I have no twelve month update because we haven't been to Lou's appointment yet. I am waiting until a sufficient amount of time has passed for his latest ear infection to clear up because I absolutely refuse to pay one more co-pay than I have to.
We went to the ENT last week and it was a good visit. The first thing we did was meet with an audiologist who conducted a hearing test. She first measured the amount of fluid behind Lou's ear drums. As we suspected, his right ear has a moderate to severe amount of fluid, while his left has much less.
The hearing test consisted of me sitting in a sound proof booth with Lou in my lap. I had a book that I had to make him pay attention to but I couldn't speak to him. That's harder than it sounds. The audiologist (and BVZ) were outside the booth and she activated a series of tones in different parts of the room and gauged how quickly and accurately he responded to the tones. There were also battery powered stuffed animals in clear boxes mounted on the walls that would randomly start moving. Lou would jump every single time. He has the VZ startle reflex for sure.
He passed the hearing test with flying colors. It was a Friday and the audiologist said he was the easiest kid to test that she'd had all week. Apparently, the ideal hearing test is one in which the patient wears ear phones and the audiologist can accurately determine which ear either hears the tone or doesn't hear it. That's obviously not possible with a baby and so the results aren't quite as accurate. Because his right ear is always full of fluid and infected much worse than the left it is possible that his left ear is compensating and he was registering the tones coming from the right side with his left ear. It's pretty much impossible to tell right now. (Of course there is a hearing test for kids that involves sedating the patient and measuring, oh I don't know. Brain waves? But we clearly aren't in need of anything remotely that intense or invasive right now).
Next we waited in the exam room for about 40 minutes while we tried to prevent Lou from destroying everything in his path. At this age, Norah was more than willing to sit in my lap and read book after book while we waited for the doctor. Lou wanted to strangle himself in the blood pressure machine, lick the floor, destroy a jar of tongue depressors, and activate the chair's hydraulic lift. Over and over and over.
The ENT did his examination and then we talked about our options for about 45 minutes. I am one of those with a lot of questions. He was great. Basically we have three options. The first is to do nothing and see if Lou just grows out of it. The other extreme is to have ear tubes put in. It is an out-patient surgical procedure, but the kid has to be completely sedated. The tube, which is about the size of the head of a large pin, allows the fluid that builds up in the eustachian tube and harbors bacteria (resulting in an ear infection), to actually drain. There are some consideration with tubes...they can fall out and have to be replaced, the kid can't completely submerge his head in a bathtub or swimming pool, and in rare cases, the tube has to be surgically removed and/or a small perforation in the eardrum can result (rare and totally fixable). The ENT was supportive of Lou getting tubes if that's what we wanted.
The middle of the road option was to try and clear up his ears and see what happens once we are out of cold and flu season. The problem with chronic ear infections is that the fluid behind the ear drum never clears out and becomes a breeding ground for bacteria. Kid gets a cold, bacteria is introduced, and BAM. Ear infection. The ENT's recommendation, and what we were most comfortable with, was to put Lou on a five day course of oral steroids to dry out the fluid and continue his current antibiotic for another ten days, so that there isn't a re-infection while the fluid is drying up. Once the fluid is actually gone, we can see what happens the next time he gets sick. If he gets a cold and automatically gets another infection, we will know that the anatomy of his ear is preventing the gunk from moving through like it's supposed to and tubes will be the next step.
He finished the steroid a few days ago and for the first time in five months he doesn't have a runny nose. I suspect that he is actually allergic to Texas, just like 95% of the population (myself included). There is all kinds of cedar and oak and mold and pollen around here. It's a wonder anyone can actually breathe.
I am glad to have a plan and that he seems to be responding so well to said plan. Stay tuned.