Osteopathy for Jonica - here's a new one!

Fri 19th Nov - Today Jonica had her first Osteopathy appointment. Osteopathy involves treatment of the musculoskeletal system (bones, muscles & joints) to optimize body function. I've been seeing an Osteo for years to treat/manage back & neck pain (a vocational hazard), and i like to have my kids checked after they're born since being born is a bit unkind to one's back and neck. By the time Jarrah was about 6wks old we noticed he was quite crescent-shaped, so i took him along to my Osteo...and she straightened him out! :-) Kaelen was a little bent but not much; had him checked anyway and he's been fine.

Jonica was quite obviously crescent-shaped by about 3wks old. I had of course planned to have her checked but hadn't got it yet; this observation pushed me along a bit. I like to have a check-over myself, too, after giving birth - being pregnant does weird things to your body and sometimes I need a bit of help getting back to the right shape again, along with the new stresses of carrying a baby on the outside, and the effects of breastfeeding. MissJ had also been a bit unsettled at times and i had wondered if she might be in some discomfort.

So we went to see my trusty Osteo...who had been off work herself for about 3-4 months with a badly broken leg! It was nice to see her again, and nice to be able to introduce our new addition to her. She treated MissJ first, and my mother and I sat there and watched her straighten out...it was quite amazing! The change was very noticeable during the treatment! Apparently MissJ was quite tight and restricted on her left side; Osteo was able to achieve some good changes but wants to see her again in a few weeks.

Although MissJ was quite unsettled after the treatment (due to tiredness & hunger, the treatment of babies is *very* gentle), I'm pleased we went. She slept well the rest of the day and the next day, so perhaps it's really helping?

And an amazing thing is happening...we have a week next week without an appointment! Oh, except that MissJ needs her 2month immunizations...

Next appt: Tues 30th Nov - Jonica, Aus Hearing follow-up

Two appointments in one day - such a busy baby!

Mon 15th Nov - Paediatrician's 6wk check & Aus Hearing fitting appointment

Well, today's the day i've been waiting

for, the day my little girl becomes "complete", so to speak...the day she begins to hear the world as you and i hear it, and i'm excited! Might seem an odd thing to be excited about, but i've really felt like we've been in a holding pattern until now, knowing that she's not really been able to fully participate in her world because part of it's missing, and i've just been looking forward to her having full access to *all* her senses so that we can connect more fully with her, and she with us. I feel like we're in the "Ready, set..." stage, and that today is "...Go!!"

The little moulds that were made 2wks ago were ready and not yet too small, so the hearing aids were setup, fitted and tested...and didn't seem to bother her too much at all! :-) My Dad came to the appointment with us and took her first photo...

So, here we go...the world is now our oyster, let's see where she ends up!

Next appt: Fri 19th Nov - osteo check-up

ENT - Jonica & Jarrah

Fri 12th Nov - ENT for Jonica & Jarrah

Although this appointment was initially for Jonica, Jarrah actually took most of the time :-) ENT looked in Jonica's ears, was satisfied that she was fine to receive hearing aids & wrote a letter to that effect. Easy, done.

Jarrah, however, is always a puzzle :-) We really don't know why his ears keep blocking up, but the reason is really less important than the solution. In consultation with our ENT, we've decided to have J's grommets replaced - a new grommet placed in the right ear and the left grommet renewed - with the aim of giving him the best possible access to sound as soon as possible. He just seems to be susceptible to upper respiratory problems, so we have to do our best to keep him as well as possible. New grommets will go in on Wed 8th December, just in time for summer...

Given that we were all in the city for this appointment, that Daddy works in the city these days, and that our ENT was running distinctly late, we decided to visit Daddy and have lunch together. Daddy works near the Botanic Gardens so we went and got sushi, found a nice park bench to eat on, then the boys had a play on a playground. It was nice to have an impromptu picnic lunch together, then it was nice to get everybody home and have a good sleep :-)

Next appt: Mon 15th Nov - Jonica's 6wk check-up with Paediatrician, & hearing aid fitting @ Aus Hearing

Aus Hearing check-up - Jarrah

Wed 10th Nov - Jarrah's Aus Hearing check-up

I was pretty unwell on this day, so my parents kindly stepped in to take Jarrah to this appointment. Apparently he did well, he's now old enough to do Play Audiometry testing, which is where he performs some action when he hears a sound - in this case, drop a marble into a marble race.

