Tuesday, July 3, 2012

Hearing Loss- Barrett's Story

Barrett was born on June 10, 2007.  He came three days after his due date.  He was a beautiful baby boy and I was in love instantly.  He spent a few extra days in the hospital due to Transient Tachypnea of the Newborn (TTNB).  It wasn't a big deal.  When they did his hearing test at the hospital, he didn't pass.  They told us that it happens all the time and is usually due to fluid in the ears.  Still not a big deal.  So, we retested many times and he only passed two times in the right ear.  We were referred to an ENT and Audiologist (I don't remember where in Kansas this was).  They found the same results and sent us to the Children's Hospital in Kansas City for an un-sedated ABR (Auditory Brainstem Response) hearing test.  Because we refused to have him sedated they were only able to test his left side (which was the side he never passed his hearing test on).  We met with a new pediatric ENT in Lawrence, KS and he told us that Barrett had mild hearing loss in his left ear.  It was so mild that he didn't recommend doing anything.  We were just fine with this and went on.

We moved from Kansas to Minnesota in the spring of 2008 and went in for his 12 month well-child exam that summer.  The pediatrician wanted us to meet with a Pediatric ENT (Dr. Soumekh... whom I LOVE) and check his hearing loss with an audiologist.  I was fine with that.  No harm in double checking on my kids hearing.  So, we went to the appointment and had a hearing test.  He had mild/moderate hearing loss in his left ear and his right ear was still fine.  Dr. Soumekh said we really should get him a hearing aid, do a ct scan and some other tests.  I'm not going to lie... I was very freaked out by this entire appointment.  We agreed to get him a hearing aid (on loan) and go from there.

The hearing aid was AWFUL!  He refused to keep it in.  I was spending all day every day putting it in, then he'd pull it out.  Over and over again.  So, we decided to stop trying.  It was too hard and he could hear out of his right ear and the loss was only mild in his left ear.  He started getting speech from the school district at this time (18 months) and continued with that until age 3.  At age 3 we had to do another hearing test to see what services he'd qualify for his preschool years.  We decided to to have District 287 do this test.  She couldn't get a good read and sent us to Children's.

We meet Kate at Children's and haven't looked back.  Kate was exactly what I needed in an audiologist.  She's amazing with Barrett (and Myles), patient and knows what to do in every situation that presents itself.  So, we went in on June 17, 2010 to have Barrett's hearing test.  I remember this because it was one week after his birthday.  My mom came with because I was a ball of nerves and had a nursing baby (Myles) to take care of.  My mom went in the audiology booth with Barrett and I sat right outside with Myles watching and listening.  I knew before Kate said anything that there was something wrong. They finished the test (which Barrett did beautifully) and she gave us the results.  My little boy had moderate to severe hearing loss in BOTH EARS!  I burst into tears!  I couldn't hold it in.  I said "he understands what we're saying!"  Kate's response, "He reads lips."  I never noticed it before, but he didn't look in my eyes when I was talking.  He was watching my lips..  He can still read lips.  It really is an amazing skill to have.  I guess that's one positive thing that's come from this.  I pulled myself together and said "Well, let's get him some hearing aids."  He was fitted for hearing aids that day and three weeks later we got them.  He has never once pulled them out!  It's been two years!

Last week, we went for one of his routine appointments with Kate.  Barrett has been telling us lately that he can't hear, but with a smirk on his face and usually when we're asking him to pick up his room or brush his teeth.  So, we didn't think anything of it.  During his appointment Kate tested his hearing with his hearing aids and without.  For the first time in two years Barrett tested with a mild loss with his hearing aids in.  Ok, this could be due to him growing.  Maybe they just need to be reprogrammed. Then, we did the un-aided test.  He's lost 20dB in his low frequency (which was his best ) and is showing a loss of 5dB in all other frequencies.  If what I just told you makes no sense... see the nice descriptions and charts below.

Barrett has progressive (has gotten worse over time) bilateral (both ears) sensorineural (dysfunction of inner ear) hearing loss in the moderate to severe range.  Which means that without his hearing aids he can't hear you until the sound is 60-85dB depending on the frequency.  Conversational speech ranges in  45-60dB.

This is just showing you the varying degrees of hearing loss.

Degree of hearing lossHearing loss range (dB HL)
Normal–10 to 15
Slight16 to 25
Mild26 to 40
Moderate41 to 55
Moderately severe56 to 70
Severe71 to 90
Source: Clark, J. G. (1981). Uses and abuses of hearing loss classification.Asha, 23, 493–500. 

Sound Intensity (Loudness) source

Sound intensity, or loudness, is measured in decibels (dB).
  • A person with hearing within the normal range can hear sounds ranging from 0 to 140 dB. 
  • A whisper is around 30 dB. 
  • Conversations are usually 45 to 60 dB. 
  • Sounds that are louder than 90 dB can be uncomfortable to hear. 
  • A loud rock concert might be as loud as 110 dB. 
  • Sounds that are 120 dB or louder can be painful and can result in temporary or permanent hearing loss.

(Source CDC)

Sound Frequency (Pitch) source

Frequency is measured in hertz (Hz). A person who has hearing within the normal range can hear sounds that have frequencies between 20 and 20,000 Hz. The most important sounds we hear every day are in the 250 to 6,000 Hz range.
Speech includes a mix of low and high frequency sounds:
  • Vowel sounds like a short “o” as in the word “hot,” have low frequencies (250 to 1,000 Hz) and are usually easier to hear. 
  • Consonants like “s,” “h,” and “f,” have higher frequencies (1,500 to 6,000 Hz) and are harder to hear. Consonants convey most of the meaning of what we say. Someone who cannot hear high-frequency sounds will have a hard time understanding speech and language.

(Source CDC)

Wow!  I just gave you a lesson.... sorry if that got really technical.  I find it fascinating, but that's because it effects our daily lives around here.  

So, where do we go from here?  Right now, I don't know.  I feel like I'm mourning his hearing loss all over again.  And just when I was starting to be ok with it.  I guess they (whoever they is) don't consider a 5dB loss significant, but I do.  We meet with Dr. Soumekh (our ENT) on Friday (this is Myles' post-op  appointment for his tubes) but I'll be asking some questions about Barrett while we're there.

Prayers please!  I feel like I'm at a loss.  He's not in "normal range" for all frequencies with his hearing aids in and I don't like that.  He's reading lips more again and I don't like that.  I know that God is going to use him for wonderful things, but this really sucks!



Oh, I would love to hear your thoughts on this!  Anyone else go through anything like this?

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