Totally Tubular or Not

So we just got back from the Ear, Nose and Throat doc and it looks as is our lil guy will be getting tubes in his ears. We cannot help but to have some trepidation about this decision, but feel it is in his best interest to get done. From all the research we have done and from what the doc says, it is a routine operation and takes minutes to do.

From folks that Mama T has talked to, they all swear by it and say that it helped their child with their hearing, speech development and reduction in ear infections. The only negative I have heard is from my mom whose neighbor experienced deafness in one of her ears as a result of getting tubes. We discussed all of this with the doctor too.

He said our lil guy is a prime candidate for tubes because of the amount of fluid he still has in his ears even after getting a shot last week and still on antibiotics... his fourth different variety I might add. The doc did tell us that he would never advise putting ear numbing drops in children's ears... which we found very interesting because we have been given three prescriptions for them by our pediatrician. He just said personally that he would rather us give him Motrin or Tylenol to ease the pain.

He did say that our pediatrician did do the right thing in continually prescribing antibiotics, because that is the protocol for recurrent ear infections and sooner or later we would have ended up in his office. Mama T and I went into our lil guys last doc appointment knowing we were going to seek the name of a good Ear, Nose and Throat doctor.

So this lead me to do some research as to the rise of ear infections in our children today. What I found out was very interesting...

So why the increase in ear infections?

According to the University of Maryland Medical Center, "The rise in ear infections has paralleled the increasing incidences of other upper and lower airway disorders such as Asthma, Allergies, and Sinusitis. For example, the same bacteria are often responsible for both ear infections and sinusitis. In one study, 38% of children with ear infections also had sinusitis, and other studies have reported that nearly half of children with Otitis Media have concurrent sinusitis. Data indicates that nearly a third of infants and toddlers with upper respiratory infections go on to develop acute Otitis Media. Researchers are looking for common risk factors, such as:

• Increase in Day Care Center Attendance. Although ear infections themselves are not contagious, the respiratory infections that precipitate them can pose a risk for children with close and frequent exposure to other children. Some experts believe that the increase in ear and other infections may be due to the higher attendance of very small children, including infants, in day care centers beginning in the 1970s. Research presented at a 2006 pediatric medicine meeting suggested that it may be wise to keep very young children (under 1 year old) out of day care to avoid exposure to the upper respiratory infections that can lead to ear infections.
• Increase in Allergies. Some experts believe that an increase in allergies is also partially responsible for the higher number of ear infections, which is unlikely to be related to day care attendance. Studies indicate that 40 - 50% of children over 3 years old who have chronic Otitis Media also have allergic rhinitis (hay fever). Allergies can cause inflammation in the airways, which may contribute to ear infections. Allergies are also associated with asthma and sinusitis. However, a causal relationship between allergies and ear infections has not been definitively established." Nor has it been determined if poor indoor air quality is linked to the increase in allergies.
• Breast-feeding, "rather than formula-feeding, is one important preventive measure. Studies show that breast-feeding for at least four months cuts the number of ear infections in half."

According to Dr. Mary Ann Block of the Block Institute, other risk factors that are currently being studied are:

• Smoking and air quality. "Smoking is another factor that raises the risk of ear infections. Tobacco smoke can irritate the mucous membranes in the nasal passages, causing them to swell. This increases the likelihood of fluid getting trapped in the middle ear. Even fragrances, cologne, and air fresheners can irritate the mucous membranes.
• Genetic Factors. Children who have had previous ear infections are at greater risk as well as children with a family history of ear infections. Children born prematurely or with a low birth weight also are at greater risk. And, interestingly enough, if your child is male there is a higher risk of ear infections (boys tend to get more ear infections than girls) or if your child has a nasal speech (caused by large adenoids that block the Eustachian tube) they are also at risk.
• Nighttime Bottle. Taking a bottle to bed at nights.
• Pacifiers. Pacifiers can also increase the incidence of ear infections. It is not understood whether this is because pacifiers are not properly cleaned, or because the sucking motion causes bacteria to flow upward into the Eustachian tube."
• Food Allergies. Doctors have suggested that up to 1/3 of all cases of ear infections are due to dairy or milk allergies. Other foods may be suspect, but the connection between dairy and ear infections is one of the first places to start a food elimination program.

