CT scan today

As we try to figure out the next steps to take to deal with Wynn's re-emergent hearing loss, we figured it would be good to know what's going on inside her ears. We couldn't get a scan appointment on the same day as our office appointment, but we were able to get in at Children's Hospital pretty quickly. Within 15 minutes of check-in, Wynn was already set up for the scan as you see here.

Same machine she was scanned in several years ago, as I recall. I stayed here next to her. The hardest part for her was not being able to look around & satisfy her curiosity, especially with a big piece of SCIENCE all around her.  The scan was over in 5 minutes & we were able to get her to school before lunchtime.

Postscript - it took our ENT clinic longer than usual to get back to us due to staff absences (but we know bad news will find you immediately so we weren't worried) - all her inner-ear bones and organs are exactly where they should be and appear to be in fine working order.

With this information, we have decided to re-construct her right eardrum again - we could not get a date during Winter Break; the earliest date was at the end of January. It will be an outpatient procedure, but will take a good 3 hours (about twice as long as the last reconstruction.)

Wynn isn't happy about the prospect of another surgery - she can't hide her disappointment - but the hearing loss is really noticeable now and needs to be taken care of (and she knows that in her head, but it's OK for her heart to be sad...)

Hearing Aids no more!

Had a follow-up visit with Wynn's ear surgeon and audiologist this morning. Her right ear is fully functional! The operation earlier this summer was a complete success.

Wynn hasn't been using the hearing aids for several months now, so we returned them so that the Lions' Club can use them to help other kids.

Got to keep her ear molds though!

Eardrum Reconstruction Surgery

Yesterday Wynn had reconstructive surgery done on her right eardrum.

Think of an eardrum like a sandwich. The bread would be the layers of skin tissue facing out to the air and in toward the little bones that transmit sound to the inner ear's nerve center. The middle of the sandwich is a structural layer that still flexes but has to be strong enough to carry the inner and outer layers.

This year's exams showed that - for both ears - the middle structural layer had lost its bloodflow a long time ago due to infection - probably when Wynn was just a baby - and that layer has become brittle and calcified. No wonder it had holes, and no wonder why 2011's operation (more of a "patch job" on her left side) didn't succeed.

The operation this time was more extensive than the 2011 procedure; essentially what was done yesterday was a total re-build of her right-side eardrum. They took a small sheet of muscle tissue from behind her right ear to use as the structural layer, pulled back the healthy pieces of what was left of the inner and outer "bread" layers, cleared away the calcified structural tissue, tied in the 'donor' muscle tissue, and layered the "bread" layers onto the new structural base.

Wynn was in the O.R. for three hours, exactly as scheduled. In all, we left our house at 9:45 am and got back home at 7 pm. 

The surgeon was very happy with how everything went; there were no complications and she had no issues with anesthesia. Both Ann and I were in the recovery room as she woke up, and she was in much better spirits than she was after last year's pharangeal flap operation.

She was a little barfy last night, mostly due to mucus in her belly (now that spring has finally come to Minnesota, the pollen is thick ... and she gets the hayfever...).  But she slept well through the night and had a good breakfast and lunch so far today. (It's just after 3 pm & she's asking how soon dinner will happen!)

Photo time:

The hospital pajamas were absurdly large.  She decided to wear the bottoms as a pantsuit.

In the recovery room - once awake she was ready for popsicles!  She downed two in the fastest time I'd ever seen...

After the rush of adrenaline from coming up out of surgery, she was really tired. She took a nice nap in the post-op room. (I nodded off a little bit myself while Ann went across the street to the hospital cafeteria for dinner.)

If they offer you a wagon ride to the car, and you're still pretty tired, you take it!  Nibbler got to stay with her through the entire operation; what a brave little plushie. (He helped Ann through her operations too back in 2001!)

Hearing Aid Calibration check-up

Wynn had her hearing aids checked this morning - everything is working as intended. No additional work on the devices is needed.

She's really had no issues with the hearing aids - no stigma she's talked about from school, and she's been very responsible about cleaning them & changing batteries when needed. It's just another piece of technology to her, like her uncle's iPad or my eyeglasses...

Now Hear This!

Wynn's now using hearing aids - the molds are her own choice of colors (red, yellow, and orange mixed together.) The microphone & electronics sit behind the outer ear, with a little tube to carry the audio through the mold into her ear canal.

The aids themselves are loaners from the Lions' Club for a 6-month period. We'll know one way or another whether she'll need hearing aids permanently well before then, however.

