Overshadowing

I haven't talked much about Michael here. He's an amazing kid. At 3 years, 3 months I'm starting to think of him as a little kid and not as my baby or toddler any more. He's so smart and helpful. He loves to figure out how things work and always wants to help fix things. He's had the opportunity to help both his father and grandfather with plumbing and car projects and loves it. He loves to be read to and we spend at least 45 minutes a day reading. He knows all his letters, both uppercase and lowercase, and he knows a lot of the letter sounds. Just this week he's started to help me read books. We were reading a Little Bear book and he could read the words "cat", "duck", "hen", "bear", and "owl" each time they came up.

He plays with Ava now and I adore watching them play together. The sound of the two of them giggling over playing tug of war or watching them roll around wrestling just fills me with happiness and pride.

He also talks all the time. Seriously. All the time. Constantly. Even when he's alone in his room I'll hear him talking through the monitor. He's talking in full sentences and is pretty much intelligible to his family and to strangers at least 90% of the time, so my speech concerns for him have disappeared. All the talking is wonderful, except for one drawback.

He spent this past weekend with my parents. Friday night through Sunday evening we were without him and it gave us a lot of one-on-one time with Ava. It was amazing. She was a lot more active and assertive and talkative when he was gone. She was the one getting to direct the play. She was the one being listened to. She was the one getting all the attention. It made me realize exactly how much attention goes to Michael when he's around. It's so natural and easy to interact with the child that is talking to you and so easy to overlook the one who is silent.

I guess I need to find a way to let Ava take center stage more often even when her brother is home. She's a delight. She's funny and sweet and interested in everything going on around her. When she gets our attention she just blossoms. Now how to make it happen without making her brother feel left out?

Boo Boo

There’s nothing like having to explain to strangers (and her teachers, and the nurse at the ENT’s office, and your mother….) why your toddler pitifully wails, “Boo boo, boo boo” over and over again while you’re zipping up her coat.

You see, a couple of weeks ago Ava had an itchy spot that she was scratching bloody every time we put her to sleep. Usually we have her in pajamas with a separate top and bottom, but I remembered that a friend had given us some zippered footed pajamas as some hand-me-downs that would be perfect for this situation because she wouldn’t be able to get to the itchy spot. It worked perfectly. She loved the footed pajamas. They are brown with colored dots and she would point to dot after dot saying “da, da, da, da……”. She didn’t want to take them off when she woke up and wore them for about two days straight.

Then……. One day at nap time I accidentally caught a little bit of her thigh in the zipper. It hurt and she was pretty upset, but she did forgive me and went to sleep with the pajamas on. Then that night when it was time to put it on again, she was worried and expressed her concern to her daddy by saying, “boo boo, boo boo” over and over again. He reassured her that he would be really careful and he was. But then at the last second she looked down as he was pulling the last bit of zipper up and he caught her chin in the zipper. Well, it hurt and she completely lost it. She pretty much sobbed until he took her back out of it and dressed her in something else for the night.

She’s refused to put them on ever since. I left them hanging over the banister for a while and every time she passed by she’d say, “boo boo, boo boo!” I finally put them away. Well, now every time she comes near a zipper she’s afraid. Her coat is a major problem, but it’s winter. We can’t avoid the coat. She’s even afraid of being buckled into her car seat. It’s crazy how she’s overgeneralized the situation and I don’t have the slightest clue how to deal with it. I’m not using the pajamas any more, but we have to use the coat and the car seat. Anyone have suggestions?

ENT visit and next steps

Our visit to the ENT wasn’t a total disaster. Ava was pleasant to everyone as long as they weren’t sticking anything into her ears. She said, “hi”, and “bye” appropriately and adorably to everyone who went by. She also picked the ENT’s office as the time to learn the difference between calling every man “dada” and every woman “mama” and starting to call the men “man” and the women “lady.” Neither of those words is pronounced correctly, but it was still adorable to have her say “ma” (man) or “yea, yea” (lady) to categorize every person who went by.

When the doctor wanted to look in her ears she pulled a complete Dr. Jekyll / Mr. Hyde and screamed the whole time. I had to hold her head to my chest as she wailed and her whole head turned bright red. Seriously. I do not exaggerate. The child’s face looks like a cherry when she’s pitching a fit. Complete with alligator tears.

He said that her eardrums were retracted (indicating that there was probably fluid in the middle ear space) and that he’d send her down the hall to their pediatric audiologist to see what they could find out. They did tympanograms again which were still flat two weeks after the first time. (Because this involved more things entering the ear we had a repeat of the cherry head/alligator tears/restraint episode.) Then they tried to assess her hearing and even though she was fairly cooperative they weren’t able to get any more information than the last time. I really think she can’t hear the quieter noises and that’s why she won’t reliably respond to them. It’s likely that the fluid in her ears is impacting her hearing. Given that she still has fluid in her ears two weeks after the first time and that she no longer has a cold it is likely that she often has fluid in her middle ear space impacting her hearing.

So, the recommendation is to put in PE tubes. While they have her under sedation they’re going to do an ABR to assess her hearing. That way, in one day we’ll be able to fix the middle ear fluid problem and find out for sure if she can hear or not. PE (pressure equalization) tubes are tiny tubes placed in the eardrum. They allow any fluid in the middle ear space to drain out into the ear canal. They are often put in ears of children who have chronic ear infections. In our case, we’ve got a child with a documented language delay that has fluid in her middle ear space in the absence of an infection so the ENT feels PE tubes would be prudent. An ABR (automatic brainstem response) test is a hearing test that can be done while a child is asleep. It measures the brain’s responses to sound stimuli and can tell you if a child has a hearing loss when you can’t find out with a traditional hearing evaluation. So, all in one day we can address the middle ear related hearing loss and find out if she has any other hearing loss at the same time.

I hate the idea of having to put my baby under a general anesthetic. It will scare me even more as the day draws closer. But I don’t really feel like I have a choice. We need to clear up the middle ear fluid and we need to know if there’s any other hearing loss. She won’t fully benefit from her therapy until she can hear well.