Otitis Media, Bilateral Myringotomy with Tympanostomy Tubes, oh my!

Well yesterday was the big day. After two surgery dates getting rescheduled due to Ben's seizure and then due to a paperwork mishap.. the big day finally arrived. Ben was due to have his surgery at about 8:30 yesterday morning. It was a bit nerve wracking and definitely tiring for all involved.. but the short version of the story is that it went well.. he did great.. and he's feeling and hearing MUCH better now.

And now for the long version of the story:

Ben has had recurrent Otitis Media (middle ear infections) since he was about 4 months old. From when he was 4 months to now (15 months) he has had 8 ear infections, most of the bilateral (both ears) and a few of them requiring several rounds of antibiotics to clear them up -- just in time to get another cold and start the cycle right back up again.

After his ear drum perforated a few months ago, we went from being on the "wait and see" list with his ENT (Ear, Nose, Throat doc) to being on the "tubes now" list. The perforation healed quickly, but we didn't want to risk further ruptures and/or scarring.

He was scheduled for his first appointment to get the tubes on the Thursday of the week that he had his seizure (a monday).. so we got bumped. Then, a month later, we got bumped again because his neurologist and ENT hadn't gotten the correct clearance paperwork clearing him for surgery given the seizure (they usually wait 6 months after a febrile seizure before putting a child under anesthesia.. but they believed that his ear infections factored into the seizure.. so there was no waiting and his neurologist was fine with this.)

True to form.. shortly after we were bumped from our March 6 surgery date, Ben came down with his 8th double ear infection. After a round of Amox (pink stuff), he started having some strange episodes (this started last weekend-ish). He would occasionally roll his eyes back. There were also a few times that he shivered when it wasn't cold or anything. We called his pediatrician and did some googling while waiting for the doctor to get back to us and he confirmed that the ocular (eye) episodes and shivering could be related to his ear infection, but that they also could be pre-seizure events. Sooooo.. we started a log of the "episodes" and also changed his antibiotic. This was Monday of this week.

On Tuesday he had somewhere around 20 episodes that we saw between daycare and him being at home.

On Wednesday he had 5. This hinted that the Augmentin (antibiotic #2) was working and indeed maybe the episodes were related to his ears.

We finally made it to the big day. A bilateral myringotomy with the insertion of tympanostomy tubes. sounds impressive. Basically it's a procedure that's performed about 20 million times a year (i'm guesstimating) and is as routine as it gets, aside from the fact that anesthesia is required, which you try to avoid with kids when possible.

6:30AM - Heading to the hospital. Ben's sleeping soundly after being awake from 3am until 5am. Moms are TIRED. We had to check in at the hospital at 7am for his 8:30 surgery time.



Filling out paperwork in the waiting room. Some of the questions are silly. "How many alcoholic beverages do you drink per week?", "Are you a recovering smoker?" Aside from his name and our names.. we didn't have much to add.



Got the gown on and some stickers and some toys. At this point we were just waiting our turn. They took Ben's temp a few times (all normal) and we talked to his ENT, who would perform the surgery, and the anesthesiologist. They were concerned about the seizure issue and decided that he would be the star patient for the day and we got extra attention both before, during and most importantly, right after the surgery. Usually they book ear tube patients out the door as soon as the child wakes up and takes a sip of apple juice since the procedure is so straightforward and unrisky. Given Ben's history, they opted to keep him hooked up to monitors for about an hour and then observed him while he came around more and had some food and apple juice. Overall we were there for about 2 to 2.5 hours after the surgery.





When it was time for Ben to go to the operating room, I went with him and was able to hold him while they put the gas mask on him to knock him out. It was difficult, but at the same time.. it was "nothing" after seeing the seizure ordeal. At least this time I knew that this was completely controlled and he would be in very capable hands. After he was asleep, they showed me back to the waiting room where Shiela was waiting for me. I had enough time to sit down, put my arm on the back of her chair, breathe, and notice the pit in my stomach from "mom-worry" and then the ENT was walking in to tell us that it was over. The whole procedure must have taken less than 5 minutes. I knew that they had already started before I was out of the OR because they wanted to keep him knocked out for as short a period of time as possible.

The ENT gave us the full rundown.. he did great.. he was fine.. he was still snoozing but would be waking up soon and they would come get us very soon but not to worry because they were taking extra precautions with him and it may take a bit longer than normal to come get us. Just as she finished saying that, a nurse came out and waved us in.. he woke up and was NOT happy with the nurses.. The nurse that was in charge of his observation handed him to me and said to shiela "wow.. he's a big and STRONG boy".

I sat in a reclinable wheelchair with him on my chest and he settled down and fell asleep for close to an hour. As former NICU inhabitants, it was reassuring to have him hooked to the monitors.. too bad we can't bring those home with us!

Once he woke up he had some apple juice and they moved us over to a brighter area for him to continue coming around and to have a snack and some further observation before we were discharged.

Here is a pic of him wanting to get down and explore.. while waiting for more apple juice and some Cheerios. This is pure temper.. not to be mistaken for fear/anxiety/pain/etc.



Still a bit groggy.. with bed hair



Feeling better -- eating cheerios and flirting with all the nurses just before getting to go home.



After we got home.. we gave him some lunch and he went right down for a 2+ hour nap. We both crashed as well. When he woke up.. he was incredible.. he was hearing so much better and was happier than we've seen him in lord knows how long. The relief of having his ears drained and the pressure released much have been incredible. He laughed and played and was just in an incredible mood.