Showing posts with label UPDATE. Show all posts
Showing posts with label UPDATE. Show all posts

Wednesday, February 27, 2008

Update!



Kelley's hearing test was earlier in the month, and the results were, honestly, just ok. Her 'surgery ear' as she calls it, is about 45% of normal. I need to look at the good side - prior to her surgeries, it was about 5% of normal.

So, we faxed the results to California Ear Institute, and Sheri Byrne-Haber called a little more than a week later. Apparently she had to catch Dr. Roberson before he left for Nepal to do some work. Busy guy, huh? Anyway - she told us that Dr. Roberson recommended we have her tested again in three-four months, and send the results again. In the meantime, we could have her fitted for a kind of hearing aid called an Oticon Delta.

Now the dilemma. Do we proceed with a hearing aid fitting, or do we wait until her second surgery with Dr. Reinisch? Dr. Reinisch is going to be making some adjustments to her ear that could affect how the hearing aid fits her. We haven't made up our minds yet.

If you would like to read a little bit more about Sheri Byrne-Haber, who I think is amazing, read this article about her. She is a person you definitely want on your side.

Monday, January 28, 2008

Update!












Well, our budding star did great at her Christmas program....we took a movie of it, but figuring out how to post it here would require more technical skill than I have time for, so we'll have to save it for another day.

Pics! The ear looks great - we are so happy. After a brief communication with Dr. Reinisch, we are likely going to be scheduling a second surgery very soon. Her ear does need some refinements. The posterior sulcus (pocket behind the ear), the shape of the canal opening (which at the moment is not very round - kind of jagged almost), and the tragus are the areas that need refinement. That, and the strange little hairs growing out of her ear. Thankfully she doesn't seem to notice or care. According to Dr. Reinisch, this is a much less invasive surgery that doesn't require an extended stay or even any hair shaving.

Now the fun begins - we've changed insurance companies since March 07, so we are going to have to tiptoe around that minefield to find out exactly what has to happen for pre-approval for the surgery, percentages, etc. We've been there a few times now, so hopefully I've gained enough knowledge to get through it with our pocket book relatively unscathed.

One interesting thing to note - the ear is pretty stiff. It doesn't bend like a natural ear does. Apparently this is normal for this type of implant. That doesn't bother Kelley, either, so I guess it doesn't bother us.

As for her hearing, she was actually scheduled to have a hearing test today, which we were to send to CEI for Dr. Roberson & Sheri Byrne-Haber to review. Unfortunately, Kelley has come down with her winter sickness, and we have to postpone. She's coughing, sniffly, running a low fever, and is really tired. Probably not the best of circumstances under which to test. We'd like to get the best results possible, obviously, so we have the best information going forward. It is likely, however, that if we don't have improvement from her July test, then we will seriously look into adding the titanium implement and seeing if that makes a difference.

She is doing well in school, and her teacher is very accommodating about where she sits in her classroom. There have been a few worksheets that come home that could use a little improvement, with remarks like "didn't follow directions." This makes me wonder what the circumstances were in the classroom when instructions were given. Was there ambient noise? Was someone else engaging her at the time? Questions for her teacher when we have our next conference.

And, we still haven't changed our minds on the SoundBridge. Right now we are thinking that it is a 'no' for us.

The final two pics - we had a snow day today. I bundled everyone up and let them tromp around outside. Ryan was totally fascinated by the snow, too. Kelley was showing him what snow was in the last picture and his face totally lit up. He had a great time.

Ok, so, now I'm going to take a little time to fancy up this blog. I've learned a few new tricks, so I'm going to add links in the margins & whatnot.

Always, thank you for reading and keeping up. The support we get from everyone in our lives is amazing.

Sunday, October 28, 2007

Busiest.Summer.Ever.






Heck, it's been over for a month and we're still running. Here's the latest with Kelley's ear and surgery.

As you can see by the picture, it looks amazing. We are so happy with the results. People who know that she's had the surgery comment on how "real" it looks, and people who don't know about the surgery don't even blink, even when she wears her hair up in a ponytail. The scars on the other parts of her body - outer thigh split thickness skin graft from her July '06 canalplasty - and the March '07 MedPor implant surgery across her stomach, continue to fade away, also.

