December
2007
Hearing Test0
All babies get a hearing screen before they leave the ICN. As I understand it, the screen works by sending soundwaves into the ears and sensors measure if there’s a response or not. It does not actually measure hearing, but a “pass” indicates that the measured response was great enough that there are unlikely to be hearing problems. A “refer” means a more detailed test is required.
Of course, Dorrie never likes to do anything the same way as everyone else, so instead of kicking back a pass OR a refer, the three times they tried to run the screen on her, it just ran and ran and never came up with an answer at all.
And so began the audiology saga. The ICN called audiology to try and schedule an appointment for her to have an actual hearing test, since the screen would not work. They were told audiology was fully booked and the test would be scheduled for some time in February. I said this was not acceptable — if there’s a problem, we need to know now, not in February, so intervention can begin.
So they went back to try and make the appointment sooner and ran into some sort of a bureaucratic brick wall — Dorrie did not have a “refer” result, so she could not get an appointment period. Argh! After asking about this at rounds for five or six days and seeing that the usual suspects were getting nowhere, I hit upon an idea: screw the proper channels. I came in the next day determined to have the nurse page the unit’s PT, but was pleasantly surprised to find her already at Dorrie’s bedspace, apparently having heard the whole ridiculous story and wanting to talk to me herself.
The next day, she had Dorrie an appointment with audiology.
We managed to get in earlier than that, though, due to snow related cancellations. After some debate as to whether or not she was allowed to go at all — the room in audiology is just a regular office and does not have suction or oxygen in the wall like the hospital rooms — Dorrie and her entourage (respiratory tech, nurse, mom, transport) headed off. We got down there to find that the door, normal sized, would not admit her transport bed.
Some maneuvering got us in through the door, but that was where Dorrie’s cooperation ended. She had slept peacefully on the way down, but as soon as they started sticking things in her ears she was having none of it. She was hungry and she was annoyed and she would not calm down unless she had her pacifier. Which, along with her normal snotty breathing, was far too loud for the test to show useful information.
From there, the only options were to somehow get into the Pain Free Clinic for a sedated test, or wait until she was older and perhaps would tolerate the regular test better. Since early intervention is the key, we naturally didn’t want to wait however many months it might take for her to be ready to sleep through it on her own. Pain Free it was, and fortunately it didn’t take very long before there was another snowstorm to create an open space for Dorrie.
The sedated test itself went okay right up until they were nearly done, at which point Dorrie decided she was tired of the sedation and would stop moving air properly. Because she never actually stopped breathing as far as I could tell, I don’t think I would call this the same as one of her little “episodes”, but the result was very similar: major desat, bradycardia. She only got pale, though, not blue, so I’m not sure I believe the numbers as they displayed. I also can’t say I was thrilled with how anesthesia dealt with the problem, but they eventually got the job done, and I’m sure that interfering would have been the wrong thing to do — at least as it went. If it had gone on much longer it would have been another story.
For all that, though, the results of the test were… inconclusive. Sigh.
At least this time we know that the test was done and the lack of a reading is the fault of her ears, not her breathing or some outside interference. The only problem is that we don’t know why the test didn’t give a good reading. It could be indicative of a hearing loss (but they couldn’t get a good enough signal to test for that), it could mean she has a hearing disorder (auditory dyslexia?), or it could just mean she has middle ear issues, such as fluid. Or any combination of the previous. But we won’t know what the answer is until she gets an ENT consult re: fluid and is retested in a few months so we can see if the disorder observed has resolved itself or persisted.
In the meantime, we’ll have to operate on the assumption that everything might be true.