Kaelen - Aus Hearing checkup

Fri 5th Dec - This must have been the shortest Aus Hearing appt we've ever had! Still nearly 1hr, but they were even running close to time at the end of the day, so we were done a lot earlier than i expected.

I wasn't sure what to expect from this appt - every time we go to Aus Hearing with J they do testing of some sort, so i wasn't sure if they would do the same with Kaelen, but it turns out this was just to check the settings of his aids and take new impressions for ear moulds. Because the babies grow so fast, they go through moulds like they're going out of style (i think this will be Kaelen's 3rd or 4th set, in 10 weeks!) and the size of their ear canal changes, which affects the levels at which the hearing aids are set, so they need to be tweaked regularly, it seems. This is all a bit new, cos Jarrah didn't have hearing aids as a baby, so he's only just got his first new set of moulds and had his first tweak. So, a rather uneventful appt!

A quick update on Kaelen's general progress though - we had our last speech lesson for the year yesterday, and he's really beginning to respond well to voices, and locating sounds around him (turning to them when he hears them). His speech teacher was very pleased with what she saw yesterday, he was listening really well and turning to her right away when he heard her voice, which is very age-appropriate. His current favourite sound is "Sh-sh-sh-sh-sh" - this is pretty much guaranteed to produce some giggles! Which is also great, cos that's quite a soft sound, and shows that he's hearing well in the high frequencies.

Next appt: Tues 6th January 2009, K @ ENT

Strike, how can a kid grow so much?!?

Well i thought Kaelen was looking bigger (especially longer), and some of the mums at MOPS yesterday commented that he looked bigger, but this morning we went to child health and found out just How MUCH! :-)

It seems that in the last 4 weeks Kaelen has put on nearly 1 whole kilogram (!) and grown about 5cm in length!! My goodness boy, are you thinking NBA already?!? Perhaps he was just doing some catching up (and stashing a bit away for Ron...), but to me that seems an astronomical amount to grow in 4 weeks. At least we know what he's been doing with all the milk he's been drinking...

Thinking of starting solids next week, really only so we can offer him a wide variety of tastes and flavours before he gets too set in his ways at the ripe old age of 6 months, as i've heard of happening. Perhaps he'll actually have some need for them by then too...

On the hearing front, Kaelen has begun to respond very clearly to voices in the last 7-10 days. He has always responded well to noise-makers such as rattles & cymbals & cellophane (a favourite!), but about 10 days ago at his speech lesson he decided that he liked "meow" very much, and would grin from ear to ear upon every repetition. During last week this reaction gradually spread to other sounds, "moo", "quack quack" (especially from Daddy!), "woof woof" & other animal sounds. This is a great sign, cos it shows he's really beginning to tune in to voices, which is critical for developing speech. He even responded to a few things without his hearing aids, so there's obviously enough residual hearing there that he still gets some input without his technology. According to his speech teacher, we should expect him to develop age-appropriately; because he got his aids so early, he really hasn't missed much at all.

Which comes first - the chicken or the egg?

Or, in this case, the teeth or the ears?

Since my last entry, Jarrah's ears have continued to discharge, alternating sides of course - and then i discovered he had a new tooth! His first 2-yr-old molar! That was prob about 2 weeks ago, and followed a few days of runny nose in addition to ear discharge. Then, last week, about when the discharge swapped sides, i discovered a second 2-yr-old molar.

So, which comes first - the teeth or the ears?

Now i'm not sure if the ear discharge is related to or even caused by the teeth, or if the timing was just unhappy co-incidence. I also don't know if the runny nose was caused by either the teeth or the ears, or how about both...it's all a mystery. What i do know is that he's hearing spectacularly at the moment, so any discharge that is there doesn't appear to be bothering him too much...

Children are complicated sometimes... :-)

Easier said than done...

Did i say something last post like, "if we can just keep Jarrah's ears healthy..."?

Well, it seems this is easier said than done.

Tomorrow is 7 days since that last test. Tomorrow will be day 3 of our next round of drops due to discharge from his right ear. And, i must confess, we didn't get on the drops right away, we waited a day or two for things to present themselves clearly.

How can this be?

How can a child go from having clear, apparently healthy ears on day 1, to having lots of odourous discharge (thus preventing the wearing of a certain hearing aid) in less than 7 days, probably closer to 3 days? With no obvious catalyst or other illness? This is verging on ridiculous.

Despite all this, Jarrah did very well at speech today with only one ear in - detected all 7 Ling sounds and listened very well to instructions...you could see his little brain processing the contents of the sentence backwards, it was fascinating! Apparently kids who are cochlear candidates don't detect all 7 Ling sounds, so that's encouraging that he can do that with only 1 hearing aid and who-knows-how-little-hearing in the other ear - and it confirms the opinions and decisions that have been offered and made so far.

*Sigh*, off to make my chemist richer than he already was...

Jarrah - Aus Hearing checkup

Tues, 4th Nov - Well, the good news keeps on coming! It's been a long time coming, but at least it's coming! Grab it, with both hands, and don't ever, ever let go!

Today was another routine check-up at Australian Hearing for Jarrah. They've been happening every 3 months because his levels have been fluctuating so much, so he's starting to get a little bored of the puppet game. The VROA (Visual Reinforcement Orientation Audiometry) is where they put little pipes in his ears, play sounds at various frequencies and levels through the pipes, and when he responds by turning to the sound he's "rewarded" by something visual, usually a puppet lit up in a box, hence my term "puppet test". The plan for today was to try a different method of testing, designed for slightly older children, but because of the work he's been doing at Yeerongpilly it was considered that he should cope fine. Unfortunately our regular audiologist was not at today's appointment, so that different method of testing was not used, even though i mentioned that it had been discussed and approved at our last appointment.

Nevermind, we had another go with the puppets. Ears were checked and clear, grommets were in place and open, and Jarrah had slept reasonably well last night so he was in a very good frame of mind for testing, thankfully! The priority was to get clear results on the right ear, since we hadn't had any decent results from that ear since January, so they began with that side. I can usually hear some of the tones as the test goes by, but today i heard very little...which made me wonder whether they were testing much, or if Jarrah was hearing well. But then, i could see when it was a response because they showed the puppet!

Jarrah lost interest part-way through testing the left ear, but the results they did get were not different from the previous test, so they were deemed accurate. What we did get was this:

Right ear:

250Hz - 75db (previously 70db, so within margin of error)

500Hz - 70db (previously 70 or 75db, so within margin of error)

1kHz - 60db (previously 85-90db, so significantly improved!!)

2kHz - 70db (previously 65db, so within margin of error)

4kHz - 60db (previously 105db, so significantly improved!!)

Left ear:

1kHz - 75db (previously 70-75db, so within margin of error)

4kHz - 80-85db (previously 90-105db, so some improvement)

These are virtually the same results as Jarrah returned at the test immediately after he was fitted with hearing aids nearly 12 months ago, in fact the left ear 4kHz result is actually slightly better.

HOORAY!!

This for me confirms the decision of the Mater Implant audiologist who was of the opinion that Jarrah was not in need of cochlear implants, and tells me that most of the fluctuations we've seen throughout 2008 have been due to middle ear conditions. Therefore, if we can keep J's middle ears healthy (ie. infection-free), then with his hearing aids he should do just fine.

By the way, he's trying to say lots of words like "eggshell" and "truck" and "clock" these days, and his favourite song atm is "Bananas In Pajamas", which kind of sounds like "naa ni ni, naa ni ni, aaaaah naa ni ni, naa ni ni..." I must confess it took me a few days to figure out which song that was... :-)

Next appt: Fri 5th Dec, Kaelen's Aus Hearing check-up

Jarrah - Mater Implant Team appt

Tues 28th Oct - Today we had an appointment with an audiologist from the Mater Hospital's Cochlear Implant team. Our ENT has been making implant noises all year, and because he freely admits he's not an implant specialist he encouraged us to have a meeting with them sooner rather than later, just in case implants would be helpful. He basically said he didn't want to mess us around by saying we didn't need to talk to them, only to find out in a few years time that we should have gone years ago...so i feel like he did the best thing for us.

We got to meet a new audiologist! And just when we thought we were getting to know everyone... Anyway, we sat and talked over Jarrah's history (the whole 2 years of it!) while he played at a table nearby. I got to see a real live implant, both the piece that is surgically implanted as well as the external component. I've seen plenty of the external components at playgroup, but i'd never seen the piece that actually goes in the head :-s It's impressive, really, how much is done by such small components, and it's amazing what functionality such a device gives to people who would otherwise hear virtually nothing.

We chatted, Jarrah played, Jarrah sang "Twinkle, Twinkle, Little Star" (clearly enough that the audiologist recognised it), Jarrah investigated all the computers in the room (as he does!), and Jarrah basically convinced the audiologist by all this that he doesn't need implants.

