Hearing Aids, NYU, Dr. Citron

We finally got the hearing aids. We got them on Wednesday the 11th. He didn't seem to have any notable response to anything with them in. There is a lot to the care and testing of the hearing aids. I had a lesson on everything when we picked them up.

On Thursday and Friday last week we went to NYU. We had three appointments. Two of them were to test Jack's hearing in the booth. They put us in a sound proof booth and put a small ear phone like device in Jack's ears. Then they send sound through them to see if he responds. If they think he does they make a stuffed monkey light up and play the cymbols.

They felt he responded to certain sounds in his left ear at about 75 dB. He only responded at certain frequencies. Personally, I really didn't note him to be responding all that much.If he moved his head or turned at all they were saying he was responding. He is a pretty antsy guy so it is really hard to tell why he is moving. Hearing at 75 dB is still a pretty profound hearing loss and he still qualifies for cochlear implants, but it is a lot different than the results of the auditory brainstem response (ABR) tests that he had at LIJ.

The audiologist told me that his hearing may be a bit better than it was when he was previously tested. If that is the case, his hearing aids are programmed wrong. She said that they could be hurting his ears and they may need to be reprogrammed. So I took them off him. She asked me if I wanted Jack to have another ABR at NYU. I told her that I do. The ABR is objective and the behavioral booth is very subjective. I don't want to damage any residual hearing he may have by using hearing aids that are programmed wrong.

The next day he had the same test for his right ear. He was a little irritable and the test was coming out all over the place. His right ear has auditory neuropathy and that means he doen't process sound even if he hears it. He did not test well with that ear.

Jack was also evaluated by a speech therapist. She was listening to his babbling and counting the different types of sounds he makes. She told me his cry sounds immature and she thinks he may have some vocal cord damage. He will need to be evaluated for that. It seems like we hear bad news at all of these appointments and I find it pretty frustrating.

We go back to NYU this Thursday for two more appointments. I am going to try to take the train this time. It was pretty tough driving in there and I was forced to park in a garage costing $37. I think it might be cheaper and easier to take the train even though it will be rush hour. We will see.

On Sunday we had my Dad so Betty could go to a baby shower. He is getting pretty bad and it was hard dealing with him. Julianna was very helpful and she is pretty understanding about Pop-Pop's brain disease. It was nice to be able to give Betty a bit of a break.

I had an appointment with Dr. Marc Citron my medical oncologist. He took blood and sent me for a chest x-ray. He did an exam and said he thinks everything looks normal. He also told me that I am now in the time where I have the greatest risk of recurrence. Once this year passes my chance of recurrence will start dropping dramatically. It can be pretty stressful to think about so I try not to.

Julianna is enjoying school and her activities. She has violin, ice skating, dance and arts and crafts. I am trying to find a place for swimming lessons that is a little closer to home than our last place. Jack i s happy and is proud of his two new teeth. We are all enjoying fall and having a good time!

Hearing Aid Molds

Jack had an appointment yesterday for his hearing aid molds. It was at the LIJ Hearing and Speech Center. He was very cooperative. They put a silly putty like substance in his ear and then wait about 5 minutes for it to harden. They did this for each ear.

We also had to pick out the color of his hearing aids. I decided on a metallic blue and black. They had what the called "flesh color", but it was not the color of Jack's flesh, so I decided against it. Even the Crayola crayon company has gotten rid of their "flesh" color crayon since it was not the color of a lot of people's flesh.

The molds will now go to a lab where they will make the part of the hearing aid that goes into his ear. The woman told me that they like to get a very tight fit or else everyone (except Jack) will hear a whistling noise coming from the hearing aid. We will go back in two weeks to pick them up.

The hearing aids are covered by Early Intervention which is great because they cost $1750 each. We were originally told we would get loaner hearing aids since we are hoping Jack will get cochlear implants and then he won't need the hearing aids anymore. I asked about this and the woman said he was already approved so we should just get them. She also said they didn't currently have any loaner hearing aids. I don't have to personally pay for them but it does seem a waste of money. She said I could bring them back when he is finished with them. I think I will find someone who needs them myself and send them to them. So, if you are reading this and need hearing aids for your child contact me and I will get them to you when I can.

