Sunday, December 27, 2015

Hearing Loss

This past monday we went back to have Stella's hearing tests repeated to try to get more accurate results and see if anything has changed. The first time we went she wasn't very cooperative for the test that she was supposed to be asleep for (ABR=Auditory Brainstem Response testing).  

This time she did sleep so we obtained more information, especially regarding her left ear. After the testing the audiologist shared the results with me. 

Once again, Stella had an absent response for the OAE. She had a flat tympanogram and high thresholds for the ABR, meaning things need to be fairly loud for her to hear them. Stella's hearing loss is currently classified as a mild-moderate conductive loss consistent with middle ear fluid. The audiologist referred us to see an ENT. 

One of the Drs he recommended had great availability and we were able to see him on Wednesday. He may have been one of the cutest Drs ever (bonus!) and our appointment was fairly quick and easy. He again repeated the tympanogram and said it's likely fluid that Stella has affecting her hearing. He said she will not likely need hearing aids once the fluid resolves, but time will tell. He wanted to wait 6 weeks before seeing Stella again. If she still has the failed tympanogram he wants to put her under anesthesia and bring her into an OR. At that time they will likely place tubes. He said they would also do a complete ABR as well to get specific results about her hearing abilities in both ears since she will be asleep. 

When I asked about the congestion and gagging he seemed to think a lot of it was related to reflux. He thought we should see a pediatric GI Dr as her reflux is a an "underlying issue" likely impacting the fluid in her ears. 

So, we have the next 6 weeks to try to get the reflux more under control. We tried switching to Prevacid which works differently and is supposed to be stronger, but it went horribly. It was like it didn't work at all and she went back to screaming most of the day. Currently she's on Zantac twice a day and while I feel like it takes the edge off (she's not screaming in pain all day) she still has quite a few reflux symptoms. We went through a few days last week where she didn't want to eat (likely from the pain of reflux) and was going 4-5 hrs between daytime feedings. She wakes up so congested most mornings I have to suction her, and she has the most sensitive gag reflex I've ever seen. Even though it's a ways off, I'm concerned it will affect her eating of solid foods if we don't get it under control. I'm reluctant to switch meds as it went so poorly last time, but don't feel like what's she's on is doing the trick. I did some reading yesterday and found that reflux is very common in these kiddos with fluid in their ears and that some of the fluid was found to be stomach acid when studied. 

If anyone has any experience with tubes in infants, feel free to share your experience. I'd love to hear more as I don't feel like this is hugely common. 

Monday, December 7, 2015

Updates and Stella at 2 Months

Life is crazy with three kids aged two and under. Since I lasted posted it's has been a whirlwind. L & C are currently potty training. They go completely bottomless at home and just wear loose fitting pants  when we go places. We had been giving them peanut m&m's every time they went on the potty but quickly had to switch to mini m&m's. Good thing they like all things "baby" and get even more excited about their tiny treat. I have to laugh because that wouldn't be my reaction to the situation, haha. Both girls are taking a lot more. Lucy, or "You You You" as she refers to herself, is stringing two and three word sentences together regularly. She talks a lot and is pretty clear and easy to understand most times. Clara, or "Claka" as she calls herself is also using more words. Unfortunately, she still relies on whining quite a bit. W and are constantly reminding her to use her words, but she's a very emotional little girl. The girls copy each other constantly and if one does something the other has to as well. That's part of why the potty training is going so well. That are always encouraging each other and both want the reward of course. Lucy continues to process auditory information at an amazing speed and W and I joke that she's already smarter than us. It's tough for Clara because if you ask them both a question Lucy usually answers before Clara has time to fully process it. Clara is more like a typical two year old in that regard. She's usually happy to let Lucy take charge though. Lucy loves playing with her babies and is very helpful with Stella. We're always reminding her that some jobs are only for mommy and daddy. I swear she thinks she's the grown up in charge half the time. Clara continues to love her books. She'll sit and let pretty much anyone read her a book. She has her favorites, and she's also super into monkeys lately. We've been getting a lot of books from the library about monkeys and she loves any monkey stuffed animal. Clara also loves baby Stella and is always trying to talk to her and get her to smile or coo to her. Both girls love when Stella blows bubbles with her mouth and they get so excited about it. It's so cute. They are such good big sisters who are rarely jealous.
Stella turned 2 months old on the third
All my girls in matching outfits that my friend bought them. 
Helping daddy give Stella her first bottle.

Showing off their sweaters their Grandma knit for them. 

Getting their nails painted by Pop Pop.
Three across. 
Reading books with Grandpa Scott on Thanksgiving. 
Snuggles for baby Stella. 
That's an interesting use for breast pump pieces!