HOORAY!!!

This is probably the best news we've ever received from an appointment for Jarrah. I must confess that i would have been surprised if we'd been told that he did need implants - he seems to have a fair bit of residual hearing, all or most of which would be destroyed by the implants - but, not being an audiologist or having any experience in the implant area, i really didn't know exactly what to expect. Jarrah's audiograms (hearing test results) apparently make him look like a classic implant candidate, but his functionality seems to be waaaay better than his audiograms would indicate.

So...this presses the Pause button on this option for now. We may need to revisit implants once J starts school, depending on how well he copes with a more difficult listening environment, but at least we have a few years between now and then. No testing was done at this appointment - i think that had been the plan, but once the audiologist saw what Jarrah was doing, and once we said we were due to see Aus Hearing next week, it was decided that tests were not necessary today. At some point soon Mater do want to do a Speech & Langauge assessment so that, if Jarrah's hearing deteriorates in the future, we have a baseline with which to compare.

I think Jarrah gets songs "on the brain", like a lot of people do. I very often hear him singing away during the day, quite a mixture of songs, and i recognise most of them. Occasionally there will be one that i can't work out, but it often comes around again and again over a few days, and i'll eventually figure out what it is. He also shows that he can discriminate between instruments on a recording - if i play a CD that is pure piano music (eg. Suzuki Piano Bk 1) he will move his fingers & hands as if playing the piano, but if i play something that's heavy on guitars or drums (eg. Colin Buchanan) he'll either strum as if playing a guitar or flail his hands as if playing the drums :-) It's very cute to watch, but it's also encouraging, cos i can see that he's getting good timbre information.

Sometimes people with hearing losses don't just have lower hearing thresholds, but they can also have distortions of what they do hear. That has made me wonder on occasion exactly what Jarrah hears, and whether he hears clearly or not. I'm beginning to conclude that he hears reasonably clearly, or without much distortion. For him to make such distinctions of instrumental timbre, he must have enough clarity to be able to hear the difference.

And i've just today realised why continuing with signing is still important for him. For words that sound similar yet are quite different, i'm not convinced that he hears the subtle differences just yet, so doing the sign for those words helps him to understand that i really am saying a different word. I can't remember quite what it was i was saying to him today, but it was a word that could have been confused with another one he knows, and i suddenly realised that at this point in time it is mostly the sign that differentiates between those two words. Because i can't be sure exactly how clearly he's hearing my words, it would appear that the signs will be helpful in allowing him to understand a wider range of words, and prevent confusion. That might seem like an odd observation to make, but it reinforces to me why i should continue learning signs. 

Not that i'm worried about learning more sign, but it helps me to know i'm doing the right thing...

Next appt: Tues 4th Nov, check-up for Jarrah @ Aus Hearing

Kaelen's Aus Hearing follow-up

Tues 14th Oct - nothing unusual to report at this follow-up appointment, except that Jarrah again amazed the audiologists by being far more interested in all their instruments and noise-makers for Kaelen's tests than in the puzzles or toys they were offering him, and also by singing back some of the noises at pitch :-) And no, we didn't get any results worth recording from the tests cos Jarrah helped a bit too much...but we did take new impressions for new ear-moulds (babies grow so fast at this age!!) and setup the next couple of appointments. I think i shall have to have Jarrah visit somebody for Kaelen's appointments, and probably vice versa as Kaelen gets older.

Next appt: Tues 28th Oct, Mater Cochlear Implant Team for Jarrah. I have no idea what's going to happen at this appointment, which is actually a strange feeling, as most of the appointments we have these days are follow-ups, check-ups, or appointments for Kaelen that i've already been to with Jarrah. I don't know if they're going to assess him for implant candidacy, or if this is just some sort of preliminary informationy-type appointment. We'll see...

An unexpected letter...well, sort of...

Thurs, 2nd Oct - taking the kids out for a walk, collected the mail from the letterbox on the way out, thought maybe i could read it along the way. Hmmm, from the Mater, what could that be? Open...newsletter, from the Cochlear Implant Team. Oh.

Our ENT had said he would get the Mater Implant Team to contact us and have a preliminary appointment for Jarrah, just to see if he would get more benefit from an implant than just his hearing aids, even though he seems to function quite well. I hadn't heard anything yet, so i was just waiting for a phone call to arrange an appointment or whatever. Interesting that they sent us a newsletter before we've even had an appointment, maybe they'll call soon...

Next letter - hmmm, Mater also...odd. Oh, "we've made an appointment with the Cochlear Implant Team for you", nice, thanks for checking that it was convenient, good thing it is. Tuesday 28th Oct 11am, about 4wks time, in between Kaelen's Aus Hearing follow-up & Jarrah's next Aus Hearing check-up. Well, that just completes the circle, doesn't it, at least we'll have some news for the Aus Hearing ppl.

Well that was a bit deflating. A clear reminder that major surgery is still a possibility, an "in-yr-face" reminder that all is not as it should be with Jarrah's hearing, despite him functioning so well, that this is a decision that we may need to make one day. *Sigh*, i guess this is the job of a parent, to make the best choices possible for a child while they're unable to make those choices for themselves, and this is a toughy. I know there is some debate around as to whether parents should have the right to make these choices, and i don't plan to enter that debate here, but even just looking at the possibility makes me sad, knowing that such things are necessary.

I know, you're going to say, "just be thankful there's something they can do, 50 years ago they would have been institutionalised, isn't technology amazing these days with what they can do, be grateful you found out early and do something for them" - yes, all those things are true, and there's always someone worse off than me, i'm not claiming to be the most hard-done-by person in the universe...but that doesn't make actually dealing with it any easier. I'm sure every parent who faces this challenge finds it hard - otherwise it wouldn't be a challenge, by definition, right? I guess it just felt a little out-of-the-blue because i was expecting a phone call, expecting to be consulted in the appointment-making process...yeah, that's probably it, it happened in a very different way to what i expected, caught me off guard.

So, the saga continues, a new set of experts to get to know...

Kaelen - has hearing aids!

Tues 30th Sept - Kaelen turns 3 months old tomorrow, and today was his hearing aid fitting appointment. Such a miracle that technology now allows a 3-month-old hearing-impaired child full access to sound...20 years ago nobody would probably have known the 3-month-old child was hearing-impaired at that age! The molds look so tiny compared to Jarrah's...i guess his ears are quite a bit smaller, 2 years makes such a difference! The units are the same colour, so i've written their first initial on each one so i can tell them apart.

Kaelen responded quite well then they were first switched on. There's a lot of messing about in the appointment before we get to the 'switching on' bit, mostly setting up the units, checking that the molds fit properly, checking that the tubing (that joins the mold to the unit, that pipes the sound into the ear) is sitting correctly so the hearing aids stay on properly, and then cutting that tubing to the correct length, talking through the safety aspects of using hearing aids with children, talking through the various functions of the hearing aids (some of which are disabled for children)...all the information, legal & procedural stuff. Then, there is the moment of truth - the aid is inserted and the battery clipped in. Pause, while the hearing aid powers up. Sound!

Kaelen was having a feed at the time his first aid was switched on, so we could see his face quite well. He didn't seem stressed about it at all, although his eyes definitely got wider :-) "Wow, the world sound like *this*?" The second one was not as dramatic, probably because it just complimented the first one, but there was definitely a reaction, and not a bad one, which is what we like to see. Then they do some quick checks with loud noise-makers to make sure he's not uncomfortable with those loud sounds, and if it's all good then that's it - we're done!

Today was not quite as emotional for me as i thought it was going to be...perhaps i processed a lot of that emotion during these last 2 weeks, knowing it was coming. Or perhaps this is just a lull, and it'll all hit me again tomorrow morning when i have to put 4 hearings aids into 2 children, not just 2 into 1...i don't know, but i must confess that i was fearful that i would cry all over the audiologists. Fortunately, that didn't eventuate, i was calm, cool & collected the whole day. Let's see what tomorrow brings...

I'm really hoping that getting hearing aids this early will mean that Kaelen will develop speech reasonably normally. It's hard to tell what's going to happen, and we don't know if there are any distortions along with the volume loss, so all we can do for know is hope, pray, and do our best to give him the best possible chance. Hopefully his brain will switch on to listening in these early months and it won't be the effort for him that it is for Jarrah.

For reference, i thought i'd upload this Frequency comparison chart. It gives a bit of an idea of what sounds fall in what ranges (both frequency & volume), both speech sounds and other environmental sounds, and therefore what sounds should be accessible by people with certain amounts of loss. This chart makes no sense for Jarrah, he constantly makes sounds that are allegedly outside his hearing range, so we just nod and keep going, but i include it anyway as i find it an interesting guide.