Next steps - a follow-up visit and recalibration if needed in about two weeks.  Then, later in May, we'll shoot for surgery to restore her right eardrum.  If that's successful, she won't need the aids.

Loving Yinghua Academy!

Here she is Monday morning, at our front door in her uniform and ready to go to her new school.

Any worries we had about Wynn transitioning into Yinghua were put to bed Monday afternoon; she adores the place. This morning as I dropped her off, she was skipping all the way to the front door of the school. She has art and music classes several times per week, gym every day, an hour plus of math every day, and of course all the Mandarin she can drink in.  She's already begun showing off what she's learned; last night she wrote the characters for 1 through 6 for us, and then used wooden building blocks to make the symbols, too.

* proud Baba smile *

Friday afternoon I'll pick her up a little early and we'll go to her ear doctor for the post-surgical follow-up. She's not complained of pain at all over this past week - had some dry skin back behind the ear a couple nights ago, which Vaseline took care of. No fever, nausea, or any other complications, and she never needed the Tylenol with codeine that she was prescribed. (In fact, she only had a pain reliever Wednesday afternoon, and nothing since.)

She is one tough cookie.

I'm hoping she gets the all-clear to start swimming again Friday! I'm missing our Friday Family Swim Nights!

Feeling MUCH better

The bandages were off Thursday morning and she had a wonderful time with her Grandmas Thursday and Friday. She did need more nap time these past four days, but otherwise she was active and up to her usual activities.

She's not reported any pain or nausea, and has had a normal appetite this whole time. She's taking eardrops three times a day to prevent infection, and we'll get a follow-up appointment scheduled in the next few days. She's got packing on the inside of her left eardrum which will dissolve over the next couple weeks; right now she's a little hard-of-hearing on that side because of all that stuffing. Outside, there's only a small patch behind her ear where they shaved off hair and a teensy scar; if you weren't looking directly at it you'd never see it.  We have to keep the area dry until the follow-up appointment, so we carefully wash her hair - and no Family Swim Time.  That's probably been the biggest disruption this weekend.

Ann and Wynn toured Yinghua Academy Friday afternoon and she got to meet her teacher.  The first day at her new school is tomorrow! Hooray!

The Second Ear Surgery

 Here's where they're going to be working...

 Mmm...a bomb pop is just the thing after 17 hours with nothing to eat or drink

 Can we go home, already?

I'm home but still really tired

The day started far too early; check-in was at 6:15, and neither Ann nor I had gotten adequate sleep last night. The staff at the Ritchie Surgical Center was well-prepared, however, and the check-in process was smooth. We were never sitting for more than five minutes between seeing nurses, specialists, or the surgeon.

The surgery, while taking about 2-1/2 hours, went even better than expected. As planned, her surgeon took a tiny, thin layer of muscle tissue from just behind her ear and used it to patch the tear in her eardrum. The drum tissue itself had some areas where it had calcified, but there was more healthy tissue there than originally thought, so the regeneration process will be faster and stronger. The tiny bones in the inner ear that transmit sound from the eardrum to the auditory nerve were all in perfect working order. Some bony deposits in the inner ear were removed, which should improve aeration and eliminate the "in a tunnel" sound that Wynn has probably been registering on her left side.

No tube was put in on the left; we want the drum to heal up first and then see if anything else is even needed. As you can see from the photos, she has quite a bit of dressing on her left side, but that will be coming off later tomorrow. There is also packing inside her head which will dissolve over the next couple weeks.

We got home about 2:00 - Wynn fell asleep in the car on the way home and had a nice nap on the couch, too. She's been logy but still cheerful and able to tell us if she needs anything. A Matchbox race car from the hospital and a Fashion Rarity My Little Pony from Grandma Marilyn have kept her occupied, and she's had a good appetite, too, already eating mashed potatoes, half a banana, some pancakes, and apple juice. And unlike last time, no problems with nausea.

We have pain meds ready if she needs them, but since we got home she's had no complaints, and her temperature has been running as expected; no fever. She'll need eardrops for a week to prevent infection (and she really doesn't like eardrops), but outside of that the only prescription is good food, good rest, fresh air, and taking it easy for several days.

Kindergarten Switch!

Here's what the building looks like without snow.

From back in January - Wynn had a great time.

This is what we in the education business call a "text-rich environment". No worries about how much teachers can put up on the walls here...

