2/21/16 - Ruby leading Mama's tap class.

titsay
we're not kids anymore.
taylor price
ojovivo

if i look back, i am lost

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hello vonnie

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$LAYYYTER

Andulka
Mike Driver
Three Goblin Art
PUT YOUR BEARD IN MY MOUTH

shark vs the universe
he wasn't even looking at me and he found me
Cosimo Galluzzi
wallacepolsom
Stranger Things
Sade Olutola
seen from United States
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seen from Malaysia
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seen from United States

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seen from Argentina
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@deafinitelymaybe
2/21/16 - Ruby leading Mama's tap class.
MRI Results
10/22/15
It took us awhile to get an appointment with our very busy ENT, Dr. John Niparko at USC, to get our MRI results. He has become so busy that he only comes into the office once a week, so getting an appointment is like winning the lottery. We had one scheduled for about 5 weeks later (I know, crazy, right?) and went in for the appointment. We get there and immediately we can tell something is wrong... they didn’t have our scans. HOW FRUSTRATING! Now, if this were almost any other situation, I probably would just go to a new doctor, but Dr. Niparko is supposed to be the best surgeon around, especially with kids, so if anyone is going to be doing this surgery on my baby girl, it’s going to be him. So we suck it up and wait a little but longer...
We ended up bringing our own copy of the MRI into them to upload to their system the next day, and they said they will call us with the results in a few weeks. A FEW WEEKS?!?! Are you joking? This is a joke, right? Nope.
After bugging them almost every other day for the next week, Dr. Niparko’s nurse calls to let me know that they need to forward the scans to the neuroradiologist to get better measurements. Not sure what all that means, but I gathered that it meant that something was abnormal.
Finally, they called me with the results...
Ruby is missing her left cochlear nerve. Therefore, she is not a candidate for a Cochlear Implant after all. Ugh. Part of me is pissed that we went through all of that for NOTHING. But the other part of me is relieved that we at least have the results and she will not have to undergo major surgery (at this time), and we finally can go ahead with getting a BAHA.
More on the BAHA soon. We’re getting fitted this Friday!
MRI at CHLA
Ruby’s CT Scan came back inconclusive. Our ENT noticed there was something off about her left cochlea and cochlear nerve region but couldn't thoroughly make a Cochlear Implant recommendation without getting more detail with an MRI. So that was our next step...
On August 11th, we had our MRI scheduled at Children’s Hospital Los Angeles. This was a lot more nerve-wracking than the CT as they have to sedate young children because they need to lie still for over an hour (let’s be honest, I’m not even sure I could do that!). Ruby had never had an IV put in her, let alone be sedated, so this was uncharted territory for us...
We had to deprive her of food starting around midnight the night before. We were allowed to give clear liquids up until an hour or two before check-in time, which is (I think) 3 hours before the procedure. This was hard enough. Luckily, our little Ruby loves her juice (gatorade).
Once we arrived, we had to go through and do some prep. They asked us a bunch of questions and got her IV started. She barely flinched at the IV.
The nurses and volunteers (I think some were volunteers??) there are so good about distracting the kids with toys. Heck, I was pretty distracted myself by the bubbles and the lights. Thank goodness for that, since I was a ball of nerves. The IV was put in her arm, and in order to make sure she didn’t yank it out (which she still managed to do once), they covered it with a gauze/towel cast.
Then, we met with the anesthesiologist. He told us that he was going to use Propofol as the anesthetic because it is fast acting for both sedation and wearing off. I couldn’t stop thinking, “Isn’t that the drug that Michael Jackson died from?! How is that safe for my BABY??!!” The scariest moment was to come... Only one parent was allowed into the room while Ruby “falls asleep” (at least CHLA realizes how important it is to have mom or dad as the last person your child sees). Harrison went in. I waited in the other room. It got really quiet. 5 minutes felt like an eternity. FINALLY Harrison came back and said it went fine.
