Sigh. Holy anticlimax, Batman.
The long-awaited ENT appointment was this morning. This is how I just summarized it for E.G.:
One thing that I find infuriating in general -- it's not just them -- is when you have to tell your story to waves of people, and the next wave seems to have no idea what you've already said. This time it was a nurse, who just took the story, then I think a resident, who asked all the same questions again and then looked at sozlet's ears, then an actual Dr., who looked at sozlet's ears, got some wax out, and started to make pronouncements that made it clear that she didn't know what I'd already told the previous two (and she didn't ask.)
The end of the appointment was kind of a blur, I'll follow up. It went like this:
The doctor asked if sozlet had had any ear infections since the last appointment, I said no, she asked again (quite skeptically I might add), I said no, she took a look, said there was too much wax (while I have complaints, she handled everything with sozlet well, was gentle etc.), got some wax out of sozlet's ear, looked, said there was some fluid in the middle ear, started to say something about the hearing test, was moving on to something else when I said wait, you know that sozlet has a cold now..? she said oh OK (one of those things I'd told the other people), asked me how much sozlet weighed, I said I don't know, she said OK she'd have a nurse come in and weigh her, then we can make an appointment for 4 weeks from now, then on her way out the door said something about a prescription, I stopped her and said wait, prescription? for what? She said oh antibiotics to get the fluid out of her ear, I said um I'd prefer not actually (thinking this would start some sort of explanation of why the doc thought it was necessary/ what was up), she said oh no problem that's fine, then smiled and left. I was left knowing that I hadn't gotten all the answers I'd wanted but confused, needed to tend to sozlet, needed to make the appointment, etc. It was one of those situations where the interpreter added just enough lag time that I wasn't able to break in the way I wanted to and clarify, and things just kind of kept going boom boom boom and while I grabbed the antibiotic part and the sozlet has a cold now part I let a lot more go by, like:
- She doesn't have an ear infection now, does she?
- Does she have a sinus infection?
- The message I clearly received was that the antibiotic prescription was to get the fluid out of the ear -- that doesn't make sense. What about decongestant? (I'm open to antibiotic if necessary, that just didn't make sense. And the doctor conceded that quickly, didn't press at all.)
- Is the tubes situation resolved, since she hasn't had a new ear infection and doesn't now, and we're coming back just for the hearing test? Why ARE we coming back in 4 weeks?
The doctor was of a type I can't stand -- in a huge hurry, never asked me if I had any questions, never explained what she was about to do, never explained reasoning, never wrapped up, (nothing like, "OK, then go ahead and make the appointment and I'll see you in four weeks!") just issued orders and slipped out before the interpreter was finished interpreting her last sentence. She was good with sozlet, though, talked her through getting the wax out which sozlet doesn't like, so that's something. I'd hoped that this would be resolved by now, though, and it doesn't seem to be.
Ugh. I absolutely hate that. I absolutely hate the routine where you have to repeat your story from one person to the next because they don't talk to each other. What's the point of telling the first two people if they aren't going to tell the third?
If it were me, and this isn't necessarily a recommendation, I'd consider the tube question resolved. And by resolved I mean that she shouldn't get them. This is one of those things I hate about medical practice in general, and I'm afraid it's why I never go to the doctor myself.
But hooray for the sozlet! It sounds like she's doing a lot better even though she has a cold. What is it, 3 more weeks until spring? I am so looking forward to that.
Wow, what an ordeal to go through only to have so many questions unresolved.
I'm with you on that Dr. The assumption is that the fluid is a result of an infection. I've had pediatricians from the same group take different positions on whether to treat the presense of fluid with antibiotics, decongestants, or nothing at all. The one I liked best was the one who said he preferred not prescribing antibiotics to a low grade infection that could probably heal itself. His preference was not to over medicate but that if a fever or significant pain should ensue to call back in and he'd write the scrip. I've also had them write one out but suggest not filling it unless things didn't improve. The pitfall to avoid is starting to take antibiotics and then stopping part way through the course.
How is Sozlet's temp?
No temp at all. Very snotty, but no temp.
I really don't think it's an ear infection, assume the fluid build-up is just part of the general mucosity. She might have a sinus infection, though.
Her hearing is pretty good. I did notice that in the last couple of days it was down a notch from perfect, but still quite good.
It's soooooooooooooooooo frustrating because she's had this glorious utterly clear nose for most of these two months, and then whammo at -- well, not the worst possible time, because whatever it is it's not an ear infection, and THAT would be lousy timing. But wish I could show them her glorious utterly clear nose (and presumably glorious utterly clear ears).
I agree with you on which approach you liked best, J_B.
And totally agree with you, FreeDuck. I've had some good physicians, I know they're out there, some outstanding ones, but seems like there's an awful lot of clunkers along the way. Grrrrrrrrrr...
Thanks for the sympathy, I'm way frustrated and this helps.
I sent an email to the hospital's general contact asking how to best contact the doctor for follow-up questions. (I called the number listed about 20 times -- well, relay person hit redial about that often -- but steadily busy.)
