Lest you think Ari always smiles, here he is at the end of a very long morning of doctor appointments at Arkansas Children's Hospital on Wednesday. He was so done!
I can't count the number of ear infections Ari has had. I can't. I didn't track them. They happen often. He's on his 3rd set of tubes. He's had 4 ear infections since the last set of tubes were placed in August. He had his ENT check up Wednesday.
Turns out his left ear tube had fallen out (so Dr. Nolder went in and got it out, much to his discomfort), and the right one has partially fallen out (but she left it in for whatever it can still do). The idea behind ear tubes is that you are giving the ears a channel to drain from so they don't get stopped up and infected. Kids with Down syndrome have an especially difficult time with ear infections because their ear parts are smaller than normal developing kids and often their ears are lower so the canals that drain from the ears internally don't have room to drain down...they just run across...which doesn't work well for draining.
Ari's hearing test wasn't great (he wasn't very compliant), but he could hear some things, so the decision was made to see how he does with the one remaining tube and come back and check his ears in 3 months. Why? The next set of ear tubes will be T-tubes which are designed to stay in for 10 years and 40% of the time leave a hole behind that has to be surgically repaired. This carries an increased risk for hearing loss...although if he keeps getting ear infections, that's a risk too. Ari's ears spit out ear tubes like crazy because his middle ear is so small, there's just not much room in there and it wiggles free easily. I don't think the T-tube would be any different and could even be more irritating (sigh).
While we were there, I asked Dr. Nolder to look at Ari's tonsils. They've grown. A lot in the past few months. She said that's normal for all kids, but his have gotten pretty big. Again, because the anatomy of kids with Down syndrome is usually smaller than normal developing kids, big tonsils aren't just annoying, they can actually obstruct breathing leading to sleep apnea among other things...so Ari is now scheduled for a sleep study in June. These are actually recommended for all kids with Down syndrome before they are 4 years old so this wasn't a huge surprise to me, but I was sad to see that she confirmed my huge new tonsils observation:(
If the sleep study reveals apnea and breathing issues, we would then have to consider a tonsillectomy. Of course after Ari's surgery to remove his adenoids last may that ended up in his intubation and hospitalization, I'm not at all excited about another extended surgery like that...BUT we have some new info that could help us when we do have to get those tonsils taken out. More on that in the next post...
Love to all,
Dorothy
I can't count the number of ear infections Ari has had. I can't. I didn't track them. They happen often. He's on his 3rd set of tubes. He's had 4 ear infections since the last set of tubes were placed in August. He had his ENT check up Wednesday.
Turns out his left ear tube had fallen out (so Dr. Nolder went in and got it out, much to his discomfort), and the right one has partially fallen out (but she left it in for whatever it can still do). The idea behind ear tubes is that you are giving the ears a channel to drain from so they don't get stopped up and infected. Kids with Down syndrome have an especially difficult time with ear infections because their ear parts are smaller than normal developing kids and often their ears are lower so the canals that drain from the ears internally don't have room to drain down...they just run across...which doesn't work well for draining.
Ari's hearing test wasn't great (he wasn't very compliant), but he could hear some things, so the decision was made to see how he does with the one remaining tube and come back and check his ears in 3 months. Why? The next set of ear tubes will be T-tubes which are designed to stay in for 10 years and 40% of the time leave a hole behind that has to be surgically repaired. This carries an increased risk for hearing loss...although if he keeps getting ear infections, that's a risk too. Ari's ears spit out ear tubes like crazy because his middle ear is so small, there's just not much room in there and it wiggles free easily. I don't think the T-tube would be any different and could even be more irritating (sigh).
While we were there, I asked Dr. Nolder to look at Ari's tonsils. They've grown. A lot in the past few months. She said that's normal for all kids, but his have gotten pretty big. Again, because the anatomy of kids with Down syndrome is usually smaller than normal developing kids, big tonsils aren't just annoying, they can actually obstruct breathing leading to sleep apnea among other things...so Ari is now scheduled for a sleep study in June. These are actually recommended for all kids with Down syndrome before they are 4 years old so this wasn't a huge surprise to me, but I was sad to see that she confirmed my huge new tonsils observation:(
If the sleep study reveals apnea and breathing issues, we would then have to consider a tonsillectomy. Of course after Ari's surgery to remove his adenoids last may that ended up in his intubation and hospitalization, I'm not at all excited about another extended surgery like that...BUT we have some new info that could help us when we do have to get those tonsils taken out. More on that in the next post...
Love to all,
Dorothy
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