THEN THE REAL WAITING GAME BEGAN. We had to wait about 90 minutes for the MRI to be done. I guess that’s just as long as brain scans take. I tried to kill some time by drawing, doing some work on my laptop, making a run to the cafe, etc. But time ticked by SOOOO SLOOOOOWLY.
Finally, just after the 90 minute mark, they called me and let us know she was coming out. We met her in a recovery room where she was still sleeping. She looked so peaceful. Probably the best sleep of her life. They had us talk to her and rub her back to get her to wake up. They weren’t going to discharge her until she was up and drinking some juice. After about 5 minutes, she started to come to. She was so drowsy and high off drugs still. It was really quite adorable.
Lastly, they gave us some take home instructions on what to look for in case there is a problem with the anesthesia. But Ruby was just fine (despite still being “drunk”), and we got to take her home!
6/16/15 - Ruby had a CT scan done today at CHLA to help see if she is a candidate for a cochlear implant
Just some updates...
3/27/15
Sorry, it’s been awhile since I’ve updated, so I figured I would just do a brief update about many topics all in one post. Here we go…
John Tracy Clinic
We’ve continuously taken Ruby to Friday Family School at John Tracy Clinic. It still serves as a great place to learn about hearing loss and how it affects our child’s development, and also, it serves as a wonderful place to network and share experiences with other parents in similar situations. Sometimes we feel a little out of place as most families there have children with bilateral hearing loss and have hearing aids or cochlear implants. Regardless, we like going to still get the latest on hearing loss and its technologies and hopefully meet other families of unilateral kids too.
We’ve also been going to “Demo Home” at JTC since January, and we love that as well. This is where our Demo Home teacher, who is also a certified Audio Verbal Therapist (AVT), uses a play-based method to engage our hard of hearing child. She not only works with Ruby, but a big part of it is teaching the parents to be the best at-home spoken language facilitators for our children. We learn different methods to try and expose our HoH child to as much language as possible through singing songs, reading books, and playing with toys. The parents learn how to use every day moments as opportunities to interject more language and listening.
ENT at House Ear Clinic
We’ve now gone to House for 2 ENT appointments. The 1st one was right after her 1st ABR. Both times, the ENT just confirmed that the anatomy looks normal from what he can see “superficially”, and also ensures that the good ear still looks good. We just went a week ago to make sure everything looked okay in Ruby’s good ear since she had multiple ear infections over the course of the last month or so. He said there was a little residual fluid but it wasn’t enough to affect her hearing…
EAR INFECTIONS
At the end of February, Ruby got her first real sickness. She had a cough, a stuffy nose, and eventually, double ear infections. We went to her pediatrician and got put on amoxicillin. One ear got better but the other ear (her “good” ear) got worse, so they put us on another course of a different antibiotics, Cefdinir. (We think) This one made Ruby break out in hives, so she might be allergic. Therefore, we stopped that one and hoped that nature would take its course and make her ear infections go away. We went in to the pediatrician’s office every couple of days to ensure that the infection wasn’t getting worse and to make sure that the fluid build up was going away. It’s scary for Ruby because if there is too much fluid in her “good” ear, she could basically go deaf temporarily as the fluid would muffle her ability to hear out of that ear. After the infection was gone, we made an appointment with the ENT to make sure there wasn’t any scarring and that everything was still good (see above).
Audiology at USC Keck C3
In February, we had Ruby’s first behavioral/booth hearing test when she was about 8 months old. Our audiologist said she was a perfect patient as she learned to turn toward the visual cue and did it pretty consistently during the whole test. I hope to explain in more detail what happens in the booth test in a later post, but I just wanted to state that this booth test verified that Ruby’s hearing is typical in her right ear, and she still had no response in her left ear.
Our audiologist recommended that we look into getting Ruby a softband BAHA at around 12 months. I just called our insurance company (Assurant Health through Aetna Signature) to see if they would cover the BAHA, and we were denied. I’m going to try and fight it.
