All Ears. Again.

Wednesday, October 26, 2011

My little one is under the weather.

On Monday night, Nora woke up at 2:00 a.m. and was up for two hours--something that is very unusual for her. She didn't seem sick at all, so we chalked it up to possible teething and went on with our day as normal (albeit a little extra tired).

But when I picked her up from daycare yesterday, she seemed a little out of it. She looked tired. Her eyes had that glazed-over, "sick look." Our daycare provider said that she seemed quiet and not as active as usual. I thought she felt a little warm. Still, I took her home and Michael and I plopped her in her high chair to give her some dinner.

For the past week or so, Nora has been a rockstar when it comes to eating. It must've been the fact that I blogged about her food habits; she wanted to prove me wrong! She suddenly took to eating everything we put in front of her, so we've taken advantage by offering her a huge variety of new foods in the hopes that when she goes through another "picky stage," we'll have a bigger arsenal of familiar foods to pull from.

So anyway, we got her home last night and tried to feed her and... she wouldn't eat anything. We knew something was up right away, since the things we were trying to serve her were some of her favorites. Macaroni and cheese! She wouldn't touch it. We ended up getting her to eat a little bit of a dinner roll, but that was it. We called it quits on dinner, and I took her upstairs to get her ready for bed, even though it was early.

I discovered she did have a fever--101.6 by her ear thermometer. Not crazy high or anything, but a fever nonetheless. I gave her a bath, and she proceeded to freak me out a little bit by having chills when I was getting her pajamas on. Poor kid.

She promptly passed out, and we prepared ourselves to have another bad night. To our surprise, she slept quite well. We heard a couple of coughing fits throughout the night, and a few short little cries, but she always settled right back down.

This morning, she still looked terrible, and she once again had a 101+ degree fever, so we made her a doctor's appointment.

It turns out the poor kid has a double ear infection. AGAIN. Or, still. We're not sure whether it's a new infection, or if the one she had (diagnosed on 10/10) just never went away, even after a 10-day course of antibiotics. We stopped by the pharmacy to get her a new, stronger antibiotic, and I took her home and put her down for a nap. Michael came home from work to take the afternoon shift so I could go into work to attend meetings and get some things done. (Hooray, full-time working parents!)

THE KID TOOK A 4-HOUR NAP. If that right there is not a sign of her illness, I don't know what is.

By the time I got home, she was still looking pretty sick, but she was in good spirits.

Another fever tonight, so I don't know what to do about daycare tomorrow. Our provider doesn't really have any set rules, just expects everyone to use their best judgement. Ear infections aren't contagious, but she has the start of a cold now, too. Today, her pediatrician said she didn't think it was a good idea for her to return to daycare while she has the fever, so... I don't know. *sigh*

The biggest development in all of this is that our pediatrician started talking TUBES. Nora has had a few ear infections, but I guess I didn't realize that it was anything abnormal until today. By our count, she's had 3-4 that we've treated since last Christmas, when she got her first one at three months old. Plus, there was an additional one that we detected at her 12-month well-baby appointment that we decided not to treat because she was showing absolutely no symptoms of it, and it didn't seem to be bothering her.

The pediatrician essentially said that if she can get away with having just one more ear infection between now and March, we'd be good. However, if she gets two within that timeframe, she wants to order the surgery to have tubes placed in her ears.

Blahhhhh. Not what I wanted to hear. I know it's a minor, common, outpatient procedure that takes like five minutes, but no one wants to put their baby under anesthesia, you know? Anyway, I'm not going to really spend time worrying about it until its actually upon us, but honestly, based on her history, I just don't see us getting to March with only one more ear infection.

I'm curious... Does your child have tubes in his/her ears? How old was he/she when they were inserted? What was the rationale for the decision? How many ear infections had he/she been diagnosed with before the tubes? Did the tubes prevent any further ear infections? Were they/will they be removed at a certain age? 

Even though tubes are just a possibility at this point, we do need to think ahead a bit because we are approaching open enrollment for health insurance with our employers. Right now, we have Michael and Nora on a high-deductible insurance plan through his job, and me on my own separate plan, as that was the most cost-effective solution for us. With Michael and Nora's plan, we've been taking the extra money that we would be spending on premiums and putting it in a health savings account. We have a nice chunk of money in there after only 10 months of paying into it, but we're not sure it's enough to cover the surgery, since we still have a deductible/co-insurance we'd have to pay.

So, that begs the question... if we think it's a good possibility that she'll need this surgery, should we consider switching to a traditional health plan for 2012? The premiums are much higher, but the surgery would likely be fully covered. We have to wait to get the 2012 insurance offerings from our employers, then try to get an estimate for what the surgery would cost, and go from there. It's definitely hard to figure out life insurance, but health insurance is a beast, too!