Read more: http://www.healthy-holistic-living.com/ear-tubes.html#ixzz0ebVtPg

It is interesting because our son has been in daycare since he was three months old and he sleeps with 3 sometimes 4 pacifiers. He doesn't constantly have the pacifiers in his mouth while he sleeps though which is a good thing I guess.

So the next thing I was curious about was the pros and cons of the tubes... well this same site has a good list of those too.

The pros and cons of tympanosotomy ear tubes:

Often times when a child experiences chronic ear infections or chronic fluid in the ear, he or she will be referred to the Otolaryngologist to place tympanosotomy tubes in the ear, a surgical procedure. Usually, doctors will recommend the surgery if the child has 3 episodes (ear infections) within 6 months or 4 episodes in 12 months. This is especially true if the antibiotic treatments are tried and have failed to resolve the issue. The reasoning here is that the child's recurring ear infections are due to fluid in the middle ear canal. This fluid is unable to drain down the Eustachian tube. If the fluid could drain, the bacteria would not be able to grow and cause an infection.

The issue at hand remains: to tube or not to tube…..let's identify the possible benefits and then review the possible risks or side effects.

According to Dr. Judith E. C. Lieu of St. Louis Children's Hospital, studies have shown that tympanosotomy ear tubes can improve the quality of life for children (and families) in the following ways:

• "Reduce the frequency (number in one year) of ear infections
• Reduce the severity of symptoms (ear pain, fussiness, poor sleep, hearing loss, etc) associated with ear infections
• Improve or cure the hearing loss that comes from chronic fluid in the middle ear
• Reduce caregiver anxiety about children who are often sick with ear infections
• Reduce how much antibiotic a child receives for ear infections"

Dr. Lieu states that, "although tympanosotomy ear tubes can be a wonderful help to managing ear infections and hearing loss associated with fluid in the middle ear, they do not cure ear infections and hearing loss entirely. And they can result in some complications.

• Even with tubes, children have an average of 1 to 2 ear infections per year. When ear infections occur, care givers may see drainage from the ears, which can look like the drainage from the nose when someone has the common cold or sinus infection.
• Water exposure in the ears with tympanosotomy tubes can sometimes cause ear infections, particularly when the water is dirty or contaminated (such as with bath water or lake/river/ocean water). Some type of ear plug is usually recommended when you expect a child with tubes will be exposed to dirty water.
• Persistent holes in the eardrum may exist even after the tympanosotomy ear tubes have come out on their own, sometimes requiring more surgery to repair the eardrum.
• Minor degrees of ear drum scarring happen in almost one-third of children with tympanosotomy tubes. This usually does not result in any change in the way the eardrum functions."

The key seems to find out what is most likely to be the cause of your child's ear infection and to treat the problem before tympanosotomy ear tubes become necessary. At the first sign of an ear infection, or if your child has had chronic problems in the past, it is worth considering the risk factors above and eliminating as many of the possible offenders. Especially food allergies, with over 1/3 of all ear infections being the result of a dairy allergy, it is worth investigating.

Your best defense is to be as informed as possible. Getting to know what causes ear infections, understanding your child's type of ear and knowing the risks involved in surgery will help you make the best and most informed decision for your child.

Read more: http://www.healthy-holistic-living.com/ear-tubes.html#ixzz0ebaJXmdK

The pros and cons are interesting too and make me want to pay closer attention to the foods he is eating including his milk intake. He was not properly weaned off of formula when we moved him to his new daycare months ago so now I am thinking it could possibly be some sort of milk allergy. I will have to look into this closer.