IFSP with LAUSD
We had our 6 month review for our Individual Family Service Plan (IFSP). There were definitely things that I wanted to add/change as I now have done more research. This whole process has been very stressful as LAUSD hasn’t been the most accommodating and has denied the addition of some services that we’ve requested (ie: AVT, mileage, Friday Family School at JTC, etc.). We went through 3 separate sessions with our DHH teacher and Service Coordinator, and they still didn’t give me what I wanted for our family. I am beginning to start Due Process (a way to try and appeal the IFSP) and am working on filing the complaint. This just seems like a lot of paperwork and bureaucracy to get the most appropriate services for my daughter…
Possbility of Cochlear Implant for Single-sided Deafness?
There was another mom I recently met at Friday Family School at JTC who goes to House for audiology and ENT, and she said that her ENT (Dr. Wilkinson) is willing to perform the CI surgery on her son who has profound unilateral hearing loss. She doesn’t know if insurance will cover it, but she did get the preliminary MRI covered. This whole conversation got me to researching which ENTs/surgeons have done this on patients with unilateral hearing loss, and which of those patients are children. The US has been doing cochlear implants for over 30 years now on bilaterally deaf people and children, but a cochlear implant for single-sided deafness is still not FDA approved (it is however approved in other countries). I posted about this in the “parents of children with cochlear implants” Facebook group and got pointed towards lots of great resources. I’ve just started reaching out to other audiologists and ENTs to get some advice, experiences and information. I will definitely keep you guys posted.
John Tracy Clinic
We are fortunate enough to have been referred to John Tracy Clinic. Their website defines them as "the leading diagnostic and education center for young children with hearing loss", but they are so much more.
In August of 2014, we went to them for a 2nd opinion after having a so-so experience at UCLA Audiology. At the time, their diagnostic services were free, so there was no reason not to have another ABR. Plus, their offices are literally about a mile away from our home. The results were confirmed to be the same as UCLA, but the delivery of the information and the facilities were so different. They specialize in dealing with children under 3 years of age, and so they were so much more kid-friendly and sensitive to new parents.
They also referred us to Friday Family School, which started in September of 2014 (follows a normal school year schedule). Every Friday, JTC hosts a combination baby playgroup and parent education / support group. This also has been free of charge, which is crazy considering how valuable it is. "School" starts at 9am, with about 30min of playtime with parents (going through listening/language activities). Then at around 9:45am, the parents leave any child over 6 months old (otherwise the baby goes with you) with the JTC teachers, grad students, and/or volunteers, and go to an educational lecture (touching on all sorts of subjects related to hearing loss like audiograms, hearing aids, vestibular systems, child development, etc.). After about an hour of lecture, the parents then go to a support group. This is a time where parents can ask questions, share experiences, and discuss topics that only other parents with DHH children will understand. At about 11:30, school is over and you pick up your baby from "class". It is such a great experience, and we've learned so much from even just 4 months of going. The only "weird" thing is that they focus solely on teaching your child to speak, so sign language is not used at all, and the teachers just work on the child's audio and verbal skills.
A couple pictures of us playing during Friday Family School:
Also, JTC offers a service called Demonstration Home. We just started a few weeks ago, so more on that later...
Early Start Program
Because Ruby has now been officially diagnosed with a hearing loss, she qualifies for the Early Start Program. This is an intervention program that helps pre-preschool aged infants and toddlers who have disabilities that might hinder their development. You can read more about it here. In Ruby’s case, the audiologist at UCLA referred us to the program.
Starting in August, a “teacher” from LAUSD came to our house to do our intake. She asked a lot of questions regarding Ruby’s medical history as well as what our goals and/or worries are about her development. I must say that it was kind of nice to talk to someone who wasn’t a doctor or audiologist about it all and to actually get it down on paper and help us “connect the dots”, so to speak. We said we were most concerned about making sure Ruby hits all of her developmental milestones, especially regarding speech and language. We don’t want her falling behind, and we want her to be ready for preschool (and then kindergarten) and hopefully be able to lead a “normal” life.