Next appointment: Tues 14th October - hearing aid follow-up appt for Kaelen

Kaelen - Australian Hearing appt

Wed 17th Sept was Kaelen's initial appointment with Australian Hearing. At this initial appointment the usual procedure is to perform a few tests to confirm the results sent through from the Mater and decide on a course of action (usually the recommendation of hearing aids). For Kaelen this was pretty much a foregone conclusion so the testing was routine, but at least it showed the same kinds of results to the Mater, so again, his hearing appears to be stable - which is a nice change!

Nana accompanied us to this appointment, which was nice - good for her to see what happens, and handy to have someone to hold Kaelen when i needed to sign papers or do other things. :-) I didn't realise that Kaelen needed to be asleep for the testing though, so we were there at a time when he was fairly awake after a feed. Fortunately, he's a sleep-anywhere kid, and by the time they were wanting to begin the testing it was getting close to his sleep-time anyway, so they set us up in the sound booth (all testing is done in sound-proof rooms so prevent extraneous noise from interfering) and left us for 10mins to get him to sleep. He was a bit wiggly, both tired-wiggly & tummy-wiggly so after a few mins i put him over my knee to ease the tummy pains...and he was soon fast asleep :-) Lucky i never had to do this infant test with Jarrah, there is *no way* he would have done that...

The testing showed a 50-60db hearing loss, which is exactly what we expected, so then it was on to choosing colours for his behind-the-ear unit and making impressions of his ears for the molds. I had wondered about getting a different colour unit to Jarrah so i could tell them apart easily, but in the end i just went with the skin-colour again, and we'll put stickers or nail-polish or something on them to tell them apart (might even put their initial on the unit so that Jarrah can tell which is his and which is Kaelen's too...just thought of that!). Impressions are taken by squirting a nice cold goo into the ear canal and around the outer ear which then needs to be left to set for about 2minutes - an eternity to a small child! - so that wasn't entirely pleasant, but it's got to be done. Oh, and because Kaelen's so much smaller than Jarrah was at this point, we'll be needing to get new molds as he grows, which will probably be a much more regular event :-s Great...

So, back to Australian Hearing on Tues 30th Sept for hearing aid fitting, then a follow-up appointment on Tues 14th Oct to check and make sure they're doing ok. On 1st Oct Kaelen turns 3 months old, so he'll have good access to sound a lot earlier than Jarrah did - hopefully this will mean we can avoid some of the speech delays and discipline issues we've had with Jarrah along the way...although i think it will be more difficult seeing hearing aids on my baby's ears this time, he's so little...

A side-note, humourous but totally irrelevant - i got my wedding rings re-sized last week, as i hadn't been able to wear them since Jan 2006 while i was pregnant with Jarrah. After he was born i took a while to lose all the baby weight, but even when i had i found that my knuckles had spread a bit and i still couldn't get my rings on! Since we were thinking of having another baby fairly soon i didn't bother about getting them re-sized at the time, but this time i thought i would since i'm not carrying much extra weight. They were a size J, and they only needed to be made one size bigger, up to a size K - who would have thought that my kids would be imprinted in my ring sizes?!? :-)

Next appt: Tues 30th Sept 10:30am Australian Hearing - Kaelen's hearing aid fitting

ENT - double trouble :-)

Well, no trouble actually - thankfully!!

Tues 9th Sept was the infamous double ENT appointment, both boys to be checked out. Dr checked Jarrah's grommets - all good...hooray!! The left side had some discharge going on at the time of surgery, but it was all cleared up now and looking fine. I reported Jarrah's increased responses as expected, and fortunately Jarrah was much more talkative during today's appointment than he's been during any previous ENT appt's, so Dr got a much more accurate picture of what he's doing...which is good. We have still been referred to the Mater Cochlear Implant team, just waiting to hear from them.

Kaelen was asleep at the appointment time (surprise, surprise! He sleeps anywhere, almost anytime...), so Dr was loathed to wake him to have a look in his ears, but he was due for a feed anyway so i said, "Go ahead! If you don't wake him, i will :-)" Apparently Kaelen has reasonably large ear canals, and nothing appeared to be amiss so far. There's nothing that can really be done surgically at this stage, he's far too little, so it's a matter of wait-and-see, get hearing aids from Aus Hearing (they'll be able to compensate for the conductive loss anyway), and let's check him again in 3-4 months time.

So, nothing major to report really...which in some ways is a good thing! The only disappointment of the day was that our friends who were going to accompany us into town and picnic with us afterwards were unable to make it due to late illness...would have been nice for the kids to have a run together, but nevermind, maybe next time.

Next appt: Wed 17th Sept 8:15am - Kaelen @ Australian Hearing

It's amazing what deaf kids can do...

Jarrah was hearing exceptionally well today. He wore both hearing aids yesterday, but today he seemed to be doing well without them so we got a bit lazy and didn't put them in...and he still said new words that we hadn't heard before, like "hot", and "squirrel", and "weasel". With no hearing aids. And they actually sounded something like the word. Go figure.

The Aus Hearing audiologists were amazed some time ago, when we discussed what sort of toys Jarrah enjoys, that he loves musical instruments. Considering his test results, they were surprised he was getting any benefit from them at all, but he truly loves banging on the piano 

(singing along, of course!), or pretending to play a violin with two pencils (correct hands most of the time), or drumming with two pencils (Mummy's favourite...not!), or whacking his toy glockenspiel. He sings many different songs, often spontaneously, and has recently fallen in love with the stereo - it's often the first thing he turns on in the morning (except when Mummy & Daddy object at 6am!!), and then sits right in front of it and listens intently for a few minutes before finding something else to do.

For his 2nd birthday, we bought him a little ukulele, cos he loves watching me play guitar and always wants a turn. Yesterday I got out my violin (for the first time in quite a while :-s) and so he went and got his uke to play along :-) Today, just before dinner, Daddy and the two boys were playing downstairs and I went down to tell them dinner was ready, just in time to see Jarrah bringing his uke out to where Daddy & Kaelen were. It was clear he wanted to play, so i got him to sit down and he proceeded to serenade Kaelen, strumming most gently and singing away...

Then, he decided it was Kaelen's turn to play the uke...

Very cute, what a considerate boy we have! And all this still without hearing aids!

It's amazing what deaf kids can do...

Kaelen's first speech "lesson"

What do you do with a nearly-9wk-old baby in a speech "lesson"?

Good question, actually. Think of it not so much as a lesson for the baby, but a lesson for Mum. Children with hearing losses often don't naturally tune in to environmental sounds the way hearing kids do, so the first thing they usually need is to be taught to listen. That seems very strange to those of us with normal hearing, we just assume that everyone can listen - as i sit here typing i notice that Kaelen has stopped crying and is hopefully going to sleep, i can hear various birds outside, and the occasional passing truck on the main road, and although none of these sounds are in my immediate listening space i still notice that they're there. Hearing impaired children may not hear those detailed sounds that i hear, and therefore what they do hear becomes just a blur of noise - at least, that's my interpretation. Teaching them to listen involves helping them to acknowledge when they do hear something, encouraging them to notice what they hear, and respond to it in some way.

So today was about making sounds and seeing Kaelen's response when he did hear something. It was interesting actually, very educational for me, it was good to see him respond to sound in that controlled environment because now i know what to look for at home to show that he's heard something - his eyes widen, or he frowns, or smiles, or looks to me for confirmation / assurance. He's definitely hearing things, so we can begin to use the "learning to listen" sounds with various objects to help him tune in to these things - animal sounds, transport sounds (cars, planes, trains, etc.) - and of course i have an expert helper in Jarrah, who i'm sure will be more than happy to make lots of these sounds for Kaelen! :-)

Amazingly, Kaelen was awake for the whole session (which is only short at this stage but will get longer as he gets older), and only started to get tired right at the end. He liked the cow, especially when i wiggled it quickly, that drew some smiles! We actually got little chuckles at home on Sunday which was very cute, so he's clearly trying to communicate, and responding to us.

Yet to hear from Australian Hearing, but i'm sure they'll get to us in the fullness of time...

And so it begins...

Nothing earth-shattering, but just the beginning of the process for Kaelen, making it slightly more real...we were at speech today and of course people were asking how we went with Kaelen's hearing test last Friday, so of course i told them, and we were encouraged to begin the process of enrolling him in the speech centre too. The centre has to make an application to the Dept of Education for funding for a place for Kaelen, but based on his test results they think this won't be a problem, so i signed the permission form today for the centre to make the application. *Sigh*, one step at a time, and each step reminds me that it's real, it's not just a game we've been playing, "let's test the baby's ears", it's serious and needs to be addressed.