If it's just, tube thing is resolved and the doc wants sozlet to come back when the fluid is gone to see what's up with her hearing, fine, cool, no problem. I'm not actually concerned about her hearing -- there has been pretty clear cause and effect, and her speech development hasn't suffered at all (as if!). (Interpreter today said that the way sozlet talks reminds her of the girl from "Miracle on 34th Street" -- very mature and composed.)
is getting a 2nd opinion a possibility?
Maddening.
Is one of the history-taking people in the ENT office a paraprofessional who is supposed to explain things that the doctor is too busy to explain?
Given the family history and the Sozelet's talent for ear infections, have you considered finding a new doctor?
Any chance that E.G. could make the next appointment? I might be drummed out of the Feminist League, but doctors are much more chatty with fathers than with mothers.
At least the Sozelet behaved herself with dignity and old-fashioned decorum. You had more than enough Misbehavior By Professionals to deal with today.
Hold your dominion.
Is there a reason she didn't recommend decongestant? A little Dimetapp might be just the ticket.
Soz, as usual, delighted and amazed! We have to keep up hearing about this child and know how she is when she is 20, 30, 40... I should live so long. LOL
Yeah, I dunno why she didn't. That's one of my questions.
The good news is that I've been busy and was given the email for the "Clinical Leader of the Ear, Nose and Throat Clinic" and told that she had sozlet's chart and to go ahead and ask her any questions I had. I did, no answer yet, but I only sent it a couple of hours ago + it's probably past their office hours. Hope to get some answers tomorrow.
I'm happy with the response I've been getting so far (maybe 5 emails exchanged to get to this point). I've been super nice, but I think it was also clear I was not amused.
Dogged does it. Endurance is an under-appreciated virtue.
Question unrelated to ears:
Do you think that the Sozelet's signing has given her a leg up in the manual coordination department?
Back in the '40's at least 3/4 of the girls in my Grade School classes "took" piano. Most of them seemed more competent in craft work in the elementary years than those of us who had no musical talent. They also had an edge in sewing and typing.
I think that signing from such a young age would work wonders in developing deft fingers.
Oh, that was to Swimpy, actually. :-)
You know, when I think about 20 years from now, if this site still exists, I worry about her being mortified -- maybe I'll delete everything when she's say 7? 10?
A random-ish thought in the midst of this, nimh's story about the game he created with his nephew reminded me but I never got it down, all the games we have that I have tired of long, long, LONG before she does.
An example is "Milk." "Let's play Milk!" rings out, oh, several times a day. I have no idea when or why I started Milk, but it is a game where I go grocery shopping, and the teddy bear is a loaf of bread, the green frog is a bunch of grapes, and she... is a carton of milk. She sits still while I lug her hither and yon. First I take her off the shelf and put her in the cart. Then I put her on the check out counter. Then I turn into the check out person for a minute and scan her. Then I go back and forth between being me and check out person and pay. Then she's put in a bag with all the other groceries. Then she's put in the trunk. Then I drive home. Then I take out the groceries and put them away. Then I decide I'm thirsty after all of that, take out the milk, unscrew the cap, pour myself a tall glass (she's upside-down at this point), and drink it.
The end.
It's really not that exciting.
But she NEVER EVER EVER tires of it, and I tired of it about 1,852 times ago. I try to introduce variety, but no, it has to be exactly the same way every time.
There are about 10 of these games in steady rotation. (She just had a bath and I'm afraid a new one was just created. Had to do with an underwater zoo.) (Which by the way I think is a cool idea -- hers. It's a giant tank with friendly fish -- think coral reef -- NO SHARKS [her emphasis] -- and people go snorkeling. Don't you think that would be a hit in the landlocked midwest?)
And behind again...
Could be. Fine motor skills. What's interesting is that the part of the brain involved in ASL is the language part and not the fine motor part -- that is, when someone is learning ASL, it's the fine motor part, and when they make the switch to fluency, it's the language part.
I'm full of unrequited Ph.D theses, and one is why interpreters get carpal tunnel syndrome but native ASL speakers, who sign as much or more, do not.
That carpal tunnel snippet is fascinating.
Just now, she told me that her doll Pinky was sick, and I should be Pinky's mama and she, sozlet, would be the doctor. (This is a frequent game, from before she was sick with any regularity.) She asked, "So why did you bring your daughter in today?", and I said, "Um, she has a upset tummy." She nodded sagely and started to examine Pinky. This included x-rays -- she created the x-ray in secret, just asking me how to spell certain words before getting back to her work. Then when she was finished, she presented me with this:
http://img158.exs.cx/my.php?loc=img158&image=pinkysmaller7at.jpg
(Couldn't figure out how to resize the image and it's too big to post here -- I'm really missing my Adobe PhotoDeluxe software, but anyway...)
The legend if you can't read it is: "PINKY HAD TOO MUCH CHOCOLATE." She has chocolate in her hand and also in her tummy.
I asked sozlet why Pinky had a smile on her face if she had too much chocolate, and she shrugged and said "she's a doll -- she always has a happy face on."
Interesting report in the BBC (posted by Stradee on rainforest thread) about lack of a relationship between language and understanding that has implications for dementia, aphasis, and animals. Sorry I don't have the link.
Great pic, Soz. I'd have a smile on my face if I ate too much chocolate too!
too....much....chocolate....???????
(non sequitur)
Wow! How old is the sozlet?
Nice xray and a story to go with it.