The actual program teacher started with us in late August, which is the same time LAUSD started. As of now, the teacher has only come one time as we’ve currently decided to have them come once per month (and her next visit is tomorrow!). This can increase to a maximum of once a week if we feel it is necessary. The original intake teacher as well as Ruby’s new teacher have all said that once a month should be fine unless we see Ruby starting to fall behind. We’ll just have to monitor her closely and up the amount of times per month if we think she needs it.
So far, we’ve just gone through some of the basics of what we should be doing with Ruby at home to really stimulate speech and language learning… Most have to do with speaking a lot to her - singing songs, narrating everything, reading books, using facial expressions while speaking, and making the Ling 6 sounds, etc. These are a "select" 6 sounds that represent a wide spectrum (audiologists can show you on an audiogram) that babies need to hear, imitate and discriminate in order to learn language and hear well (it also serves as a test to make sure hearing aids and cochlear implants are working). Here are the sounds from low frequency to high:
/m/ /oo/ /ah/ /ee/ /sh/ /s/
We look forward to our future classes as we are supposed to learn more about the anatomy of the ear, types of hearing loss, how to bond and soothe our infant, etc. The teacher also is a good resource regarding audiology, ENTs, and so much more about the hard of hearing world. She will always check in with us and go over our latest appointments and will help us keep track of Ruby’s language and speech development. We’re truly grateful for this program and can’t believe that it’s FREE (it’s both state and federally funded). We’ll keep you posted on the progress of the program.
1st ABR at UCLA Audiology
After Ruby failed her newborn hearing screening at the hospital, they referred us to an audiology appointment scheduled at UCLA a month later. On July 7th, we took Ruby in for her full diagnostic Auditory Brainstem Response test.
Because the baby needs to be asleep for the test, we were told to keep her awake beforehand and not feed her so that we could feed her right before the test and get her to sleep. This was harder than it sounds! I was so used to feeding on demand that it seemed horrible to withhold from her. In addition, I had to continuously poke and prod her in the car on the way to UCLA so that she didn’t fall asleep. I seriously felt like I was torturing our little one.
When we arrived, we were told to feed Ruby. As we fed her, the audiologist prepped her for the test by putting some “electrodes” on her forehead and by her ears. She then also put headphones (this time they looked like clip on earrings) on her ears. When we were done feeding, we put her in a little bassinet and tried to get her to sleep. When she fell asleep, they started the test.
The audiologist had people training with her so as the test was given, we just heard whispering amongst them. They did not explain what was going on at all. All we could do was sit quietly by and guess what was happening in our minds. We could hear the clicks and pulses get louder and louder. And as the pulses got louder, and the whispers between the audiologists get louder, our anxiety grew. Why wasn’t anyone telling us what they were doing or what they were discussing? Was everything okay? Finally, the audiologist told us that she failed in her left ear again but that we still shouldn’t worry because they would test the right ear and then re-test the left ear again as there could just be a problem with the test. So, the test continued in silence as we heard the clicks and pulses. This time, my anxiety level had hit a new peak. They told us that her right ear tested normal and that they would go ahead and re-test the left. As we sat nervously by listening to the ever growing clicks and pulses, all we could do was try and decipher the looks on the faces of the audiologist and her trainees. Finally, the audiologist started to speak. I was hoping that the first go around was just a mistake and that they found she was perfectly fine. Turns out, she failed again in the left ear, and this time, there was no “don’t worry” or “this happens all the time”. I started to feel a pit in my stomach. This is something you do NOT want to hear.
The audiologist did say however that there was still a possibility that something could have been physically blocking the soundwaves from going through (which was our hope, of course). Therefore, they were going to perform a Bone Conduction ABR test in the left ear to see if there was any response when sound is transmitted through the bone versus just through air. This would rule out if there was any blockage or fluid causing the hearing loss. They placed an additional node type thing on the leftside of her forehead and began the test. My heart was pounding and I had NO IDEA what was going on… all I could do was keep my fingers crossed. After the test was complete, the audiologist quickly mentioned that Ruby also failed this test and that she would go over the results with us. What?! I don’t understand. What just happened? And why doesn’t this seem like a big deal?