Although funding for his place will take a couple of weeks to be approved, Jarrah's teacher is more than happy to begin working with him immediately...which is great, but we'll have to work on the whole staying-awake thing :-) Kaelen tends to have a feed half-way through Jarrah's lesson, and is often extremely sleepy after that feed, doesn't always have any awake-time at all just yet, but hopefully as he gets bigger he will stay awake. Although, i should just apply the universal law of the quickest way to wake a sleeping baby - put them down! :-) Works every time...

And it seems that the boys will both qualify for Health Care cards due to their losses, and i may qualify for a Carers Allowance...not too worried about the allowance, but the card for the boys will be useful...better block out another hour to spend on the phone to Centrelink trying to figure it all out...

I had the dubious honour of making a double-ENT appointment the other day - a follow-up for Jarrah after his grommets, and an initial appointment for Kaelen following the results of his tests. I'm sure our ENT will be thrilled to see all of us...although a kind friend has suggested accompanying us into town with her kids and perhaps having a picnic together afterwards, which sounds like a jolly good idea to me. It'll be nice to do something pleasant in town while we're there, and it'll be very nice to have some company, both for me and the kidlets...you can never quite tell what these ENT appt's are going to turn up, so it'll be nice to have someone to talk to afterwards...

ENT appt's: Tues 9th September 10:15am

Kaelen - confirmation hearing test - now with full results

Fri 22nd Aug was Kaelen's confirmation hearing test. He got 2 Refer results in his newborn hearing screens, so we had his first ABR (Auditory Brainstem Response) in mid-July and this second ABR was to confirm that the results we got were accurate. And it seems they were. Pity, that.

Kaelen has a bilateral hearing loss, which is just a fancy way of saying he has loss in both ears. I've misplaced my copy of the report from his first test and i haven't received a copy of the report from this latest test yet so i'm working a bit from memory here, but from what i can recall his right ear responds to sound at approx. 50-60db, which is a moderate to moderately-severe loss, and his left ear responds at the moment to sound at about 80db, which is a moderately-severe to profound loss. There appears to be some conductive (middle ear) component on the left side which complicates things somewhat, but the right side appears to be only a sensorineural loss (no middle ear component).

The testing on Friday was comprehensive, the audiologist said she got all the tests done that she had planned so we have a pretty good picture of what's going on now. I'll come back and check/complete this detail once i get this latest report, but here's what i remember of the results, and a bit of an explanation of what it all means...

Tests completed on Kaelen included air conduction both sides, bone conduction both sides, frequency-specific air conduction both sides at 1kHz, 2kHz & 4kHz, tympanometry & TEOA emissions testing. Took about 3hrs and he had to be asleep for all of it - lucky he's a sleepy kid!

Air conduction - tests performed by placing a headphone over the ear and delivering sound signals through the complete ear mechanism (outer, middle & inner ear). Can be done using a clicking sound, which covers most hearing frequencies, or using specific frequencies for more accurate mapping of a person's loss.

Bone conduction - tests performed by placing a transmitter on the skull just behind the ear and delivering sound directly to the inner ear, thus bypassing the outer and middle ears and giving a better indication of what the cochlea & nerve can do. For more info on how our ears and brains are connected (it's really interesting if you're into that sort of thing), see this wikipedia article.

Tympanometry - tests giving the volume of the outer ear canal, indicating whether or not the eardrum is intact, and showing whether or not the eardrum is able to move.

TEOAE's (Transient Evoked Otoacoustic Emissions) - testing of the movement of the hairs within the ear. In a person with normal hearing these emissions are present; if these emissions are absent, that indicates abnormal hearing.

Results: (all have a margin of error of +/-10db; Pass = 20db)

Air conduction Right:

Click = 50db

500Hz = 60db

1kHz = 60db

2kHz = 50db

4kHz = 60db

Air conduction Left:

Click =  80db

1kHz = 70db

2kHz =80db

4kHz =90db

Bone conduction Right: 40db

Bone conduction Left: 55db

Tympanometry: showed eardrum movement on both sides, but is known to not always be accurate in babies this small

TEOA emissions: absent

So, what does all this mean? It would appear that Kaelen's loss is stable (unlike Jarrah's which fluctuated significantly in this newborn period, and apparently continues to do so), so that means we can begin the intervention process right away. Mater Audiology will refer us to Australian Hearing for Kaelen to be fitted with hearing aids in the near future, we will need to go to our ENT to see what's going on in the left middle ear and fix it if at all possible, and he will begin the intervention programme along with Jarrah next week. It's kind of a lot to process at once yet at the same time it's all familiar, so i'm not sure that it's really hit me yet...i think it will become real the day i see my little baby wearing hearing aids. That could be a tough day.

In the meantime, here we go again...

Jarrah - grommets & adenoids

Well, as of yesterday, Wed Aug 20th, Jarrah is sporting a new set of grommets and is now adenoid-less. His right grommet had come out and the ear had blocked up again, and our ENT had advised replacing both grommets and removing his adenoids while they had him, so yesterday was the day.

Keith took Jarrah in for the operation this time, and i went to MOPS with Kaelen - not because i didn't want to go with Jarrah, but because we felt it might be tricky with both kidlets, especially as Jarrah tends to be sleepy/groggy/teary after a general anaesthetic, and i didn't relish the idea of juggling 2 small people if Kaelen happened to be unsettled at the time. So this was an experience for Daddy too, cos up til now I've always been the one with Jarrah for any of these procedures. Keith has come to some but never been able to stay and go through the whole event, so it was interesting for him i think to see how it all goes, and interesting for me to see how Keith handles it. Not that it's earth-shattering, or that i'm looking for one of us to be better or worse, but i was just curious about what Keith's reactions might be.

And i think a few things caught him unawares...which is ok, just i think he was a bit surprised at his own reaction. We are allowed to travel with Jarrah into theatre and be with him as he goes to sleep, and then we wait back in the day ward. Keith said he found himself a little choked up, a little teary as J was going under, not something he had expected. They prayed quickly before J was given the gas, partly as a signal to J that he was going to sleep now, but i think also to give Daddy some strength too, to help him know that it'll be ok.

Anyway, all seems to have gone well. ENT put a larger grommet in the right side this time, hopefully to keep it open, and apparently J's adenoids were large - not sure if that means inflamed, but there was perhaps more of them there than there should have been, so it's probably a good thing that they're gone. The unfortunate short-term consequence is that there's some dried blood around, which makes J's nose a bit itchy...it'll pass.

On the hearing front, there was again an immediate difference, as with the first set. J's almost-favourite toy at the moment is a Leap Frog baby Leap Pad, with books and cartridges that you insert and interact with the books by pressing the pictures. Prior to today, he couldn't hear the sounds at all without his hearing aids, even with the volume up full. Trying to do so was tantrum-inducing material, as i think he thought it wasn't working or something. When everyone got home at about 2pm, that was the first thing he went for, and i thought, "Uh-oh, here we go, can we put his aids in?" We let him try, and at default volume it was a bit tricky, but once we turned the volume up full he was fine! Amazing! He could hear it enough to play with it happily without hearing aids! That shows that the new set of grommets and removal of the muck that was in his ear has made a significant, measurable difference - and that's enough for me!

Jarrah - Aus Hearing checkup Fri July 18th

What a busy week! I guess it's welcome to the world of having 2 boys with hearing losses - appointments, appointments & more appointments! Because Jarrah's hearing levels appear to fluctuate, Australian Hearing monitor him every 3 months (instead of every 6 months) just to make sure his hearing aids are set correctly etc., and to keep a finger on what exactly his ears are doing...well, probably more like approximately than exactly!

So the day after Kaelen's hearing test, we have an Aus Hearing checkup for Jarrah. This involves a VROA (puppet test) & the usual volume & tympanometry tests (are the grommets open, and is the ear drum moving?). The audiologist still couldn't see the right grommet, which was the one giving us trouble last time back in April, but there was some movement of the eardrum, although not much so they suspected there may be some fluid building up there again. They managed to complete testing for the left ear before Jarrah got bored with the whole game and his levels in the higher frequencies were pretty much the same as previous tests, but in the lower frequencies they appeared to have deteriorated into the profound range...which was really not the news i wanted to hear, and just so didn't line up with what he appears to hear (granted, with hearing aids) and what he can do in terms of speech. They were very concerned about that and therefore really wanted to test the right ear urgently, so we had make yet another appointment! Fortunately someone had just cancelled a booking for the following Tuesday, so we grabbed that one.

Our speech teacher was astounded when i told her about the results the following Monday. She found it amazing that Jarrah is doing what he's doing speech-wise and making the progress that he's making with such a severe loss. He's a mystery...