As for Stella, she's now 9 pounds 11 ounces and quickly growing out of clothes that L & C didn't fit in to for what feels like forever. The combination of being a full term baby and likely my last makes it feel like it's going by that much faster. Stella, or "Stella-Lella", and "Lellie" as I often call her sleeps about 6 hours at night. She's not a super easy or relaxed baby and I think her reflux has a lot to do with that. We tried increasing her Zantac and have just switched to Prevacid to see if it works better. Her crying and discomfort have definitely decreased, but she still sounds congested a lot. 

Relating to the congestion likely is her hearing abilities. Stella failed her newborn screening twice in the hospital and then again a week later when we followed up. This meant we got a referral to an audiologist for more involved testing. Initially I really didn't feel like she was hearing us or startling to sounds. She's improved there and will turn when she hears our voices, but she once again failed the same test (absent responses on the OAE and a flat tympanogram). The ABR testing showed that she is hearing and the nerve and cochlea are likely intact and functioning well. They weren't able to get a full reading of her hearing abilities on that test because she was supposed to sleep and really wouldn't for long. I even wore her for part of it but she kept rubbing off the electrodes or waking up during testing. The audiologist was very patient and we were there for over two hours. Her results on that test were consistent with fluid in her ears. The audiologist said he was able to visualize her eardrums and there were no signs of infection.  It's likely just fluid that hasn't resolved from her birth. That paired with the congestion from reflux encouraged me to increase her dose of the reflux medication. The tube that drains your ears is in the back of your throat and much flatter in children (making it harder to drain). It makes sense if she refluxing all the time it's either causing her ears to have a hard time draining or adding to the congestion in her ears. We go back in another month to retest and if the results are the same we will get a referral to an ENT. 

Prior to increasing her reflux meds I hired a lactation consultant. This person said her grassiness and fussiness was likely from an upper lip tie and her difficulty latching well because of it. She said she was likely swallowing a lot of air and not eating very efficiently. I knew the lip tie was there and was something we'd have to deal with at some point, but decided to take her to have it lasered since it was the end of the year and we've met our deductibles. Apparently, she was also a little tongue tied so that was also lasered. The dentist quickly did the procedures and I nursed immediately after. I was given stretches to do with her and sent on my way. Unfortunately, there wasn't a ton of follow up from the lactation consultant after that apart from telling me I needed to be patient with her and to try and relax. Unfortunately those things didn't help any and she's still clicking her tongue/smacking her lips a lot when she eats. This is discouraging and frustrating to me because it's uncomfortable. I guess breastfeeding will never be "easy" for me. I think I figured by this point we'd have that stuff ironed out. It makes me think if I can't help myself with nursing problems, how could I ever help others?

Apart from the reflux Stella really is a sweet baby. She started smiling and cooing shortly after we had her lip tie lasered. I think it did help some with her mood, but just not as much as I had hoped. I feel like the reflux is really one of our main underlying issues. She loves watching her sisters and when they talk to her she smiles at them frequently. She loves the ring sling I bought and almost immediately falls asleep in it every time. She's so snuggly and sweet in there and I absolutely love wearing her. It's something I feel like I missed out on a bit with the girls. You just can't wear twins like you can a single baby. She's so strong and stands up on her feet. This is one of our best burping techniques currently. She still likes her pacifier but has a crazy strong and unpredictable gag reflex. Sometimes she takes the pacifier like it's the best thing ever and other times she gags, wretches, and acts like it's poison. She found her hands and often has them in her mouth all covered with drool. Her eyes are really blue and she still has quite a bit of dark brown hair. I think he eyes will stay blue.

I tell the girls to put things at her feet (rather than on her face). Guess they got a little carried away. 

Stella's Thanksgiving outfit. 
Always with the tongue. 

Such a sweet and snuggly baby. 
As for me, life is crazy. We celebrated Thanksgiving at home with my dad and then went to my moms for a second meal for dinner. My c section incision became infected a few weeks after Stella's birth and I had to go back to my OB multiple times and take antibiotics. I had a tooth that needed a crown and then a root canal. I haven't had much time for myself and W is working on being able to take care of all three girls alone. I'm going out for the first night tonight and leaving him with all three. It's tough to feel like I always have someone with me or attached to me. I'm definitely in high demand. I love it and wouldn't change it for the world, but it can be exhausting at times. I'm hoping to find some time for yoga or some exercise for myself soon. Even though I've lost most of the weight I gained with Stella things really don't sit and look the same. The "shelf" above my c section incision looks worse having had two surgeries but I try not to focus on that. My body also gave birth to three children in two years. We get out of the house most days and L & C are currently doing soccer and gymnastics. We also go to story time at the library most weeks. We've signed up for music classes again starting in January and I'm really looking forward to that.

Life certainly is crazy and I'd love to make more time for writing and this blog. I do love that I have this space that I can come to and write whenever I want or need to though. It's nice to know it'll always be here waiting for me. Whether the people will still be waiting here to read is another story. I remind myself that I write for me and to document these days that would otherwise be forgotten in detail.