Friday, November 5, 2010

Doctor, Doctor

We've had our fair share of doctors lately. As thankful as I am that we have health insurance and access to modern medical care... oofta. Enough is enough, already. Last week, the boys' had four appointments between the two of them; and three of them were for Drew.

Our easiest appointment was at the dentist - Drew's follow-up appointment after his introductory visit. We both went back in for a regular cleaning on Monday the 25th, and Drew did stellar. He got a bit fidgety in the chair and had some trouble opening his mouth as wide as the hygienist needed it to be, but all in all, he was awesome. The hygienist even told me so. :) Of course, picking out a new toothbrush was the coolest part. That, and getting another "prize" when he was finished. He picked out a Lightening McQueen stamp at his first visit, and that's all he talked about when he found out he was going back to the dentist. He wanted another stamp. Thankfully, the dentist's office had a few left. I don't want to know what would have happened if there hadn't been.

I was so thankful with Drew's easy-peasy visit to the dentist, especially considering what happened the day before. That would have been when *unplanned* doctor's visit #1 occurred.

But first, let me back up a bit. Since Drew's nasty double-ear infection back in June, he's had fluid in his ears. He has seen his pediatrician monthly to recheck his ears, and the fluid has persisted. At our last visit at the end of September, Dr. Hunter referred Drew for an ENT appointment. She said that three months is long enough to let Drew's ears go - the fluid wasn't resolving on its own, and at this point, it probably wouldn't. The referral was sent and the next day we had an appointment...for a month later. Bummer. But such is the healthcare system, I guess. Anyway, I digress.

Let me also mention, though, that all this time, Drew hasn't complained of any more ear pain. He didn't get any more infections and he didn't seem bothered by it. Oh, well, I take that back. He may have said his ears hurt, on occasion, but it wasn't anything that affected his sleep or behavior, and it wasn't anything that a couple doses of tylenol couldn't resolve.

Until last Sunday, that is. Before we left for church, he began complaining that his ears hurt. I thought that they could be but *insert bad mother moment here* I thought he was fibbing because he had seen me tend to my ears that morning (I had been having some ear issues, too). Church was three quarters over when someone came and told me that Drew was complaining his ear hurt while he was down in the nursery. I figured *insert another bad mother moment here* he'd be okay until church finished and I could get down there.

Well. Not so much. He was crying by the time I got to him, and so I whisked him home and pumped him full of pain relievers.

They. Did. Nothing.

Oh my good Lord in heaven.

Never, never have I been completely beside myself in not knowing what to do. I know now that the pain he must have been in was unbearable, and contributing to that was fatigue. He was tired, in pain, and couldn't understand why neither his mom or dad could make it go away. I knew that by 2:00, when the ibuprofen I'd given him at 11 hadn't seem to touch his pain, that we'd never make it through the night. He had to go the Urgent Care. And he had to get there pronto.

Keep in mind...Drew is crying and screaming and uncomfortable this entire time. I tried to distract him with a movie while we waited for the pain meds to kick in (which they obviously never did) and he was occasionally distracted by it, but there was no denying how miserable he was.

The crying and screaming didn't stop as we were waiting in the UC waiting room. We saw the same doctor that we did back in June when he had HSP, and if I was less than impressed with him then, I was 10 times more so this time. This doctor just lacks any kind of bedside manner or sensitivity with children, he comes off as arrogant, and it seemed like it was more important to get rid of the screaming kid than it was to treat him (and, get this...I find out the next day that the guy is a pediatrician! what?!). On the plus side, we were seen almost right away, and back out the door 15 minutes after we walked in. The doctor looked in his ears, said "they don't look that bad" (which came across to me that he didn't think it was a big deal), and he gave us two prescriptions - an antibiotic for an infection and drops for pain. I prayed that it would at least get us through the night until I could call his pediatrician in the morning.

Let me just interject here that this has been the most painful mothering moment I've experienced. It's a combination of extreme sympathy and compassion, mixed with utter frustration. It hurts, almost physically, when our kids are hurting. And when you couple that with the fact that there is absolutely nothing you can do to fix it or take it away...unbearable. I even teared up while we were in the Urgent Care. Okay, well, more than just "teared up." I was a mess. It just became a breaking point of Drew's pain and tears mixed with my inability to kiss the pain away. Ug-ly.