A sudden change of fortune Friday night - we got a call from Yinghua Academy, the Mandarin immersion school from the Minneapolis district asking if we were still interested in having Wynn attend!


As you recall back in January 2011, we toured this building and put Wynn in the enrollment lottery for getting into one of the two Kindergarten classes they had available. In February we found out her number was too high, and so we began the enrollment process for our local White Bear Lake elementary. Well, it turns out that Yinghua was able to get more money and more native-Mandarin teachers, so they now offer four Kindergarten classes.


Still, it took two kids to leave the school before Wynn's number finally came up to the top of the list.


Ann and I had to wrestle hard with the decision Friday night and Saturday morning - Wynn just left the preschool she'd attended for four years and all her friends from there; she's been so enthusiastic about her teacher and being in a big building these past two weeks; and the building where she's at does get good test scores and has a strong community support base. Plus, it's literally five minutes' drive from our house.


Yinghua has a solid math and language program, also very strong test scores. And she would learn Mandarin now - White Bear doesn't even touch it partially until middle-school. Yes, the commute would be longer for both me and Ann - her especially; the school's about 10-15 minutes on the far side of my office. Certainly the parent profile of this new school is different - they've seen a huge number of adopted kids. We'll be among fellow travelers at parent meetings.


We don't have any reservations about Wynn's resilience or her ability to thrive in a new environment - but it is going to be hard on her this particular week, with her second ear surgery on Wednesday (more on that later). She was so gung-ho on making new friends here in White Bear, and now she's going to have to say goodbye already.


But we drove her past the new school Saturday afternoon, and will be taking her there again Tuesday evening for "curriculum night."  Ann is going to try to arrange a walk-through at the school with Wynn Friday afternoon to meet the teachers & staff. Wynn's first day will be next Monday, the 26th.


With our acceptance, we've already fired off a list of questions to the administrator on how to get Wynn up and running, figure out her speech-therapy schedule, set up extended-day hours, and such. We've got to pick up fresh supplies again, and this school has uniforms that we have to scramble to find in her size. Can't say I'm looking forward to all the paperwork, either, both on the admission side for Minneapolis and the transfer-out side for White Bear.


Still, a new door has opened on Wynn's future. It's what we wanted for her in the first place. And when something as pleasantly unexpected like this happens - like how we were matched with Wynn in the very beginning - we have to jump through that door.

Eardrum update, August 11

Wynn had her follow-up appointment Tuesday, and essentially we know now what we believed a week ago. Wynn will need reconstructive surgery on her left eardrum; they'll use a thin snip of muscle tissue to rebuild her eardrum & serve as a medium for regeneration. The procedure will take 3+ hours but she'll get to go home after surgery.

They tested her hearing again, and the audiologist found that on her right side, where the tube insertion was successful, the excess fluid has drained nicely and Wynn's hearing is on par or a little better than other kids her age. (Huge sigh of relief.)

On her left side, it seems the fluid has drained too, and she is actually picking up some sound; this is good news for the surgery as it means the little bones of the middle ear are still hooked up to the eardrum, and that part of the eardrum is at least trying to do its job.

The surgery is scheduled for September 21, which gives Wynn a chance at settling into her new Kindergarten routine and Ann a chance to settle into routine at her new school position, too.

Meanwhile -- Wynn's been taking swimming lessons, and tonight was the final lesson in her first course. The kids in the course got to ride in a foam canoe, apparently! And our Wynn more than passed her test - she floated on her back without needing a foam support; while on her back she was able to swim and change direction; and then she flipped over and swam for about 15 feet to the other side of the pool! Her teachers are very impressed at what she's learned in just the past 4 weeks.

While she is definitely ready to move on to the next level, the schedule for next month's course runs right into the ear surgery, so she'll have to pick it up in October. However, Ann and I take her to the YMCA on Friday night and Sunday morning for family swim time, so she'll still get to practice her skills.

Eardrum update

We got the news we were pretty much expecting to hear at today's eardrum follow-up visit. Her right eardrum is healing up nicely and she's able to hear a much more complete range of sounds on that side. However, she's effectively deaf on the left side.

The left eardrum has a substantial tear which has been there for years. The examining doctor today was able to see right through it into the inner ear (using his normal scope.) The drum membrane is scarred and brittle, so it's not doing its job of vibrating when sound hits it and sending those vibrations into the little bones of the inner ear which are wired up to the brain. No idea what the cause of the tear was; obviously it wasn't there when she had tubes put in back in September 2007. Sometimes there can be a weak spot in the eardrum tissue and once a hole develops it can tear just like in a piece of fabric.