Tuesday 22nd July, we re-present at Australian Hearing. First, volume & tympanometry tests, and guess what...that's right, they've changed - in 4 days!! The volume was similar, but now there was NO movement of the eardrum, a clear indication of fluid building up again. The poor audiologists didn't quite know what to make of this, they were astonished at the change in 4 days...welcome to my world. This was no surprise to me, as throughout Jarrah's life i've seen his hearing change from day to day, even within a day - deaf as a post in the morning, sharp as a tack in the afternoon. I mean, i think they knew there was fluctuation, but the rate and amount of change took them quite by surprise. Anyway, the bottom line of that was that they could test the right side but wouldn't get accurate results because of interference from the middle ear, and we needed to go back to our ENT to sort it all out. I can't remember what the levels of the right ear were like, because the results weren't really valid anyway...

Tuesday 29th July - ENT visit. Of course our ENT is always happy to see us :-s He remarked last time that Jarrah has just about the thickest file of all his patients...i don't see that record being taken from him too soon. We discussed Jarrah's progress and middle ear situation, and, after a visual examination, ENT decided that the right grommet was definitely gone - in his words, "there's no way it can be still in there". This was the situation we thought we might face after our last visit, so there wasn't much to discuss in terms of where to from here - more grommets & removal of adenoids (http://en.wikipedia.org/wiki/Adenoids). Simple.

What wasn't so simple was the suggestion again that perhaps we should have a preliminary visit with a cochlear implant specialist...not because Jarrah's in dire need, although his audiograms are pointing in that direction, but more because ENT acknowledged that he's not an implant specialist, and would rather we see someone sooner and get an expert opinion than wait a few years and then have them say "you should have been here years ago!". So although it's a difficult conversation to have, i appreciated that he respected us enough to advise us to get that expert opinion. He therefore asked if he could pass our details on and get them to contact us...and hard as it was, i had no reason to say no. This doesn't mean that Jarrah's definitely getting implants, and even if he'd benefit from them it's up to us in the end to decide whether or not to go ahead.

So, upcoming appointments:

Wed 20th August: insertion of grommets & removal of adenoids for Jarrah

Fri 22nd August: next ABR hearing test for Kaelen

What a week...

Here we go again...

The night after Kaelen's first hearing screen, they repeated it as is standard practice. His result was Refer this time too, which by then didn't surprise me at all, but was still disappointing. This meant more in-depth testing at Mater Audiology, sometime in the following 2 weeks. That was a bit different for us - because Jarrah was born at the Mater hospital we were able to go straight to Audiology the same day as his 2nd screen. Kaelen was not born at the Mater, so had to be referred by the hospital and then Mater were to contact us to arrange an appointment. Consequently, this time we left hospital knowing there was probably a problem but with no idea of the scale, and waiting on the phone to have a chance to find out.

This is the one thing i don't like about the Healthy Hearing programme. It's great that children who need help get picked up really early so that they can get the help they need, etc. etc., but it really puts a downer on having a new baby. You barely get a few days to enjoy them before you get this news, and it really rains on your parade. I know, they've got to do the screening while the babies are still in hospital, cos if they don't do it then it's unlikely to actually get done...but if there was any other way, if there was any option which allowed new mums to enjoy their little ones for just a little longer before getting this news, i'd vote for that. Now, i know that the vast majority of the population don't actually get bad news, so for most people it wouldn't really matter...but it's a burden on parents who do get bad news, no sooner do you have this new life than you've got something to worry about. Great, thanks. Of course, this is not the programme's fault, and truth be told, without Healthy Hearing Jarrah would probably still not be saying anything except "ah", and we'd be wondering why we had such a stubborn, willful, rude child who didn't listen to a single thing we said...but i just wish there was some way i could have enjoyed my babies for a little longer before sadness entered their lives. I guess it was grace that i was given 2 days with Kaelen, where i only had 1 day with Jarrah...

Our Mater Audiology appointment was set up for Thurs 17th July. Fortunately Kaelen is a sleep-anywhere baby, so he settled really well for the test (they need to be asleep for the testing), and even after he woke for a feed in the middle of it, settled again immediately. Unfortunately, the results did not look good as they started coming in. As this was initial testing they were just using a generic 'click' sound, not specific frequencies, but that gives enough information for a start. His right ear returned 60db (about the level of normal conversation) and his left ear returned 80db (significantly louder than normal conversation), although they were fairly sure there was a conductive component to the left ear, so potentially some fluid in the middle ear or something like that. They also did some bone conduction tests, which bypass the middle ear altogether (and therefore any fluid that may be hindering transmission of sound through there) and test what the inner ear (the cochlear & nerves) is actually able to do. The right ear levels were within the margin of error of the standard air conduction tests they did at first, but the left ear levels were significantly better than the air conduction tests, further hinting at a conductive component to the loss.

Audiologists never seem to like to give a final result too quickly. They always want to give the babies more time to grow and drain, or another chance - which is wonderful, but it can string the process out a bit. It seems fairly clear to me from these test results that we're dealing with a loss not unlike Jarrah's, but they want to test again in 4-6wks to confirm these results. I guess we're not losing too much time by waiting another 4wks or so, but this time i won't be letting it string out as long as Jarrah...nor, i think, will they.

Welcome Kaelen Marc!

Welcome to Kaelen Marc Harbottle, born on Tues 1st of July at 11:22am after just 3 hours of labour (that's if you don't count all the contractions in the preceding 3 weeks!), weighing in at 3.315kgs (7 pounds 5 ounces in the old money) and measuring 49cm (sorry, no inches conversion) - our "compact model".

Kaelen was induced a week before his actual due date, mostly because Jarrah had been an average weight baby but had got his shoulders a bit stuck on the way out. This is usually seen in larger babies (4kgs+) so it was decided that, in an attempt to avoid any trouble this time, we should bring this baby on a little early. Things were beginning to move anyway (due to all those lovely contractions!) so my Dr felt it wouldn't be a problem. It was kind of weird, having an appointment to have a baby. Jarrah had begun the process on his own (with my waters breaking) but i needed help in getting regular contractions going, so we really had no idea when he was going to arrive until it all began ("Well, looks like i'm having a baby today!"). This was obviously quite different, and it just felt odd having it in the diary. As a friend of mine said, "9am - hairdresser, 10am - shopping, 11am - Have baby!" very weird.

Anyway, things went nearly according to plan. The labour and birth themselves were trouble-free, which was a blessing, but everything happened so fast that sadly my parents missed the actual birth. We had made arrangements for them to arrive at what we thought would be a reasonable time, and worked in with their schedule for the morning, but unfortunately nobody told Kaelen about their schedule, much less that he had to wait for it! Despite a text message sent by Keith at 5 to 11 saying "COME NOW OR TOO LATE", they were just that - too late. Nevermind, they did arrive (with brother Jarrah in tow) about 30mins after the birth, and we had a lovely time introducing them to their 2nd grandson. I think my Dad is quite enjoying having grandsons - i have only one sister so he never got to raise boys, and i think he's quite enjoying having at least one little boy who just thinks he's the best!

During those first couple of days, we were watching Kaelen like hawks for every sign that he could hear normally. I could have sworn that he woke to my phone alarm once, and re-settled once i turned it off. We were really hopeful that this time we'd have a hearing child, the chance to raise a "normal" child and know what it's like to have a child who can hear you and develops speech "normally", without having to be taught how to listen. For us at the moment, the only normal we know is hearing impairment, although of course when i spend time with friends who have hearing children of the same age as Jarrah, i can see the difference. Sometimes i am envious of them, that they can call their 2-yr-old from the other end of the house and the child responds, that they can say, "Go and get your croc shoes from your wardrobe" and the child goes and returns with the correct shoes. For us, it was an achievement when, only about 6 weeks ago, Jarrah understood the word shoes, let alone where they were or what type of shoes they were. We're still working on the difference between his big black shoes (sneakers) and his slippers. "Language is a miracle", yes that's true, so where's my miracle? I must have missed something on that one...

Kaelen's hearing was tested on the Thursday after his birth. I hadn't seen how they did the hearing screen for Jarrah, so i was glad in some ways that they brought a mobile unit to my room. I'm a curious soul, so i like to see how things are done :-) The nurses were all aware of Jarrah's condition, so they were taking special interest in Kaelen's results, hoping like us for a Pass.

The test took a lot longer than i expected, although the results are available as soon as the test is done. Unfortunately, Kaelen's results was also a Refer, in both ears. Of course, this doesn't mean there's definitely a problem but, given the family history, it wasn't a good sign. He wasn't particularly well settled for the test either, but this kind of test is more a yes/no test than a detailed how-much test.

