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.