As the audiologist sat down with us to go over the results, I started to feel a bit ill. The pit in my stomach had grown larger and was now making its way up my throat. She told us that Ruby had a profound sensorineural hearing loss and that it would not get better. Period. End of sentence. And that’s pretty much all I heard as my eyes welled up with tears. The rest of the explanation of results pretty much went over my head as I sat there in shock. The audiologist was speaking but I could not actually hear or understand anything she was saying. The words she was using were so foreign. Profound? Sensorineural? What? Bone conduction? Genetic testing? Before long, all I could do was see red. I wanted to punch her in the face (joking, sorta). She went on and on about how Ruby will need early intervention and how it could be a genetic disorder that affects her kidneys or her heart, and yet, she didn’t make it seem like it was too big of a deal. Ok, I’m about to pass out at this point. Why didn’t you give us more warning? Why didn’t you break it to us slowly? Could you please go over all these big words you’re using? How can this be related to her heart or kidneys? ENT? I don’t even know what the inside of an ear looks like! SLOW DOWN. And of course, I couldn’t get any of those questions out. I was still too busy crying and feeling sorry for my little Ruby. The appointment was over and we almost walked away without the results or referrals. All they gave us was some outdated reading materials that basically showed the horrible stats of kids with unilateral hearing loss (having a hard time in school/failing at least one grade level and having behavior problems, etc.). In the end, they didn’t give us the results (I had to ask for them later) or audiogram, and I still felt so uninformed.
In retrospect, I think the audiologist had forgotten that this was our first time dealing with anything related to hearing loss while she deals with it everyday. However, that is no excuse for making us feel the way we did - sad, ignorant and defeated. Now, almost 2 months later, I still have negative feelings toward this first audiology experience. I’m not sure if it really would have been “better” at a different location or with a different audiology as it will always be hard telling a parent of his/her child’s hearing loss.
Prior to the appointment, we were not very worried. Everyone had led us to believe that we were most likely just fine and that there was just some sort of misreading in the hospital screening. Unfortunately, it was mistrusting and ignorant on our part for blindly believing everyone and not being more thorough or prepared. We have now “grieved” a bit and have googled and learned a lot more about hearing loss, hearing tests, and the ear. In the future, we will come more prepared with questions and know to ask for the results and audiogram. If we could do it all over again, we would have taken the hospital screening more seriously and been a bit more prepared for potential bad news at the audiologist; instead, we just felt so unbelievably blindsided with the news of Ruby’s hearing loss that we couldn’t fully take advantage of our time with the audiologist and get the information needed to try and give our daughter the best care that we can.
—S
NEWBORN HEARING SCREENING
The picture was taken during Ruby’s newborn hearing screening given at the hospital. As far as I know, this screening is given to every newborn in the state of California (birthed at a hospital) through the Newborn Hearing Screening Program (NHSP). Here is a link to their FAQs page, which gives a pretty good overview of the program. In short, it’s a program implemented in all California hospitals with the intention to identify any hearing loss as early as possible and then to refer infants to intervention services before the age of 6 months so that they don’t fall behind in speech and language development.
As mentioned before, Ruby failed the screening in her left ear. The 1st screening happened just the day after she was born. We were brand new parents and brand new to EVERYTHING related to babies, so we just let the administrator do her thing and didn’t pay too much attention as we were just overwhelmed with having a newborn and recovering from my c-section. The test administrator put some earphones in her ears and some other nodes to detect brain activity. It didn’t seem like too big of a deal, even when a bunch of nurses came barging in the room to fix my IV. The test machine screen had a bunch of numbers that went up and down, and the administrator didn’t bother explaining what was happening other than the machine transmitting sounds/pulses to Ruby through the earphones. After Ruby did not pass in her left ear, the nurse told us not to worry because infants failing was fairly common. Sometimes infants have residual fluid in their ears from birth or their ear parts (?) are not fully developed or their was a distraction during the test, etc. Ok, good, Ruby was a newborn after all, so of course she probably just has fluid left in the ear, and plus, there was that distraction during the test, so obviously we have nothing to worry about. Any worry of mine was put at ease knowing that it was “fairly common”.