I was so, so disappointed. I hardly even know what to write next to capture what i felt after that test. I think the biggest thought in my mind at that point was "Why?" Why do other families get 2, 3, 4, 5, 6 healthy kids and i get 2 deaf ones? Wasn't 1 enough? I did ask for a hearing child, God, why is the answer no? Didn't you hear me? Why taunt a musician with deaf children, as if to mock the very gift I was given? This is simply not fair.

And then what about him? Hard as it is to parent a deaf child, what about the difficulties he will face throughout his life? Why give him this burden, such a tiny package with now a huge obstacle to overcome? What is God's purpose for him in all this? Will Kaelen too have to endure being looked at, poked and prodded, scanned, sedated and operated on? So much for such a small person.

Then i have to remember that it's not the end of the world. The screen is not conclusive, there is time for things to improve if it's just congestion, and even if the worst result comes, we've been here before. We have a network of friends and family to help and support us, we have a team of professionals around us to advise and direct us - we can do this. I just really wish we didn't have to.

The journey thus far... - part 8 - nearly there!

It's amazing the things you learn as a parent of a hearing-impaired child...lucky i like to know stuff, otherwise i think i would have got jack of this long ago. Hopefully you've learned a few things from reading this blog too - well, i'm about to subject you to more!

There are these things called Ling sounds. They are a set of 7 sounds that make up the building blocks of all speech. They cover all the frequencies at which English speech sounds are made, things like 's', 'sh', 'm', 'ee', 'or', 'oo' & 'ah'. They were categorised by a guy named David Ling...hence the name, Ling sounds. Cool, huh?

Every week at speech, Jarrah is tested with the Ling sounds, to see if and how well he's detecting each sound, and potentially copying it, making the sound himself. During and for a while after his "episode" he had not been detecting them too well, getting the easy ones, but not even detecting some that, according to his audiograms which i don't believe, were outside his range of hearing. One morning in late May, before testing the Ling sounds at speech, his teacher began to make her cochlear implant noises. She had previously said that he was obviously getting good access to sound with just his hearing aid at this stage, and that we shouldn't need to think about implant until perhaps he gets to school, if the noisy learning environment is too challenging. Because of his sudden lack of progress during the episode, she was now wondering if we shouldn't take him and at least get him assessed to see if he's really a candidate, and think about doing something sooner rather than later.

Well, she picked the wrong time to say that! That morning, Jarrah detected and copied every Ling sound, even ones he had previously not got at all, even the dreaded 'ee' sound!! It just seemed like he had switched on all of a sudden...as if all the set-back he had suffered during the episode suddenly didn't matter, there was progress to be made. What a relief, in some ways, yet at the same time deepening the mystery that is our son and his hearing...

In June, Jarrah turned 2 years old. So much has happened in those 2 years...yes, all the normal developmental stuff, but the journey through hearing loss over these 2 years has been...well...lots of things. Sometimes it's been easy, other times hard, it's been fun and not-fun, educational, depressing, enriching, frustrating, exciting, confusing, surprising, baffling...often all in one day :-) It's made me really question the goodness of God, but it's also brought me closer to a point of accepting that everything happens for a purpose, and that He will bring good out of what is otherwise a bad situation. I can see now that Jarrah will function just fine in a speaking world, even though these early years are going to be a lot of work. Because his hearing appears to fluctuate on a daily basis, i've had to learn (and am still learning) to "read" him each day to assess how much to expect of him, and how strict i can realistically be with him that day. 

Our 2nd baby is due on July 7th, and a few months ago i really wondered how on earth i was going to manage a newborn with a hearing impaired child. Jarrah was so unresponsive and understood so little of what i said to him that i really was very apprehensive about what the immediate future held. Thankfully, as my due date has approached, Jarrah has come ahead in leaps and bounds, to the point where by our last speech lesson for Term 2 in late June i thought, "OK, i think i can manage this!" He actually turns to me when i call his name, he usually comes when i call him, and, using a combination of speech and sign, i can make myself understood a large percentage of the time. Jarrah's own vocabulary, both spoken & signed, is increasing almost daily, which of course makes it much easier for me to know what he needs...and wants :-)

July is going to be busy - baby due around the 7th, then our next Australian Hearing check-up on the 18th, plus a bunch of other things going on. After the Aus Hearing appt we'll need to go back to our ENT to check on the grommets and see if anything needs doing in that department...ho-hum... 

The one thing I would really like is for this next baby to be a hearing child. While i won't be devastated if they do have a hearing loss, i would like not to have to do all this again. Admittedly, we now have a great team of professionals around us, from ENT's to chiro's to audiologists...but it would be nice, almost novel, to have a child to whom i can speak normally, who jumps at loud things, and with whom i can sign for fun, not for survival... Please, Lord, can i have a hearing child?

The journey thus far... - part 7

So, what now?

We decided, and everyone who mattered agreed (ENT, Aus Hearing, Yeerongpilly), that we just had to beat these infections. At the last visit to Australian Hearing the right grommet was not clearly visible, so it was suspected that it may have come out. Each time we go to Aus Hearing to do a VROA, they also measure the volume of the ear, and also something called "tympanometry" - in other words, the amount of movement of the ear drum. The volume tells them if there might be something blocking the ear passage, and also indicates whether or not a grommet that's meant to be there is open or blocked. A larger volume indicates an open grommet, since not only is the outer ear measured but the middle ear too through the grommet; conversely, a smaller volume indicates either the lack of a grommet altogether or a blocked grommet, since only the outer ear volume is measured. The tympanometry indicates whether or not there may be fluid built up behind the ear drum in the case of a missing or blocked grommet. Jarrah's right ear certainly measured small in volume, indicative that the grommet was either missing or blocked, but the Aus Hearing people are audiologists, not ENT specialists, so they couldn't say which.

We returned to our ENT in early May 2008, who on that day saw the right grommet but found it quite blocked. We were given yet another set of Ciproxin drops, and also some super-string antibiotic was administered into the ear at that appointment to try to kick-start the healing process. The Ciproxin drops expire after 14 days, so we had quite a short window within which to effect change. The drops had worked fine in the past, but i wondered if i had returned the hearing aid to the ear too soon...so this time we decided to use the full 14 days, no hearing aids, and perhaps none for sometime after the 14 days, until we were satisfied that the ears were clear. It was also decided that we would return to the ENT after the next Aus Hearing check-up to check on the grommets again; if either of them needed replacing at that point then we would also remove Jarrah's adenoids, simply to rule out another possible cause for the multiple infections.

During this time, since what i called Jarrah's "episode", he had ceased learning new words (or at least slowed considerably), and had stopped using some of the words and concepts that he had more recently learned. He seemed to have taken an enormous step backwards, almost like all the gains we had made through the year at Yeerongpilly had been lost. Things he had seemed to have mastered were now difficult and haphazard - maybe today, maybe not - and it really seemed like there wasn't much getting in...which i guess there wasn't, since he wasn't able to wear his hearing aids and some of the test results were indicating severe to profound losses at some frequencies. Such a discouraging time, i wondered again if he would ever speak normally, if he would ever cope at school, how long it would take until he caught up to his peers. Even his speech teacher at Yeerongpilly began to make vague cochlear implant noises, whereas previously she had said to me that he was nowhere near needing an implant. I also wondered how long it would take us to regain the ground we had seemed to have lost...

Finally, the ears were clear. By late May 2008, we were able to wear hearing aids again! In an effort to avoid further infections, i set up a structured routine for cleaning and wearing the aids: they would be worn in the mornings only, to give the ears plenty of open air time to dry out and stay dry; they would be washed every single night, and as they were put in each morning, both the ear-moulds and the ears would be wiped with a surgical alcohol wipe - anything to try to prevent the nasties getting in! Well, what do you know, something was working - before long we were at 2 weeks infection free...that's a record! Then it became 3 weeks, and then 4 - we dared to hope that we had finally beaten these infections. Still not an ideal situation, with hearing aids only being worn 4-6hrs per day, but better than none at all!! 

At last - a victory! In what seemed to be constantly uphill battle, even a plateau like this was worth celebrating!!

The journey thus far... - part 6

From about this time, late January / early February 2008, Jarrah struggled a lot with ear infections. We went through many, many bottles of Ciproxin HC ear drops, to the point where sometimes the GP wouldn't know what to prescribe, and I'd suggest Ciproxin...must say that didn't inspire a whole lot of confidence. He would usually have symptoms of a cold for about 3 days before we saw evidence of an ear infection, but they almost invariably came, so it became hard to know which came first, the cold or the infection. We continued to attend our early intervention programme, no matter how many hearing aids we were wearing (2, 1 or none), and J seemed to be doing well, making good progress, despite the infections.