She continues to be very open about her ear, showing people who ask, and telling perfect strangers "I got a new ear in DISNEYLAND!" People immediately look at me as if to say "Wha?"
So - here's the latest developments with ESD......there is none. After we received the Early Intervention paperwork from the district, Kelley and I did the enclosed "Ages and Stages Questionnaire." Apparently it's a test that Educational Services uses to gauge whether or not children are on-track developmentally. And, just as I suspected, she's just fine. She has absolutely NO developmental delays as a result of her unilateral hearing loss. I was also told by an ESD representative that based on her hearing test results, she would be right on the border for getting any assistance with a hearing device like an aid or an FM system, anyway, with the likelihood being no.

An interesting side note here before I continue.....one day this summer we were in the car driving to dance class. She said to me "Mom, this ear is loud and this one softer." It's the first time she's used words to describe the way she hears the world. For some reason that really struck me. She can now describe what she's hearing and how.

So, there we were, sort of adrift, trying to decide/figure out what our next move for her should be. We had basically been cut loose by her doctor in Portland, and ESD said "Sorry, can't help you...." When two awesome things happened....

Firstly, a dear friend who happens to work for a hearing aid company was able to obtain a hearing aid for Kelley without any cost to us. As soon as we put it in her ear, she said "Wow! I can hear on that side!" The only trouble we have with it at the moment is the fact that the portion of the aid that is supposed to hook behind her ear doesn't fit very well due to the fact that the area behind the pinna isn't as deep as on a natural ear, so it's a little unsteady. We haven't had her wear it to school or anything for fear of losing it. We're going to try to figure out what to do about that soon.

Secondly, in mid-September, we got a call from the California Ear Institute - the clinic and doctor (Dr. Roberson - so awesome!) who performed her canalplasty in the summer of '06. Apparently they are putting together a study for post-MedPor children. They are studying the hearing results of these kids after their MedPor reconstruction (what Dr. Reinisch did for us) and are finding basically two types of results......really good hearing and just so-so hearing. Kelley falls into the 'just so-so' hearing category. They've pretty much determined that the ossicles on Kelley that are fused together aren't fully bone - they are what Sherri Byrne-Haber (Dr. Roberson's go-to gal for this kind of stuff) described as 'fibrous.' Which means that sound is being partially absorbed by the fibrous tissue and not making it all the way to the brain.

We have one of two options.....the study they are putting together would involve a specialized middle-ear implant called a Vibrant Soundbridge. This is a great description and diagram of what this particular implement is all about..... http://www.vibrantmedel.us/archive/layout/patients.asp?

and this: http://www.vibrantmedel.us/archive/layout/patients.asp?SCREEN=patients&page=sbHow

John took one look at that page and said "No Way." I tend to agree. It seems like a huge step for her, and we would be making a decision that would seriously impact her in a way that years down the road she may not want....especially if technology continues to advance and alternatives are developed as she grows up. It feels very much like a decision that she should be able to make for herself when she gets older if she decides that her current level of hearing isn't sufficient for her.

So, the second option is to have another surgery. In this surgery, the middle ear bones (the hammer & anvil) would be removed, and replaced with a titanium implement that would possibly help conduct sound the way the ear bones are supposed to. This surgery would be much less invasive than the previous one performed by Dr. Roberson, so we wouldn't be stuck in a hotel room for weeks. Thank Goodness. At any rate - that is the option we are leaning toward.

Ironically, her Portland surgeon, when performing canalplasties, takes out the ossicles and replaces them with the titanium implement as a matter of course. When we were deciding on surgeons, we decided that it was too aggressive. You can't put them back in once they're gone, right? And we wanted to give her ear a chance to possibly do what it's supposed to do without putting a foreign object in it. We considered adding the titanium implement as a "step 2" if the canalplasty didn't give us stunning results.

So here's where we are: based on her most recent hearing test, Dr. Roberson felt that she has shown a steady improvement over her last 3 tests. He recommended that we have her hearing tested again in January, and to send him the results. At that point he would be in consultation with us on what he recommends. Back to a holding pattern.

That said, Kelley started full-day Kindergarten in September, and is doing great. We informed her teacher that preferential seating would be a good idea, and she's been totally willing and helpful. Kelley seems to be thriving. We're really happy with the school, too. (We chose a private religious school for her for a myriad of reasons).

She's doing wonderful, as is everyone else. And I have to say - what a little trouper our little guy Ryan has been through all of this. He gets carted around all over the place and he's just this happy little boy. He took his first unassisted steps on October17th. He's not running quite yet, but he's taking several steps at a time without holding on to anything or anyone. Plus, he's into everything he can possibly be into, as you can see by the picture of the kitchen.


I really hope someone is still reading this! As always....thank you for reading and keeping us in your thoughts.