Nate's ENT Appointment

Yesterday, Nate had his long-awaited appointment with the ENT (Ear Nose Throat specialist, also known as an Otolaryngologist).  I initially asked for a referral to check out his adenoids, as after some research we wondered if they could be involved with his speech delay, although other indications of enlarged adenoids didn't seem to be present (mouth breathing, snoring, etc).  Since the results from his hearing test in mid-December we were also wondering how his hearing came into play with all this, and if he would need to have tubes put in.  He hasn't been treated for repeated ear infections (once or twice I believe), which seems to be the main reason for tubes, so I didn't know if that would even be under consideration at the appointment yesterday.
The doctor listened carefully to the different things we've noticed, right from his disinterest in drinking as an infant, to his persistant coughing, to his speech delay and his recent hearing test.  There is a family history on Daddy's side of chronic ear infections and a requirement for tube insertion as well, which she said could definitely be a genetic condition.  She took a look at his ears, both of which were still filled with fluid, and one of which was bulging and had an active ear infection.  Apparently some kids have a high tolerance for ear infections, and if they don't complain specifically about their ears it's hard to tell if they have an infection at all.  She sent us upstairs to have an X-ray done to check out his adenoids.
X-rays on toddlers are no fun when Mommy is pregnant and not allowed to be in the room!  The poor kid was quite traumatized by the ordeal but they managed to get a useable picture which we took back downstairs to the ENT office.  It seems that his adenoids are indeed enlarged, and his nasal passages are constricted.  These would both prevent his eustachian tubes from draining properly, causing fluid buildup, hearing loss, and ear infections.  It also could contribute to a post-nasal drip, which is what the respirologist suggested in June when we were investigating his persistant coughing.  His tonsils are also quite large further down his throat, which the ENT was surprised by because they seemed fairly normal from her first visual inspection.  She definitely thought this would have hampered his swallowing ability as an infant, but since they don't seem to be affecting his eating or drinking now anymore, we'll just leave them alone for now.  What she did suggest was to remove the adenoids, cauterize some of the enlarged turbinates, and to put tubes in both his ears to help with fluid drainage.  My head was spinning when we left the office, antibiotic prescription in hand for the current ear infection.  After talking it over with Mike, we booked the surgery for mid-February.  He'll be admitted overnight at the General, and all three procedures can be done at the same time.  It all sounds a little scary and weird to book your child for surgery when he seems relatively healthy and happy.  However, all the puzzle pieces seem to fit together, and this solution makes sense.  After doing a lot of reading and talking with other parents who have been in similar situations, we're pretty confident that this is the right thing to do for our little guy, and we're looking forward to seeing how this is going to help him in his development.  We'll keep you posted on how things are going, and certainly ask for your prayers as the procedure comes closer.