant to recommend surgery) both said it was time for the surgery, we felt confident that we had exhausted all of our other options. If you can meet with a few ENTs and find one whom you are comfortable with, I think his or her advice and guidance will make it much easier to make your decision.

Best of luck!