Surgical repair is the plan. There are two options - but we probably won't know which one we have to use until Wynn is on the operating table and the surgical team is attempting the repair:

1. "Patching" the tear using a small amount of tissue they would harvest from Wynn's jaw muscle. This would be a very thin layer of course, and it would serve as a base for her eardrum tissue to grow into. This surgery would take about an hour and recovery time would be a week or so.

2. A "lateral graft" - which is more like a total rebuild if they find there isn't enough viable eardrum tissue remaining to make the "patch" work. More muscle tissue would be needed, and the ear would need to be packed up for about 3 weeks to heal. This procedure would have her in surgery for 2 hours or more.

To make sure there aren't any other surprises hiding in her inner ear, after the exam we were sent downstairs to the Children's Hospital radiology department for a quick CT scan of Wynn's head. The rad tech was great, showing Wynn all the parts of the CT scanner, how the platform raised and moved through the machine, and what she'd need to do. (She loves to see people doing science and having scientific tools explained to her.) I put on a lead suit and stood next to my daughter as she got strapped in and the machine started its work.

Wynn was very, very good at keeping still, and the whole time she had to be strapped in was less than five minutes. No complaints, and the tech said she got good images.

We have a CD with the data, and a follow-up visit with the ear doctor next Tuesday to review it, determine the next steps, and probably get the repair surgery scheduled.

The start of the school year is coming up fast for Wynn and Ann - of course we'd like to get through this development as soon as we can to make kindergarten as enjoyable as possible.

Update - Eardrum Repair

We have an appointment this Thursday, Aug. 4 to follow up on the puncture & scar tissue in Wynn's left ear. Hoping we'll have a plan of action after that meeting.

Meanwhile, she seems to be healing up just fine on the right side. She's not cranking up the volume on the TV anymore & is able to hear me whispering to her.

She's wearing wax earplugs for swimming and baths (and she's really learning a lot in the pool!) Friday nights & Sunday mornings are Family Fun Super Splash Time :)

Not According to Plan

Wynn was a great patient this morning: genial to the nursing staff, uncomplaining for having gotten up early and skipping breakfast, and not afraid in the least (she had been asking questions of us for the past week, and I guess we answered everything she wanted to know.)

We arrived at Gillette Hospital at 6:15, by 6:45 we were in pre-op, and by 7:30 I was suited up in white Tyvek and holding Wynn's hand as she drifted off to unconsciousness.

We'd barely sipped our coffee and tea when our pager went off and the operating-room nurse was telling us that the procedure was done and Wynn was moving to the recovery room.

The surgeon, Wynn's ENT specialist, came out to tell us the procedure did not go as planned. While he was able to insert a tube in her right eardrum, on her left side he said there was tissue scarring and an open hole. She will need some reconstructive work done there, but this was not the right time for that procedure.

In a couple weeks we will take her back to the ENT clinic for an additional exam and surgical consultation where the next steps will be determined.

Meanwhile we are hoping the tube on her right side will relieve the fluid imbalance there and improve her low-frequency hearing. Wynn's speech pathologist suspects we will see another significant improvement in her speaking clarity when she is able to accurately hear all she is saying. (If this is the case, it may be that continued speech therapy will prevent having to operate again on the back of her palate this winter.)

Everything is dependent; her hearing affects her speech, but the problem with her hearing comes from the same root cause as her speech issues; that is, her palate muscles aren't strong enough to do all the things they need to do. We do what we can to help her get stronger, but we're anxious that exercise alone won't get her to where she needs to be.

---

We were back in the pre-op room with Wynn shortly after 8:00, where she was trying to eat a blue popsicle but not having much success keeping it down. She had a blank look on her face, locked on the TV where Dora the Explorer was playing. The nurses checked her over and gathered her post-surgical documents, and by 9:00 we were on the road for home.

She barfed twice in the car. Thankfully Ann was sitting next to her, with a little pan to catch the bright blue goop in.

Wynn was parked on the couch out on the porch for the rest of the morning, watching some TV, napping for a bit, working on a paint-by-number set, and playing with My Little Ponies. Her tummy was still queasy for a few hours, but at 12:45 she was able to eat some soup, and she's working on a slushy-pop right now.

We'll keep watching her through the afternoon - will she crash or will she bounce off the walls? Will she be going to preschool tomorrow morning?