In the meantime, here's hoping Miss Nora gets back to her old self soon... and that maybe, just maybe, her vulnerability for ear infections will disappear! (See that there? That's optimism!)


denise October 26, 2011 at 11:17 PM  

My son has tubes in both ears and we are watching my oldest daughter's ears due to many ear infections last year. My son actually is on his second set of tubes. He is the excecption however according to the ENT we see. His first set of tubes was at 15 months. They helped tremendously! He had about 8 diagnosed ear infections and fluid in his ears, negative pressure in his ear drums leading to conductive heating loss (on top of multiple antibiotic allergies making things difficult to treat). His tubes grew out within 6 months and 14 months. The ear infections came, but were easy to treat with drops and didnt seem to cause as much pain. Within hours we saw a differerence in his balance and within weeks a huge language burst as well as decrease in his frustration due to better communication skills. The second go around we elected to take out his adenoids which were also causing plumbing trouble in his head. He has even ear infection free since then (about six months). He also has had fewer colds and faster recovery times since the second set of tubes. The number we are chalking up to luck, but the recovery time we definitely feel can correlate to the tubes. It was a big of an ordeal getting him to wear his ear plugs when swimming, but soon he got excited to put the plugs meant he got to go swimming. After all that, the bottom line is I was very glad we went ahead with tubes. I was so nervous about the procedure and anesthesia but I all had enough time to go to the bwthroom and open my book before I was holding my baby again.

Vanessa October 27, 2011 at 5:26 AM  

I don't know anything about this sort of thing but just wanbt to say, poor little Nora! I am sure the doctor knows what he's doing, but it must be hard to think of Nora having an anaesthetic. Still, I am sure she will be so much happier with fewer infections.
As for health insurance - what a pain. It's so hard dealing with all of this stuff and knowing what to do for the best. We have insurance through work, thankfully, and a National Health Service which is free for all. People in the UK always complain about it, but it's an amazing concept in my opinion, despite its problems.

Anonymous,  October 27, 2011 at 9:24 AM  

Poor baby! This idea surprised me when I heard it but I have heard a lot of success associated with it and it seems a little less "drastic" than the procedure for tubes, at least to try out - see if you can find a chiropractor that works with little ones and take her for an adjustment. If it doesn't work, then ok, but if it does, it might save you from having to deal with the tubes, if that is something that makes you nervous.

diana October 27, 2011 at 9:34 AM  

My son (6 months) just had his first ear infection. I'm hoping that it doesn't come to tubes for us, since I had many, many ear infections as a child. Starting around 6 months and continuing until I was about 12 years old, I had ear infections every 1-3 months. For whatever reason, no one talked to my parents about getting tubes in my ears, and I just took a lot of amoxicillin. I wont hesitate to ask about tubes and to go forward with putting them in if the pediatrician things it would help if Logan starts getting more ear infections. I remember nights crying because I was in pain and having to go to the Emergency room to get a script written and filled one year on Christmas Eve. (Small town, no on-call pediatrician). I also remember not being allowed to swim for days each summer due to ear infections. I'd keep monitoring it and see what happens, but I would do the tubes if the dr. thinks it's necessary.

trout28,  October 27, 2011 at 10:42 AM  

My daughter got tubes at 10 months, after one ear infection at 7 months where the fluid never drained. Because of where she was in language and gross motor development, our pediatrician and ENT felt we would see a temporary delay in development if we didn't do something. Also, over the long-term, fluid accumulation leads to other problems (like benign tumors and malformed facial structure) that we wanted to avoid. We have had 3 colds since then, and her ears now drain but if we start the ear drops as soon as we see signs of the cold, the cold doesn't seem to last as long. I also noticed an immediate difference in how fearless she was climbing, walking, etc. The procedure itself was very easy and quick. In hindsight, given that the fluid was there and not draining for 4 months, I wish we had done it sooner.

Katie P October 27, 2011 at 10:53 AM  

Carter is 3.5, and he got tubes in May after having chronic ear infections since January. We did 4-6 rounds of antibiotics and still he would not get better. I took him off dairy, completely changed his diet and did everything I possibly could have done to prevent the surgery. It wasn't until I felt I had exhausted every other avenue that I consented to even seeing the ENT.

Our ENT was fantastic and actually didn't do surgery right away. He gave us another month to try and and see if they would clear on their own. We finally agreed to the surgery deciding that the procedure was better than treating him with more antibiotics which are extremely toxic for your body.

Seeing him go under was one of the hardest things I have done with him. I am pretty anti-hospital and doctor (not in a bad way - just in I believe in preventative and wellness care rather than treating symptoms way...) but have been ultimately happy that we did it after 5 months of CHRONIC snot and fluid.

Think it through and good luck. From your descriptions, I wouldn't be ready for surgery yet either.

A Long Far View October 27, 2011 at 6:04 PM  

I don't have kids yet, but I had tubes when I was little. I think when I was around 2-3? I'm honestly not sure, but I do know that I was talking, as one of the reasons that I had them was because my mom finally realized how deaf I had become. She came to kiss my goodnight and had turned out the light, and I told her to turn the lights back on because I couldn't hear her (I'd been reading lips for awhile!). I had also had a LOT of ear infections, but once my mom realized how it was affecting my hearing (and I would imagine my speech), that's why they decided to do it.