We will keep you posted on the surgery and how it goes and please know I am not abdicating the surgery one way or the other, but it is the choice we are making for our son. Our suggestion is to do as much research as possible and make the best educated decision you can.

I will add that the thing that made me feel even more secure in our decision is that the doc said he will monitor him very closely and will be available at any time to see us and answer questions.

Update on Tuesday, March 9, 2010 at 9:20PM by Mama K and Mama T

Okay - so our little guy made it through the surgery with no complications that we know of. The only scary thing that we had happen was that several days after the surgery he became ill with an upper respiratory infection that led him to have fevers for days with the highest one spiking at 105. So scary... to make matters worse his ears were still draining after all of this and we repeatedly called the doctors and no one wanted to see him. They told us to just wait the illness out. So that is what we did.

Last week we took him back to the ear doctor for a follow-up visit and they were unable to do the hearing test because of all the fluid and drainage that was still occurring. Since they couldn't do the test they put us in a room to wait for the doctor. While we waited another nurse came in and asked us how long the drainage had been going on... we told her since the surgery and she told us that was not normal. Our response to that was that we repeatedly had called doctors only to be brushed aside. We were told that they would contact the doctor if they had to do so or that it was a result of his upper respiratory infection and it would work itself out. She asked us who we talked to and we couldn't remember her name but when we told her what was said to us she knew exactly who it was based on the repeated conversation.

The doctor then came in and asked us why this was the first he was hearing of the excessive drainage... we looked at him like he was crazy and told him we made repeated attempts to contact him and he obviously never got the messages. He informed us that he had ear infections in both ears again with the tubes in and gave us some different drops to use in his ears. It cleared up the drainage in two to three days tops. Great news!!!

So here are some things we have noticed since the ear tube placement surgery...

1. He sleeps so much better through the night consistently
2. He immediately started making noises we had never heard him make before (pushes his toy cars around and makes the motor sound) So cute!!!
3. He seems so much happier at home and at school
4. We found out the other day he says a bunch of words at school and is doing extremely well with his sign language... of course he does none of that at home :-)
5. His appetite has increased again
6. Has been nice to do things with him like taking him places... it seems like he has been sick for so long it is nice to be able to go outside and enjoy the weather as it begins to get warmer.

So now only time will tell if the ear infections have cleared up for now. I will post more once he goes back for his hearing test.

Counting Sheep Jumping over the Moon

So recently when we were visiting friends and told them we had to leave because our lil guy's bedtime was approaching fast... they looked at me like I was crazy. They said, "He has a bedtime schedule?" I said without hesitation, "Of course he does, is that surprising to you?" She looked at me and said, "Yes, actually, because so many parents today don't have their children on a schedule."

I was very surprised by this because I could not imagine not having him on a schedule, not only for his sake but for our sanity. I feel bad enough that he has to wake up at 6 a.m. and be at school by 6:30 a.m. so I can get to work early enough to be able to spend time with him in the evenings.

Children need to have a schedule and certainly they need enough sleep. People wonder why children are so unruly these days. Well it is because they are allowed to decide for themselves what they want to eat, where and when to go to bed. Society doesn't allow them to be children... they want to give them independence... that back in the day you had to earn.

Sleep and Toddlers (1-3 years)

Toddlers need about 12-14 hours of sleep in a 24-hour period. When they reach about 18 months of age their naptimes will decrease to once a day lasting about one to three hours. Naps should not occur too close to bedtime as they may delay sleep at night.

Many toddlers experience sleep problems including resisting going to bed and nighttime awakenings. Nighttime fears and nightmares are also common.

Many factors can lead to sleep problems. Toddlers' drive for independence and an increase in their motor, cognitive and social abilities can interfere with sleep. In addition, their ability to get out of bed, separation anxiety, the need for autonomy and the development of the child's imagination can lead to sleep problems. Daytime sleepiness and behavior problems may signal poor sleep or a sleep problem.