J still has a grommet in his left ear, and the results on that side were consistent with previous testing. The grommet came out of his right ear about 12 months ago and there was some concern back in August that his middle ear might be blocking up again. We saw our ENT in August who suggested that if his right ear was still blocked at this November test, we should return.

*Sigh*, time to call the ENT again.

Turns out J's right ear is still blocked, his eardrum isn't moving at all which indicates fluid build-up behind the eardrum, which translates into a conductive loss compounding the underlying loss. This means that even with his hearing aid he's still not hearing at optimal levels.

Fortunately, our next appointment on the calendar is...with our ENT! Jonica needs to get medical clearance from an ENT to receive her hearing aids, so as soon as Jarrah got home i rang the ENT and was able to get Jarrah in with her appointment. Let's see what happens...

Next appt: Fri 12th Nov - ENT for Jonica (& now Jarrah!)

Jonica - initial Aus Hearing appt

Fri 29th Oct - after an interesting week including antibiotics (for the threatening middle ear condition uncovered last week) and 2 brothers away on a holiday with Nana & Grandad for 3 days, we arrived at Friday. Grandad came to stay with Kaelen, & Nana joined us at Australian Hearing for Jonica's initial consultation. This is a fairly simple event; no testing this time, mostly information, and not much of it new to us :-)

What was new, however, was the type of hearing aid Jonica will be getting. Hearing technology companies are bringing out new models all the time (every 12-18 months!), so although Jarrah & Kaelen initially received the same units, Jonica will receive a different unit to the one Kaelen has. (Jarrah's have been updated as part of the LOCHI study, for which we are very grateful, but Kaelen's are still the original issue.)

Jonica's will be the Nios Micro, made by Phonak. The behind-the-ear unit is about 1/3 smaller than Kaelen's, so hopefully they won't flop off her ears too much, and have nearly all the groovy new features that Jarrah's have, which is great news. We decided to get pink units, thought that was appropriate, and she had impressions of her ears taken at this appointment as well. Such a superstar, she slept through the entire impression-taking process, which involves inserting a small piece of cotton & string down the ear canal, then squirting a cool green paste into the canal and filling the ear right to the edge of the outer ear. Some babies *hate* this and scream at you...nope, not Jonica, she just slept :-)

So, in approximately 2 weeks we'll receive our 3rd set of hearing aids. Jonica will be 6wks and 3days old and should have great access to sound from then. In a funny sort of way I'm a bit impatient for this next appointment...i just can't wait for her to be able to hear everything we say to her! What was sadness in Kaelen's case is nearly excitement in Jonica's case...I'm really looking forward to her having more full access to sound and being able to make more sense of the world around her. She's begun to smile at us in the last week (at not yet 4wks old!), which is of course the cutest thing you ever saw, so it'll just be so good when she can understand us more fully.

Bring on the 15th of November!

Next appt: Wed 10th Nov - Jarrah, Aus Hearing check-up

Jonica - Audiology 2 with complete Bone Conduction results

Thurs 21st October - today we revisited Mater Audiology to attempt to complete Jonica's hearing profile; while we got lots of testing done at the last appt, we didn't get a full set of results so today the plan was to fill in the gaps. Unfortunately, in the few days leading up to today, Jonica has developed a very snuffly nose and initial readings indicate that her middle ears are not completely clear, which affects her hearing.

Our audiologist began by repeating some of last time's tests, just to confirm that things hadn't changed - always a good thing to do considering Jarrah's history! These results were mildly worse than last time so we decided to check her tympanometry (movement of the eardrum) which would give us an idea of the state of her middle ears. One side had eardrum movement but negative pressure, indicating a blocked Eustachian tube (drains the middle ear down the back of the throat), and the other side had no eardrum movement. Great. No real point continuing with air conduction testing, then...