I don't really remember anything about it at all (I also had my tonsils out a year or so later and that hospital experience I do remember). For me it was definitely the right decision, but I also agree with you about not wanting to jump into it if it's NOT the right decision yet.

PhaseThreeOfLife October 27, 2011 at 6:26 PM  

Well. I have much to say on this topic. :) Ryan got his first ear infection right around the time he started daycare (4-ish months) and had them on and off (mostly on) for 4 straight months. We tried every antibiotic the doctors could think of (apparently he's very resistent to all antibiotics, which I'm sure you can imagine, freaks the heck out of me). Nothing seemed to touch these infections and it got progressively worse and worse. He got the tubes at 8 months old. Very young for the surgery, but we were out of options and they worried it would start to affect his speech development because the constant infection was hurting his hearing (and he's 13 months old and still doesn't say any words, so I think it did delay him a bit).

Everyone told me the ear infections would clear up instantly so we weren't prepared for the struggle it still was. Despite the tubes, the infection was so bad to begin with that it took several more appointments, more antibiotics, and ear-vacuuming to finally rid it for good. Once it was finally all gone, though (maybe around 10 months old), it hasn't come back yet and every time his ear are check, we're told they are clear and the tubes are working nicely.

We were also on a high deductible plan, and this surgery helped us meet that deductible. ;) I wouldn't want to advise you on which plan to choose, but if it helps, I can tell you what it cost us. The surgery itself was $1,050. Then there's a bill for the doctor to perform the surgery, the anethesiologist, and follow up doctor's visits (of which we had many, but that isn't the norm). I would say all together, this probably cost us around $1,700 for everything. Sounds like a lot, but it's probably the best money we ever spent.

Good luck. I know how stressful those ear infections are, particular because you can't see if yourself to know whether it's getting better or worse. I'll keep my fingers crossed that Nora doesn't get two more between now and March!

amybyrd October 27, 2011 at 9:16 PM  

You know we have them. I was kind of surprised our pedi was so forward in sending us to the ENT--but at 6 months they were worried about her language development. And truthfully it is a very easy surgery--I was freaked out but it was less than 5 minutes and we had no lingering issues afterwards. Also we never really knew when she had an ear infections because she didn't really get a fever or pull on her ears. And in fact for her first one she had for almost a week before we got to a doc. Sometimes they have them with few outward symptoms.

Brooke,  October 27, 2011 at 9:22 PM  

My son is 8 yrs old now, but his first ear infection was 6 weeks old (!!) and I think I was in the doctor office every month or two the first year. After that it was every other month or so. About the time he turned 4 or 5 he hasn't really had any (maybe once when he had a bad head cold). They talked about it tubes, but luckily they watched his hearing (did frequent tests with air pressure against the ear drums). He's been fine since.

I however grew up with NUMEROUS ear infections, back and forth when I ws smaller, and had tubes put in once at the first part of a week and they fell out and I had to go back in. My mom used to tell me the ENT eventuallyj ust let her pay the copays at tax time because I was in that frequent. Around 3 or 4 (before kindergarten) I had tonsils and adenoids removed too. I still had issues afterwards (not the norm) and had frequent ENT visits / hearing tests, etc. and ear drops. I s till get ear infections to this day as an adult anytime I get a bad head cold.

Good luck ! Just remember to elevate her head when she has an ear infection (i.e. put something under one end of her crib) or heat (a warm washcloth) helps ease the throbbing.

Aimee,  October 27, 2011 at 11:25 PM  

I don't have any kids yet, but I am able to share my personal experience. Growing up, I had multiple, recurrent ear infections. They were always very painful and actually caused me to have a 60% hearing loss in one ear and 40% loss in the other throughout my childhood. As a result of the hearing loss, my voice echoed and reverberated inside my head, causing me to think I was speaking louder than I actually was. I was constantly asked to "speak up," because of this.

Before the age of 11, I had 5 sets of tubes bilaterally. I don't remember the procedures being traumatic or especially inconvenient. I did have to be careful around water and avoid getting any in my ears, but nothing major. The tubes, typically, stayed in about 12 to 18 months and fell out on their own; however, one set did stay in longer and had to be removed in the ENT's office (that was not the most pleasant experience, but not terrible). I've had very few ear infections since my last set of tubes and no longer have hearing loss.

I am a speech therapist, so I also have another viewpoint. As I already mentioned, ear infections may cause decreased hearing. These offer go away after the infection is gone, but I always think about the effect it may have on language development. Young children develop language by, first, hearing others speak and gaining comprehension of words/phrases before speaking those words/phrases themselves. Therefore, if they are not able to hear everything, they are missing out on an opportunity to learn and acquire new language.

tab890 October 28, 2011 at 12:32 AM  

I'm surprised your Ped didn't offer to send you guys to an ear nose and throat specialist first before discussing the surgery. We just had the "tubes" talk with our ped because she's one more ear infection away from having to see a specialist per our ped's request.

From what it sounds like, ultimately its the parents decision, but everyone i've talked to has said what a miracle it has been for them with ear infections. I think if the time came and we had to make a decision we would do it, as hard as it would be to do.

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