We were scheduled to have our next Australian Hearing check-up on about the 2nd of April, but about a week before that, J seemed to suddenly go very deaf. He had an infection at the time, and i didn't really realise what was going on for about 3 days...he was particularly tired one Monday morning at speech, and i just thought he was tired and being a bit hard to get on with (as u do), but over the course of that day and the next 2 days, i could see that not only was he unwell, but he just simply couldn't hear me...at least, not like he had been able to the week before. Because he had infections at the time he couldn't wear any hearing aids, so we had a trying couple of weeks there, trying to herd a deaf nearly-2-yr-old. We were back to having to make physical contact to get his attention, and lots of signing, whereas we had got to the point where we were able to at least get his attention with voice alone, and he was beginning to understand a few things by listening (audition) alone. This seemed like such a set-back, like yesterday he could hear and today he can't, and for no explicable reason.

I phoned Australian Hearing, to see if it was still worth attending the check-up - they would prefer to see him with no infections so they could get accurate levels from the VROA, so we re-scheduled for another 4 weeks time. This was good timing, as it gave us a window in which to do a bunch of things - visit our chiro again for a check-up, visit our ENT to sort the infections, both of which we did. The chiro seemed to think that a small adjustment was necessary, and the ENT prescribed yet more Ciproxin HC (surprise, surprise!) and we tried our hardest to be infection free as soon as possible. We did visit Australian Hearing at the end of April and they were able to perform the required tests, even though the right ear was still not quite right. The results showed the same levels as the January tests, and now the Australian Hearing people began to make faint cochlear implant noises.

We visited our ENT again fairly soon after seeing Aus Hearing (can't remember quite why, maybe for more Ciproxin!!), and he also began to make more serious implant noises, about which i was not pleased. It's always a slightly emotional day when we go to see one of these specialists...there's usually some news i don't want to hear, and i feel so helpless, watching my son's hearing deteriorate before my very eyes. It's like he's fading away, and there's nothing i can do about, let alone detect that it's happening. I wonder if he ever did have full hearing, even for the first few hours of life, and what he heard then, if he remembers any of it. I wonder how much he has really heard in these last months 22-ish months, and if he realises that he's slowly sinking into silence...

That's what breaks my heart...the knowledge that it's possible that Jarrah will eventually become totally & profoundly deaf, and perhaps sooner rather than later. And what will life be like for him along the way? Will he be able to enjoy music, as i do? Will i be able to teach him to play the piano, or the violin, as i so looked forward to doing? Will we ever be able to play music together, as i dreamed of doing as i carried him before he was born? So many dreams seem to now be out of reach, so many things that "normal" children take for granted. I will have to teach him to speak, one word at a time. He probably won't just abosorb language like other children, communication will be hard work for him. He loves music so much though, that i can almost imagine that he'll play music in spite of his lack of hearing...almost like he'll be the opposite to most children, he'll absorb the music through the pores of his skin, yet i'll have to teach him to speak English. These are the sorts of things one doesn't anticipate in becoming a parent for the first time.

The journey thus far... - part 5

I looked up Upper Cervical Chiropractors in the Brisbane area, and had the choice of Burleigh Heads or Sandgate :-s Neither were very good options from where we are, but i decided to go with Sandgate, i think it's actually closer than the Gold Coast. I made an appointment for Jarrah and was very pleased to be able to see someone very quickly - they offered me appointments for the next day! Although we couldn't go the next day, we did, ironically, end up going the following Monday, right at the time we were supposed to go to our first speech lesson at the intervention centre! I thought it was funny...

The chiropractor we saw was lovely, and had a great manner with small children. Jarrah was obviously aware that this was someone new, but was comfortable with him and allowed the doctor to touch him, which was a great start. I had previously taken Jarrah to my osteotherapist, but J would hardly let her get near him so she wasn't able to do much for him. J seemed much happier with this chiro, for some reason, so he went ahead and made the adjustments he felt were necessary. He did warn me that i wouldn't see a difference immediately, that it may take 7 days to see any real change, and that the full effect may not be seen for up to 6 weeks - kind of reassuring that he wasn't promising miracles, almost instilled some sense of confidence that you weren't being strung along; felt realistic, and that the practitioner had a sense of that reality too. J was very good and sat / lay very still for all the adjustments, and then we made a follow-up appointment for the following week, to make sure the adjustments had stayed put.

Well we didn't really see any difference in the first 7 days. Went back for the follow-up, everything was as it should be, hooray, then it was a matter of waiting. The next day, i thought i began to see a difference in J's responses...i developed my 'cot test', as i still felt his hearing fluctuated from day to day. First thing in the morning, when it was time to get J up for the day, i'd go to his door and call his name in my normal speaking voice. Jarrah was usually already awake and usually at the far end of his cot facing away from the door, so he had to  hear me to make any response at all. Some days i had to yell loudly before he responded, yet other days he'd spin around right away - so variable! From about 7 days after that initial chiro adjustment, his response seemed to be quick more often...or was i just imagining it?

The journey thus far... - part 4

So here we are, in January 2008, with hearing aids, and enrolled in Yeerongpilly ECDU for one-on-one speech lessons in 2008...and 14wks pregnant with our 2nd baby. Who would ever have thought that Mr. Holland's Opus would happen in real life - the musician who has a deaf child. Not that Jarrah's completely deaf, but impaired enough that he requires 'amplification', and probably wouldn't develop normal speech without 'intervention'. What's the logic behind a God-fearing musician being given a child who allegedly can't hear? I don't know, but what i do know is this - Jarrah loves music and all things that make it. He astounds the audiologists by loving to sit at the piano, and favouring musical toys over others - toy xylophones and the like. He can't help it, i'm sure it's in his blood and he sees and hears Mummy playing with those things, of course they're fun...just the audiologists can't understand how he gets any benefit from them whatsoever, based on his audiograms (test results). They figure he just can't hear them. We're just praying that our new baby will be a hearing child...

We saw our ENT again just a few days after the repeat VROA test and hearing aid adjustment, and based on the results we took to him, he began to make cochlear implant noises...the 'levels are approaching that deemed suitable for implants'...'maybe you should have a preliminary appointment with an implant specialist'...not exactly what one wants to hear only 2 months after seeing results indicating only a mild-moderate loss! Implants are so permanent, so final - and such poor sound quality. I'd like to avoid that option if we can.

By this time Jarrah also has had his first round of outer ear infections (another reason for the ENT visit), which means lots of smelly discharge from the ear, antibiotic drops required 3 times a day, and no wearing of hearing aids in the affected ear - which of course means communication is impaired, just what you need with a 19-month-old boy. We'd just seem to get one ear cleared up and the other ear would go down, so it was a game swings and round-a-bouts for a while. Our next Australian Hearing check-up wasn't until April, so we figured we had time to sort things out.

Enter Upper Cervical Chiropractic. Earlier in January, my Mum had forwarded me an article about this specialised branch of chiropractic which focussed on the upper 2 or 3 vertebra in the spine, and a small bone which sits between the vertebrae and the skull - the Atlas. For more info, visit www.upcspine.com but the basic idea is that misalignment of this little Atlas bone (about the size of a credit card) can have major repercussions in one's nervous system - including hearing loss. Because we weren't really getting any answers from the standard medico's, I figured it was worth a try, anything was worth a try to restore my son's hearing...

The journey thus far... - part 3

The other excitement for December 2007 was Jarrah's first CT scan. Because there was still a hearing loss apparent after the grommets, our ENT recommended we have a CT scan of Jarrah's temporal bones done (the tiny bones in the middle ear and the cochlear structure), just to make sure they were properly formed, to check for any abnormalities. This was performed under general anaesthetic (GA), yet another unpleasant experience in child sedation, except this time the unpleasant-ness is at the beginning rather than the end. They wake up very confused and feeling a little like they've been on a roller coaster, so it takes them a little while to calm down and they usually fall asleep fairly soon after that. Jarrah had already had a GA for his grommets, so we were confident that there should be no side effects, but this time they had also put a drip in his hand "just in case" they needed it. I'm fairly sure this was the source of the discomfort and panic on his part, as he kept trying to pull it out amidst the screaming, and calmed down considerably once it was removed.

The CT scan revealed "normal morphology", which basically means that everything looks fine. In some ways I had been wishing that there was something unusual, as that would have given us a potential cause for this whole thing, and perhaps an avenue of treatment in the form of corrective surgery later on. "Normal morphology" told us nothing really, and deepened the mystery, and somewhat heightened the frustration.