I asked her if she thought the hearing aids will help Jack hear. She said Jack's hearing loss was beyond the limitations of their testing equipment. She said it was unlikely they will help him hear but you never know. They have two purposes other than helping him hear. One is to stimulate his auditory nerve and the other is to prove that he can't he helped by hearing aids so that the medical insurance will pay for his cochlear implants.

I hope they help him but I am having visions of them making a high pitch noise, the dog howling and everyone freaking out. Jack is able to ignore all the chaos but no one else is. Should be interesting.

Even though I am very aware that Jack is deaf, (or to be politically correct, I should say he has profound hearing loss) it is still a killer to hear them say, "his hearing loss is beyond the limits of our testing equipment." Julianna has no problem accepting it and Jack has no idea that anything could be different, but it still sometimes gets to me. I am not sure I will ever get to the place where it is no big deal.

Jack has been having some issues with his physical therapy. His therapist said she thinks he needs a helmet for his torticollis. I was really hoping to avoid it. He made great strides with therapy at the beginning. The therapy still seems to be helping him, but it is going a lot slower than the physical therapist would like. She said it will get harder and harder to correct as he gets bigger so we should do everything possible now. The helmet is weighted so it will force him to tilt his head to the left instead of always to the right, which is what he is doing now. He can turn his head to the left now. At first he couldn't go to the middle or the left. It seemed like his head was fused so he was turning all the way to the right. He has made a lot of progress and he can now go to the middle or the left, but he generally prefers to have his head turned to the right.

I asked the therapist if the helmet covers the ears. She said it does. I asked her how that would work with hearing aids or the cochlear implants. She said she didn't know since it had never come up before. She said they want the babies to wear the helmets 23 hours a day. I asked her how it would work if he wore his hearing aids or cochlear implants (when he gets them) in the day time and the helmet at night. She said she wasn't sure about it but she would find out. I really like his physical therapist. She has a former preemie herself, a 24 weeker, so she gets it. Her daughter had a bunch of issues but she is doing better now, although she still has significant visual impairment from having retinopathy of prematurity. She lives in Wantagh School District as well and said they are really great with special needs kids and offer a lot of services. That is good to know since it looks like we will be needing a lot.

Jack is still working on general body movement. He is still not rolling over at almost 9 months old (5 1/2 adjusted). My friend's baby is 2 1/2 months old and rolling over. All the babies in his class are sitting up. I know you aren't supposed to compare but it is tough not to. I can't help but wonder if we will ever get to the point where he is walking. He can bear weight on his legs and that is a good sign, so I hope we get there. It took him forever just to have head control, but it looks like he has that down now. I take some comfort in knowing that Julianna was very behind and eventually caught up. She was only 6 weeks early but she was many months behind in just about everything. No one would ever know that now. I hope Jack follows in her footsteps!

We still have physical therapy twice a week, speech therapy once a week and cranio-sacral therapy once a week. I do exercises with Jack constantly. I am hoping it all works. He is so happy and he laughs through all the exercises. Sometimes it hurts him and he gets mad but most of the time he is smiling and laughing. He just loves Julianna and he is happiest when he sees her. I try to get her to sit on his left side so he is forced to turn that way to see her.

Jack has a sedated CT scan on Monday. The scan is to check his inner ears and to see how thick his temporal bone is. It has to be a certain thickness in order to anchor the cochlear implant. Sometimes babies do not have a thick enough bone and the surgery has to wait until they are older. They are also going to check to make sure all his inner ear structures are present. He has an appointment with his doctor tomorrow to be cleared for the sedation.

On Tuesday night I went to the Jimmy Buffet concert at Jones Beach. While I was there I remembered the last time I saw him, four years ago. On that day I was told by a doctor that the hormone status of my cancer was the worst case scenario ( I later learned that was untrue due to herceptin) and it was an 8 out of 9 on the scale of how aggressive a tumor can be (Bloom-Richardson scale). http://maryellenandjulianna.blogspot.com/2009/08/tumor-hormone-status.html I made me think about how things often turn out a lot better than we think they will. I made it through that. Jack made it through his 106 day NICU stay where I heard over and over how he might not make it. Julianna made it through her early issues.  Maybe I will be able to bring them with me in a few years and they will BOTH be able to sing along. How cool would that be?