And so another chapter begins. As the year came to an end, I could do nothing but look forward to learning more things in 2013. More things about hearing in particular. So, let’s get acquainted with The Ear:
While this does not mean that she is deaf, it does mean that when I say mother’s intuition, it doesn’t mean “tell me your opinion about how I’m paranoid”. It means, I’m THE Mom. When I know that my baby can’t hear me from across the room, I know.
Hearing loss is typical in children with achondroplasia due to the mid-face often times being small with a flat nose and narrow nasal passages. The inner-workings of the “drainage system” are also flat, not angled. This feature retains fluid, often behind the eardrum and can cause hearing loss with or without infection. This seems to be Addie’s issue (sans infection, Amen!), however, we will know more after our appointment with ENT in a few weeks. The most common solution is putting tubes in the ears. I am concerned because children with dwarfism have different spines, and any procedure requires someone familiar with their body-type, but I know that Dr. Bober would never let us do something he felt unsafe, so we will be consulting him before anything procedural happens.
As it turns out, Addie’s ear drum is not vibrating. After a physical examination of her ear, confirming no visible fluid or wax, the testing went on as it had before. We started with the tympanogram.
A small ear bud attached to a wire is inserted in the ear, one side tested at a time. The ear bud changes the pressure in the ear. In the grid-area, a line comes up (almost like a bleep on a heart monitor). It should be flat and then raised then flat. For example:
Addie’s results were flat. Completely flat. Like this:
This reading indicates there is final fluid in the middle ear, also known as serous otitis media. Not the best way to start out, but we moved on, because she mimics and babbles, the doctor knows she can hear.
We sat in a sound-proof room where Addie turned her head toward sounds, more loud than soft, and was rewarded with flashing lights and a puppy or frog dancing for her. Her response was better this time verses last, but was still not great. Because of this, the doctor used a bone oscillator headphone test. The bone oscillator transmits sound through bone vibration to the inner ear (cochlea), bypassing the middle and outer ear. The test is placed against the bone behind each ear (mastoid bone) to test bone conduction. This test helps determine if your hearing loss is due to the middle ear issues, inner ear issues, or another problem altogether. (P.S. Thank you ONE semester of nursing school for giving me the knowledge to understand everything the doctor was telling me!)
Addie heard much better with this test, but the doctor was unable to give me much beyond that , in terms of a fluid behind her eardrum or whether the bones in the middle ear are possibly fused (not common to children with achondroplasia).
So far we know Addie’s eardrums are not moving efficiently and she has conductive hearing loss. Conductive loss means it lies in the middle ear. Whether the loss is from fluids (not permanent) and can be corrected with tubes, possibly needed her whole life, or if it’s from the ossicles of the middle ear being fused (permanent), resulting in hearing aides, remains to be seen… or heard, as the case may be. Fluid seems to be the general consensus in the audiology department, as it’s very common in children with achondroplasia, but the ENT doctor will be able to tell us more, and possibly a trip to Delaware.
I am glad to know the she tested better. Where she was in the 55-65 dB range before, she’s now in 40-45 range. What the doctor is looking for is 15 or better. Confused? The graph below breaks down the severity of hearing loss, decibels (dB) by hertz (Hz), and the one below gives examples of what are considered common sounds in that range (lawn mower, dog, etc.):
Finally, you’re now an expert on hearing! Just kidding… but I think I will be soon. I hope that this issue gets resolved soon to avoid speech delays and issues in the future, but only time will tell. For now, I will continue to sing to my sweet girl and talk to her as I always do. I’m a loud person, in general, so I’m sure that helps! I know that she hears some of what I say and knows mama, dada, baba and something that sounds like “I did it”. She may not know what she did, but I do… she stole my heart!