Darn Ear Tubes

Our ENT billing department must love us.  We are probably in their budget as an income source.  According to our ENT, Dr G, Cate has very tiny, very crooked ear canals.  They have grown with her but they are still much smaller than a typical ear canal and because of that fluid builds up behind the ear drum very easily.  We first learned this when Cate was a year old.  She had never passed a hearing test to that point so the pediatrician referred us to an Ear Nose & Throat (ENT) specialist.  We found out that Cate's hearing was probably equivalent to her being under water because of the fluid build up.  So in March 2007 we went to Children's Hospital to have ear tubes placed - she also had an Adenoidectomy because her adenoids were so large it was feared they might cause apnea if not removed.  The surgery was very short and the recovery pretty quick even with the adenoid removal.  Wow what a change!  For a little while Cate startled at everything, but within days we heard her making new noises and being much more responsive.  This started our journey with our friend the ENT.  Since Cate's ear canals are so tiny & crooked, they had to place the smallest tube they had and put them at an angle.  Ear tubes have an expected life of eighteen months to two years.  The hope being that by the time the first set falls out the child has grown enough that the ears can handle the fluid without the tubes and they never have to be replaced.  With Lucy this has been true so far, she had tubes after many, many ear infections - they fell out a couple months ago and so far no more infections and no fluid.  Not the case with Cate, hers have fallen out almost exactly one year post surgery - every year.    Every time we discover a tube is coming out we watch her for a month or two until the fluid build up and it really affects her hearing.  So she has had 5 sets - both ears every time (3/2007, 4/2008, 5/2009, 5/2010, 6/2011 - see what I mean about being an annual occurrence?) up to today.  So we should still be good for another 6 months at least right?  Well this time we've had fun kink in the system - one of the tubes they placed in June is now blocked up.  We tried everything , different kinds of drops and even a wick to hold the drops on the blockage but it will not clear.  So tomorrow we are back to Children's Hospital for a new ear tube.  In the past it has been a quick and easy out patient surgery.  They used to give Cate a drug to make her loopy and so she didn't remember the experience, then they use gas to put her out.  Dr. G then takes out any old tube parts that are still in there, drains out all the fluid, and puts the new tube in for each ear.  We have to be at the hospital 2 hours pre-surgery, then once they are ready for us it took about a half hour for the drug to take effect, they'd roll her back then about 15 minutes or so Dr. G has come to give me a report and about 15 minutes after that she comes back barely awake, groggy & unhappy, an hour plus later we get to leave.  In June we tried something different, we didn't give her the pre-drug and instead sent her back awake.  The nurses said she did great and never even seemed scared.  It made everything even easier since the gas wears off so much faster without the liquid - in June when she came back she was already awake, only a little grumpy and 20 minutes later we were in the car.  Hopefully this time it will be as smooth of a process. We will find out how remembering the previous experience plays into the fear factor for her because when we get her all gowned up and ready to roll she will actually remember what come next.  Hopefully this will not be a bad thing, she will go willing and take the gas without distress.   This time they are also going to recheck her adenoids and if they have grown back remove them again.  Its possible they did grow back because she was so young when they were removed the first time, this was a risk we knew about and hope doesn't happen. So keep your fingers crossed for a smooth surgery, no adenoids, and a little girl that can hear much better on the left side after tomorrow.
This is a picture of Dr. Cate taking care of her baby doll in June, hoping for a similar scene this time -