{I also want to mention that my parents arrived for a visit just as Drew and I returned home from the UC. I thank my lucky stars for that. Just having a few extra hands to hold Drew was a God send, but also having my parents here to support Brad and me as we try to be parents during this trauma - I'm not sure I would have made it through the evening in one piece without them.}

By 8:00 that night, the crying had pretty much resolved, and Drew was finally starting to settle down. He hadn't eaten much of anything all day, and he claimed he still wasn't hungry, but when he saw me eating Doritos, he thought maybe he'd be able to tolerate those. With some juice, of course. :)

When he woke up Monday morning, he was an entirely new kid. Back to normal and in a good mood. But by 10am, his ear was draining what looked like snot. Pretty gross. Come to find out later, his eardrum had ruptured. No wonder he wasn't in pain anymore! All that pressure was gone! I continued to pump him full of his antibiotic and ear drops (when he'd let me) and tylenol until Friday morning (the 29th) when Drew had doctor appointment #3 at Dr. Hertenstein's office for his ENT referral.

Dr. Hertenstein is great. He was very kind and gentle with Drew, and was very sure to educate me on all that was going on with Drew's ears. He confirmed that Drew's eardrum had indeed ruptured, and had already healed, but was still packed full of fluid. Because he's had this fluid for so long, and it hasn't resolved on it's own...well, the long and short of it is - Drew needs tubes. And he needs his adenoids taken out. Apparently Drew has enlarged adenoids which blocks the tubes and prevents the fluid from draining naturally. The doctor said that his goal is to go into the operating room as few times as possible, and when the adenoids are removed, four out of five kids don't need to have tubes placed again. We've also been able to tell that his ear problems have affected Drew's hearing. An audiologist did a few hearing tests on Drew that morning, as well, and confirmed that he does have some temporary hearing loss in both ears due to the fluid.

Going in to this appointment, I was totally expecting to hear the news that we received. Not knowing that much about anything medical, really, but hearing enough from friends to know that tubes were the likely option, I was pretty confident that would be the end result. But when Drew and I got back in the van to come home, I began to get so anxious and nervous.

Surgery. For my baby. I don't like the sound of that.

But I know I have to keep cool. Because I have to keep Drew cool. All he knows is that the doctor is going to fix his ears. He doesn't know what it will entail. Ugh. It's a really yucky feeling. I'm trying to keep in mind the end result - no more fluid, no pressure, improved hearing, and hopefully a better mood - but it doesn't help the visual images I create of seeing my baby rolled away to an operating room without me.

Hate that.

Surgery is scheduled for this Tuesday, the 9th. Drew's been complaining this week that his ears hurt, so I've been pumping him with tylenol and using the ear drops. My prayer now is that his ear drum doesn't rupture again before Tuesday. When Tuesday arrives, I know I'll have an entirely new set of prayers!


The fourth doctor's appointment last week was for Reed, and it wasn't really a doctor's appointment. But an appointment, nonetheless, and with medical personnel, so it counts.

Carissa, a developmental therapist, and Sarah, a speech therapist, came to our home last Wednesday (the 27th) to evaluate Reed's speech delays. The evaluation consisted of asking me questions, observing Reed in his natural environment, and engaging with him using developmental toys and tools.

Reed was found to have a 35% delay in what they call "expressive speech" (which basically means his ability to say words), which makes him eligible for speech therapy. He is within normal range for all other categories of his basic development, so there isn't anything in addition to his speech that should be of concern.

They then left it up to me. My options were to start once a week speech therapy right away, or I could monitor him at home and have him reevaluated again in three months. Most of the concern that I had (which I felt like I had because someone else caused me to be concerned) has dissipated over the past two months as I've seen Reed's vocabulary "explode" from saying only one word to now saying about five. Even though that still puts him at a delay, and at the level of a 13 month old (Reed should be saying about 20 words at his age), I'm feeling positive about his progress. He understands so many things, and can communicate well even without the use of words. I asked Sarah, the speech therapist, if in three months when he's reevaluated they find he hasn't improved any, would he be at an even greater disadvantage for not having started therapy right now. She assured me that at his young age, waiting three months isn't going to cause him any further delay.

So that was my answer. We're going to hold off on therapy for now, and both Sarah and Carissa will come back the end of January to reevaluate Reed. Sarah is going to send us some literature on things we can do at home to encourage word formation and communication. So that's that for now.

And I'd say that that is just about enough.

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