ABR

Eli had his ABR today. It was an experience to be sure…we got there first thing at 7am. I had woken Eli up at 3 am for a dream feed because he couldn’t have any food 4 hours prior to testing.
I withheld his medicines because of this. Once we arrived at TCH, the nurse was concerned his stuffiness may affect the testing or that we would have to reschedule all together. To determine how well he was breathing, she hooked him up to a machine that measured the oxygen levels in his body. All his saturation levels were high, sometimes reaching 100 which is the best it can be. This was a huge relief for me because I had been wondering how good his oxygen saturation levels were at night when he sleeps (besides showing some signs of obstructed sleep apnea, his stuffiness can be pretty bad).
So he was able to continue with testing despite his nose.

Eli took the oral sedative just fine and slept fairly well for the test. He woke up twice so the testing had to end sooner than planned but they got the majority of it done.
It wasn’t incredibly difficult to see him all hooked up but it did tug at my heart. I knew he wasn’t in any pain and I knew the sensors weren’t hurting him.20121030-153909.jpgBut he looked so tiny and vulnerable laying in that sterile crib with sensors on his head and body. Poor tiny man!
The part of the test that was incomplete was one level of sound on the right ear and then the diagnostic evaluation- meaning the cause of any hearing loss (fluid on the ears or a processing issues).
When we finished up the audiologist summed it up like this: Eli has mild to moderate hearing loss in his left ear and mild hearing loss in his right ear. His right ear has more of a loss than his left. He has fluid in his ears and stiff eardrums. We should look into getting him fitted for hearing aides and get the second part of the test immediately.

This is when my heart sank. Hearing aides? Really? Before we even have tubes? Will he regain any hearing? Whats the typical range for hearing? Keep seeing cleft palette- is this related to his split uvula? Can we do tubes sooner rather than later? From what you can tell is this primarily caused by fluid? If he would have had his decongestant would that have improved the results?

Lots of questions. So I called his ENT and I’m hoping she can shed some light on the report.
I also called his pedi to discuss the results. I read the results to his PA for some interpretation.

The results:
“Auditory brainstem response audiometry shows well formed and repeatable responses to air conducted click stimuli. For the right ear, the absolute latencies of waves I and III are delayed and wave V is within normal limits. For the left ear, wave I is delayed and waves III and V are within normal limits. All interweave intervals are within normal limits for both ears. Repeatable responses were observed to 50 dBnHL for the right ear and 40 dBnHL for the left ear for the air conducted clicks. Repeatable responses for air conducted tone bursts were observed down to the following intensity levels:
Right ear: 60 dBnHL for 500 Hz, 50 dBnHL for 2000 Hz
Left ear: 60 dBnHL for 500 Hz, 40 dBnHL for 2000 Hz, and 60 dBnHL for 4000 Hz.
Bone conduction testing could not be carried out due to Eli awakening upon placement of the bone oscillator.

Acoustic immutable measures were carried out using 1000 Hz probe tone. The tympanograms are flat for both ears and uncrossed acoustic reflexes are absent, consistent with a significant increase in stiffness for both middle ear mechanisms.

Impression: today’s results predict a moderate hearing loss for the right ear for at least the 500 Hz to 2000 Hz frequency range and a mild to moderate hearing loss for the left ear. The presence of bilateral middle ear disorderindicates that the hearing loss is at least partially conductive for both ears.

Recommendations: reevaluate by an ABR test with anxiolysis to extend today’s findings.”

She said her grandson had similar results for his ABR and later the fluid resolved on its own. But Eli’s small ears may make it impossible for his fluid to resolve on its own.
She explained that to her it sounds like the audiologist believes it to be fluid on the ears and is giving the worst case scenario of hearing aides. She also pointed out that he CAN hear. The report indicated that very clearly.

Your interpretation?

So there was some good news! And once we get an action plan with his ENT along with the remaining ABR testing completed we will have a better idea of what to do next.
It’s hard though, because I want to fix it now. I want his ears to be big enough for tubes and his hearing to be cleared up now. I don’t want him to have any additional struggles. And I don’t want to wait.
He can hear. He vocalizes very well. That’s what I have to remind myself of in the meantime.

The sedative has made him cranky, sleepy and clingy. I’m completely run down from being up at 3 and again at 5:30 and driving all over Houston. -_-
But I’m enjoying snuggling my little man on the couch.
Thanks to everyone for your thoughts and prayers. I will continue to keep you updated. 🙂

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4 Replies to “ABR”

  1. Ashley,

    Thinking of you guys. On a side note, I know two little guys with DS that have hearing aids. They are doing fabulous right now. I know its just something MORE to worry about. Like you don’t have enough to worry about, right? One little guy is Riley. You can check out his moms blog here http://hurricaneriley.blogspot.com/. She even has some videos of him reading his books. He’s in Kindergarten now. It’s just another step but he’ll do great no matter what!! Hugs.

    1. Thanks for the support. I’m going right now to check it out! 🙂
      I think once I wrap my brain around it all I will feel better. We’ve been doing so well so it feels like we got knocked down a bit. But we will do this just as awesome as we do the rest. 🙂
      It’s like when you think your kiddo is doing awesome and then you set them next to a typical peer of the same age- you start to see the differences. It’s not bad- it lights a fire under us to work harder and appreciate what we have more. 😉

  2. Sorry the results weren’t more encouraging. My little boy is 6 with Down syndrome, and although the pediatrician and ENT have both commented repeatedly that his ear canals are teeny tiny, he has not had a problem with fluid. I think your question is a good one – would the results be different if the fluid issue was resolved. If you can avoid exposing that sweet boy to rooms full of children (day care and even Sunday nursery), you might be able to stave off the kinds of viruses that result in ear infections and resulting fluctuating hearing loss. I know it sounds drastic, but I think for some kids it makes a big difference. You can always socialize in a more private setting.

    We’ll be praying for you guys.

    Blessings,
    Alyson in Texas

    1. Thanks girl. 🙂
      He’s taken care of by family and by an at home day care that has 3 other kiddos. So he is exposed a bit but not as much as he could be.
      We will try the ABR again with his medicine and again after the tubes. (Kind of think they will be a common thing in our life!)
      Thanks for the encouragement. 🙂

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