Sleep Tips For Toddlers:

• Maintain a daily sleep schedule and consistent bedtime routine.
• Make the bedroom environment the same every night and throughout the night.
• Set limits that are consistent, communicated and enforced.
• Encourage use of a security object such as a blanket or stuffed animal.

http://www.sleepforkids.org/html/habits.html

Our son's security object is his pacifier - a.k.a Chewchies! He sleeps with at least three if not more than that. One in each hand and one in his mouth. Too cute and now on to our next dilemma of how to break him from his pacifier.

Modern Family Let the Baby Cry it Out

So if you have not seen this show... you are missing out! Tonight's episode is so great... it touches on whether you should let your baby cry it out at bedtime or go in and comfort her when she cries. It is the funniest show I have seen in a very long time. So anyway... the gay couple in the show have an adopted daughter and one of the father's wants to try "ferberizing" which I have never even heard of, but basically it is the "let the child cry it out method so they learn how to cope". The other father cannot stand to hear her cry for so long and will go in and get her and bring her out to watch the movie "Scarface" of all things.

Now I have to admit that we may have done this once or twice and there have been more occasions than I can count that he has spent the night in our bed, but there were never times that I had to wrestle Mama T to the ground to prevent her from going into his bedroom and comforting him by picking him up out of the crib. Ha ha ha

There were times though that we were afraid he would never sleep in his own bed in his own room. But why would he when he had the sweet set up where he could take up 3/4s of the bed and leaving the other 1/4 for Mama T and I to fight over. I mean we did keep him in our room in a pack n play for at least ten months, but that is besides the point. :-)

It was not an easy decision to move him, but he seemed uncomfortable in the pack n play and too comfortable in our bed so we made the move for him for his benefit. I didn't like the fact that he was so far away from us, but I knew that he needed his space and that space was in his own bed in his own room.

Now the only time he sleeps with us is when he is sick or is just having a rough night, which is not that often. It normally happens when he is running a fever or is teething really badly. Once he finally did move, it was a fairly easy transition and there was not much crying that we had to listen to in the monitor. We just made sure he had numerous choochies and a consistent schedule that we made sure to stick to.

Our lil guy is growing up... too fast!

Thought Two on December 23, 2009 - Always be an Advocate

So my second thought for the day was along the lines of parents thinking they don't have a say in their child's care or vaccination schedule. This is simply not true!!! We have learned very quickly that we have had to become an advocate for our son and do it very quickly on a number of occasions and he just turned one.

So recently we took him in for his 12 month vaccinations and I had done some research on the vaccines and their side effects and went to the appointment knowing that I didn't want him to have his MMR vaccination at this appointment. I wanted to wait until he was closer to 15 months old. The funny thing is I had called ahead and spoke with a nurse about it and she told me that was fine and that I would have to sign a form stating that I didn't get him that vaccination at the time and list the reason why. I was fine with that...

My main issue was that he already was going to get two other vaccinations that day and I felt like that the MMR which is for three other illnesses would have been entirely too much. Now I know what you are thinking... she must be one of those freaks who doesn't vaccinate her child!!! Well that is the farthest from the truth. Our son has had all of his vaccinations done in the allotted time frame. He just doesn't have them all at one doctor visit. To us it is worth taking extra time off from work to take him to the doctor several times to ensure they are all done.

So to get back to the day in question... we went to our appointment and as usual we filled out the paperwork prior to seeing someone and had made note of his runny nose and sleeping issues and chest congestion. So when we went into our room a nurse practitioner came in and sat down. She never once introduced herself to us and when she did start to ask us questions she asked us like five times if anyone else lived in the house with us and each time we said no... it is just us and our son. I think she finally began to read between the lines, but boy was she slow about it.