We decided we could fill in the Bone Conduction results, since bone conduction bypasses the middle ear. Again, we checked last time's results first and they matched, so that was also good news! More good news is that technology has improved since we were here with Kaelen and they are now able to do bone conduction testing at different frequencies, previously unavailable - here are Jonica's bone conduction results:

(All have a margin of error of +/-10dB)

Bone conduction Right:

500Hz = 40dB

1kHz = 30dB

2kHz = 50dB or worse

4kHz = 50dB or worse

Bone conduction Left:

500Hz = 40dB

1kHz = 30dB

2kHz = 50dB or worse

4kHz = 50dB or worse

Tympanometry: showed middle ear dysfunction on both sides today

TEOAE: emissions absent (see entry from Kaelen's confirmation hearing test 2008 for explanation)

So, some good news here - Jonica's hearing loss appears to be mild in the low frequencies, sloping down to moderate or worse in the high frequencies. Bone conduction only tests up to 50dB, hence the "or worse" clause - her true functioning levels will be indicated when we can finish the air conduction tests after her little ears clear. But, we can say "mild"! This is cause for celebration in our house, as both Jarrah & Kaelen's losses begin at "moderate" and get worse, so for Jonica's to begin at mild is great, it means she can actually hear quite a bit of what's going on in our house, quite a lot of what i say to her at close range, it means we are definitely out of implant territory, and that in general her hearing loss is not as severe as her brothers'.

*Sigh*, it's nice to get some good news! Another test will be scheduled in 2-4weeks' time to complete the air conduction results, and we hope by then her middle ears have cleared completely.

Next appt: Friday 29th October, Jonica's initial Australian Hearing consultation

Jonica - Audiology 1

Wednesday 13th October 2010 - today was Jonica's first audiology appointment, having been referred following the hearing screens in hospital after she was born. Mum came with me which was nice, and took some photos...i'll see if i can post some so you can see what goes on during these tests.

Jonica was a good girl and slept beautifully for the entire test, so we got lots of good information. We still have to go back to complete the testing, but we got a really good idea of what we're dealing with.

I went into today preparing for the worst. We knew that we had to go into a third pregnancy prepared to have another hearing impaired baby, worst-case a profoundly deaf child, and both Keith & I had noticed that Jonica really didn't respond or startle to much. I think we had each coughed or sneezed while holding her and she hadn't jumped at all, so I was beginning to wonder if she had much hearing at all. I was doing alright until about half-way along the bus trip into town - then the anxiety of the unknown began to set in. What if she was profoundly deaf and needed cochlear implants? How much was she really hearing now, if anything? Suddenly those possibilities stared me straight in the face, and i'm thankful for the prayers of my friends for strength in that time.

Our audiologist turned out to be the same one who diagnosed Jarrah's loss 3 years ago! It was nice to see her again, although not under ideal circumstances...Jonica was already sound asleep so we got straight into testing. We completed click tests (air conduction, via a little headphone) on both sides, bone conduction on both sides (which bypasses the middle ear structures and passes sound straight to the cochlear via the skull), began some Tone Burst testing on the left side (testing different frequencies, high & mid & low sounds) and tympanometry (movement of the eardrum & middle ear pressure). These results form part of the picture, the rest will be completed at a future appointment.

It appears that Jonica has a mild-moderate loss bilaterally (both ears), which is *way* better than i was expecting. I'll post her complete results once we have them, but initial indications seem to be a sloping mild-moderate loss, between 40-60db. This is actually not quite as severe as Jarrah & Kaelen, and in my mind a cause for celebration! It seems she has quite a lot of residual hearing so she *should* actually be hearing quite a bit of what's going on. Such a sense of relief in not having to consider surgery for implants; it actually put a smile on my face to know that it seems her road will hopefully not be as hard as her brothers'... The tympanometry test showed good movement of her eardrums & no apparent blockages either in her middle ear or Eustachian tube, so these seems to be fairly reliable results.

After 1.5hrs of clicks and sitting extremely still, we were done for the day. Results will be finalised at the next appointment, although given the bone conduction results gained today we will be referred to Australian Hearing immediately. And we'll need to go see our trusty ENT again as he needs to give the OK for Jonica to be fitted with hearing aids. We signed forms at Yeerongpilly yesterday to begin Jonica's enrolment in the early intervention programme as we didn't expect today's results to contradict the newborn screens - she'll begin her sessions in 2011.

Here we go again...another bunch of extra appointments, but hopefully nothing we haven't done before...

Next appt: Thurs 21st Oct, Jonica's Audiology follow-up