Then, a couple days later, Ruby had her re-screen. A different nurse administered the test this time, and we paid more attention. I made sure that the earphones and the nodes were properly placed. I also asked what the numbers on the screen meant, and the administrator explained that she didn’t really know except that if the end number result was not in a certain range, then the infant failed. Ruby failed in her left ear. Again, the administrator said it wasn’t a big deal and that lots of newborns fail the screening in the hospital and are completely fine once they do their follow-up full diagnostic screening at an audiologist later. Our pediatrician came by not too long afterwards and confirmed what the administrator said about infants failing the newborn hearing screening at the hospital all the time but turn out to be completely fine, so we need not worry. After all, we had enough to worry about with just having a newborn, right? We were given a referral to UCLA Audiology for a full diagnostic Auditory Brainstem Response (ABR) screening a month later, and then it pretty much went out of our minds until then.
If I could do it all over again, I would have asked WAAAAAYYY more questions to the test administrator. Even if he/she didn’t know the answers, I would have at least tried to get more information out of them. I would have also appreciated more realistic or specific responses instead of the super casual “no worries” responses we received. And then, I would have gone home and looked up the California Newborn Hearing Screening Program webpage and done some additional research regarding the test results, the screening, and what this could mean for our child. Furthermore, I would have prepared myself for our first audiology appointment by learning about the different parts of the ear, the different types/levels of deafness as well as learning how to read an audiogram and thinking about what questions to ask in the worst case scenario.
—S
This is baby Ruby (at about 2 months old). She was born on June 6, 2014 8:17pm at Cedars-Sinai and came in at 7lbs. 11oz. and 21.25”. She was (and still is!) absolutely perfect! Ruby is our first baby, so we were more than ecstatic to meet her. After passing the APGAR test and getting cleaned up, she was handed to us, and we were just soooo in love! Everything seemed fine and dandy, and we were excited and anxious to embark upon our new lives as parents to a normal, healthy baby…
That is, until we had our first newborn hearing screening at the hospital the day after. This should have been our first red flag as she failed the test in her left ear, but they said it wasn’t a big deal and that lots of newborns fail for no apparent reason. We were told that someone would be back again before we left the hospital to do a re-screen. A couple days later, they re-screened her, and she failed in her left ear again. And AGAIN, they were very nonchalant about the whole situation and said that there was nothing to worry about yet. Lots of newborns fail and get better - Something about fluids possibly being stuck in the ears and their ears still developing. Okay, no big deal. Nothing to worry about. If there was something to worry about, they would have given us more info, right? All they did was refer us to the audiology department at UCLA where we had an appointment scheduled for a month down the road.
On July 7th, Ruby had her first full diagnostic ABR test at UCLA Audiology (I’ll go more into detail about this visit in a future post). This is where we first found out she had a profound sensorineural unilateral hearing loss. Besides hearing a bunch of big words I didn’t understand at the time, I don’t remember much else from this appointment other than thinking that Ruby’s future and quality of life would be in jeopardy. We were just in shock. Why didn’t anyone at the hospital take it more seriously? Why didn’t we do more research beforehand? We were devastated to say the least. Then, we came home and googled the heck out of “unilateral hearing loss”, “deafness in one ear”, etc. The stats and stories that come up are scary. After diving into the blackhole of the internet, I was certain that Ruby was going to have trouble developing speech and language and that she would not do well in school…most of which I’ve now learned is preventable with early intervention.
Now, Ruby is almost 11 weeks old and has had a 2nd diagnostic ABR (at John Tracy Clinic) which confirmed UCLA’s results and has started the Early Start Program through LAUSD. We are writing this blog to help ourselves document this journey with Ruby as well as hopefully help others who are seeking advice and/or guidance by sharing our firsthand experience in dealing with our child’s unilateral hearing loss. We, ourselves, have had a hard time finding other blogs or firsthand accounts of parenting a child with unilateral hearing loss, so we decided to do something about it, and we hope to learn something about ourselves along the way!
—S