So then we started to tell her about some of the things going on with him like the runny nose, congestion and sleeping problems and she began to chastise us by saying, "well you just need to let him cry it out," and "by no means should you ever go into his room when he is crying and pick him up and take him to bed with you." We just kind of looked at her and basically said that is easier said than done when he cries for 30 minutes or longer until you do go in there and comfort him.

So then we went and had him weighed and she was very concerned by his weight or lack of weight if you will. She said he must have been weighed wrong the previous time he was in. We just shrugged our shoulders and said he is an active boy and sometimes eats and sometimes doesn't. She was not amused... Pediasure was in his future to help boost his weight.

Then comes the fun part of this whole visit... she starts discussing with us the vaccines he is supposed to get at this visit (remember all the while never introducing herself to us). That is when I spoke up and said I would rather he did not get the MMR at this visit. She looked at me like I had three heads and that I was bringing the plague down on the earth. She got very defensive and started in with all the scare tactics, for instance "Well he is in daycare and that is a dangerous place to be without vaccinations," and so on. Then she went on to say that Mumps was on the rise and that we were placing him at risk because it is not safe to not have your child vaccinated. She also implied that we could kill our son by not having him vaccinated. I then promptly told her to look at his chart and see that he had had all his vaccinations up to this point. She then quickly back peddled a bit. This next thing she said is my all time favorite.

I told her okay... how about this... I don't want him to have a live virus injected in him until he is a little older and can handle it better. Her response was well the Chickenpox vaccine has a live virus in it... I giggled and said okay then I don't want him having two lives virus vaccinations in one day and to be honest the MMR shot is really the equivalent of three vaccinations. So he would have had five shots in one day. That is crazy and absolutely unnecessary. It became very obvious to us that she had an agenda and we were not playing along with it.

I thought at one point she was going to stick her bottom lip out and storm out of the room stomping her feet and slamming the door on her way out. As you can probably imagine I was not in the least bit amused by her third degree treatment and judgement of our family and the decisions we make for our son. We had never even seen this woman before and the only reason we were seeing her on this particular day is because both of our son's doctors are preggers and were not working.

Well we won and he only got two vaccinations and has yet to get his MMR vaccine. Here is the kicker though and the thing that you continually go back to... FOLLOW YOUR MOTHERLY INSTINCT! Within hours of him getting the vaccinations he began to run a fever and that fever spiking to 104.5 at its highest point lasted for four days. When we finally got the fever to go away we had to take him back to the doctor and we saw our doctor this time... turns out he had a sinus infection all along and should have never been given the vaccinations because he was sick!!!! Can you believe it???? Our doc would never admit it, but you could tell that if she had been the one we saw originally that day, she would have sent us home and would have told us to come back for his vaccinations when he was well.

That day we called and complained about that nurse practitioner and it turns out that was not the first and probably not the last complaint about her. She had a huge chip on her shoulder and to be quite honest we were not the parents that she should have tried to unload it on. We care very deeply for our son and for her to imply otherwise was not and is not cool under any circumstance!

Thought One on December 23, 2009

So it has been a very long time since I have blogged and for that I apologize. This time of year is so hectic, but I am in the mood to write so I will probably write about several things. Here are my thoughts for today...

Thought one - Did anyone see the story about the pediatrician from Delaware who molested all of those children in the age ranges of 6 months to two years old? If I ever met this man in person... anyway I think he will get his due once he is between the walls in prison. I cannot believe he videotaped what he did to those poor children. I sure hope he was not one of the sex offenders that the State of Georgia has lost track of. He is a very sick individual... but here is my next question... why on earth would a parent leave their baby or toddler alone with their doctor? There is no reason why the doctor needs to be alone with a child that young. Besides let's face it, it isn't like the child can tell the doctor anything. I am certainly not placing the blame on the parents... I just don't understand why they would ever leave their child in a room with the doctor alone. I hope that these parents didn't do that because they felt they did not have a say in their child's care. Which leads me to my next thought.