10 days after receiving our hearing aids from Aus Hearing, we had to go back to double-check the hearing levels that had been observed at our first visit and adjust the hearing aids levels if necessary. More weirdness occurred - it seemed that in the 4 weeks since our first Aus Hearing visit, Jarrah's levels had changed dramatically for the worse. It was decided to repeat the test after New Year, just to prove that the results were accurate before we went turning up the hearing aids as far as the results seemed to indicate they needed to be. It was between these two tests that Jarrah also had his first ear infection, an ominous sign of things to come.

We repeated the VROA at Aus Hearing in early January 2008, and the results were the same as late December 2007, so it would appear that Jarrah's hearing had in fact deteriorated in the month between our first visit to Aus Hearing and the third visit to check on the hearing aids. 

During a VROA test, sounds of various frequencies/pitches (high/low) are played at specific levels (volumes) while the child plays with a toy in front of them. The 'game' is that they turn towards the sound when they hear it and are rewarded with a lit-up dancing toy of some sort (Dorothy the Dinosaur, a police car, Pooh ear, etc.). This way the audiologists can chart how well a child hears at different frequencies, which impacts how well they detect speech sounds. At Jarrah's pre-December 2007 VROA's, he had detected all frequencies at 60-70db, the level of normal to slightly loud conversation. At the late December VROA, he had not responded to the higher frequencies (2kHz & 4kHz) until about 90db with his left ear, which is the level of a severe to profound hearing loss. This was quite a shock, since not long before he had returned results of 50db in both ears at his post-grommet ABR.

Since there were two sets of results the same, it was decided to adjust his left hearing aid to the new level - how it squealed now! I think it probably took me longer to adjust to that than it did for Jarrah to adjust to the new level. He didn't seem disturbed by it or unhappy about it - but then he's such a visual boy that perhaps he just ignored it...

The journey thus far... - part 2

Well, what a difference grommets made! It was clear from that same day that Jarrah could hear better. He lost that slightly confused look that he'd worn for months without us really noticing, only realising when it was gone, and his responses to sound were like nothing we'd seen from him before. Our ENT had apoken to me immediately after the surgery, saying it had gone well and they had removed a large quantity of thick fluid from behind Jarrah's eardrums, and that he was hopeful that this would have good effect on Jarrah's hearing. Well, he was right about one thing, the improvement was marked!

We had yet another ABR test scheduled for about 3 weeks after the grommet surgery, to give the ears time to fully dry out and any remaining fluid to drain away, so in late October 2007 we had our 3rd and most awful to-date experience of sedating young children. The medication they use apparently has a really awful after-taste, and this time Jarrah was much older than the first time, so he was able to fight the sedative effect longer and react more purposefully to the taste - in the form of clawing at his mouth to the point of drawing blood, and screaming blue-murder for what felt like at least 10 minutes. Sadly, the hospital was quite busy that day, so this happened in full view of all the other children waiting for their various procedures, which i'm sure didn't instill confidence in many of the parents waiting with them. I had to forcibly restrain Jarrah to prevent him from injuring himself, and i'm not sure who was more psychologically scarred by the event, him or me.

Once the sedative had taken effect we were able to begin testing. The results were drastically improved from what the VROA had suggested, but still in the ball-park of previous tests. He was able to hear down to 50db in both ears, which is still a moderate hearing loss but nothing a set of hearing aids couldn't help, so we were referred to Australian Hearing for "amplification". Gotta love the words they use for these things. I guess you've got to call it something sensible...

Our first visit to Australian Hearing took place in November 2007, at which they performed yet another VROA (puppet test) to confirm the results the ABR had shown. Aus Hearing were satisfied that these results were accurate, so a pair of hearing aids was planned. They had to take moulds of the inside of Jarrah's ears, which was another experience in itself! He was used to people looking in his ears and putting all sorts of things in his ears, but this stuff was cold and gooey, and another exercise in toddler restraint was had...poor kid, i'm sure he had no idea what was going on and why this was happening to him.

In early December 2007 we made our 2nd visit to Aus Hearing to collect our hearing aids. We were warned that some children take a while to get used to wearing them, that we should begin perhaps with just a few hours in the day and gradually increase the time, and that some children object to them altogether. Well, Jarrah was certainly not one of those children. The audiologists helped us fit them, and the look on Jarrah's face was priceless - a look of amazement, and a suddenly noticeable increase in response to sounds, yet again. He wore them all the way home, and all the way until bath-time without touching them once, and continued to do so for quite some time.

The journey thus far... - part 1

Our journey began on Tuesday 13th June 2006, with the birth of Jarrah. The day after he was born, he was taken off for a hearing screen, part of the Healthy Hearing programme now in all Qld hospitals. Babies have their hearing tested down to 35db (very soft), and the result is either a Pass or a Refer. Pass of course means they reached the 35db threshold, while Refer means they did not. A Refer result does not automatically mean they have a hearing loss, but it means they need to be tested again later, in case they are still congested from the birth.

Jarrah's test result was Refer. The midwives do everything they can to assure you that this doesn't mean there's definitely a problem, so we weren't too worried at first. He was tested again when he was 3 days old, and again the test result was Refer. We were then sent to the Audiology dept for more in-depth testing (an ABR = Auditory Brainstem Response), which revealed that at that point he could hear down to 40db in his left ear and down to 60db in his right ear. Again, because they are so tiny at 3 days old, a final decision is not always able to be made at that time, so we went back again 4 weeks later to repeat the test.

In July 2006, at the 4-wk-old test, Jarrah's ABR results were better, 30db in the left ear and 40db in the right ear, so we were hopeful that this whole thing was just congestion and fluid from being small and having just been born, so we setup another appointment for 6 weeks later (age 10 weeks) to repeat the test again and hopefully by then get a clear and passing result. Unfortunately, the results of this ABR in August 2006 were in fact worse than the July 2006 results, suggesting that there was something slightly odd going on. It was decided that we should consult Jarrah's paediatrician when we next saw him (age 4 months) and take his advice on how to proceed.

In October 2006 we saw Jarrah's paediatrician, who was happy with his development on the whole, with the only question mark being over his hearing. It was decided that we should give him some more time to grow, and re-test early in 2007. By February 2007, Audiology thought Jarrah might be old enough for a different type of test, a VROA (Visual Reinforcement Orientation Audiogram??), which involves the child responding to puppets and lights rather than being asleep, so that was attempted in late February but was not successful, with the Audiologists at the time deciding that he wasn't quite ready. Another ABR was scheduled for early March, and we had our first taste of the unpleasant-ness that comes with sedating children.

Through this whole process, I had noticed at home that Jarrah was a highly visual child, and seemed able to focus for quite long periods of time on visual things, like books. He also seemed to respond to sounds sometimes, but also seemed quite capable of ignoring them if he was busy looking at something. I wondered if this had something to do with his poor performance in that first VROA, but, not being an audiologist or expert in child development, had no evidence to support my theory. I still wonder that to this day, i guess only time will tell.

The ABR in early March 2007 gave the clearest results of any test so far, and i really felt like we were getting somewhere. They weren't great results, but we were beginning to get a feeling for what was really happening. At this test, Jarrah returned 50db in both ears, considered a moderate loss, which is the level of soft conversation...not perfect, but not as bad as it could have been. It was unclear as to whether this loss was all sensorineural (in the inner ear, or cochlear, and therefore a permanent loss) or a mixture of sensorineural and conductive (in the middle ear, and therefore a temporary loss, and treatable). It was decided that we should consult an ENT specialist (Ear, Nose & Throat), and then Jarrah's paediatrician to discuss the findings of the ENT and decide on a course of action.

Unfortunately the ENT we saw at this time, April 2007, was rather unhelpful. He did actually look in Jarrah's ears, but didn't give us a whole lot of information at the time, other than (paraphrased): "His ears look fine, he's got a hearing loss, deal with it." Our paediatrician decided to adopt this laid-back approach and suggested we wait another few months before re-testing. Another VROA was attempted in September 2007, but when Jarrah didn't respond at all to sounds as loud as 85db (they were hurting my ears, and he was sitting closer!), the audiologists became quite alarmed. They suspected a large middle-ear role in the problem at this point, and again recommended we see an ENT specialist.

After our previous experience i wasn't particularly keen to re-visit the ENT, so i talked to friends and got some recommendations for a new ENT specialist. We happened upon an ENT who has been exceptionally helpful and decisive, and obviously knows what he's on about. Fortunately he was not terribly busy at the time we first contacted him, so we were able to get an appointment the next day (!), about which i was very pleased. He took one look in Jarrah's ears and immediately diagnosed Glue Ear in both ears, which is a condition where fluid builds up in the middle ear (behind the ear drum) and goes sticky and gluey, preventing the ear drum from moving and sound from getting through, hence the term Glue Ear. Treatment for Glue Ear is the insertion of grommets (and removal of fluid present at the time), which we were able to do the following week. Yet another experience of the unpleasant-ness of sedating young children...