The Best Doc

Little Bits a.k.a my daughter has ear tubes. In 2006 at the recommendation of the best ENT from the number 0ne children's hospital in the country (CHOP also referred to as Children's Hospital of Philadelphia) she went in for the surgery. I must admit I was petrified. It is especially scary for a mother to watch her child being taken in for a surgery, any kind of surgery no matter how minimal it seems to others.

She was not having re-occurring ear infections (thankfully) but there was fluid in her ears, and at certain times it would effect her hearing. This was frustrating, probably more so for me than for my daughter. Of course I did hear horror stories about fluid in the ears not being treated properly so I rushed to call her pediatrician who then referred us to the ENT. Overall did the tubes help? I suppose so. Would I swear by this? No way! Would I do it again? Not so quickly.

Every year, about 500,000 children have ear tubes surgically implanted in their ear drum. The tubes reduce the number of ear infections kids get, as well as the pain that accompanies infections. In recent studies, it has been estimated that as many as one-third of kids who get ear tubes don't need them. Could this be the situation with Little Bits? Very probable. Her tubes are still in, and I have received several different opinions about what to do. One of the opinions is let the tubes fall out by themselves, and the other is if they are in her ears for over two and a half years take them out. So what should I do?

She is sensitive to sounds (some days much more so than others) which I found out later could be a result of the tubes. Last year she told me her ear hurts and when I asked " What does it feel like?" she answered, " It sounds like popcorn in my ears." Interpreted, this meant it is the sound of the popcorn popping when we make it in the microwave. Naturally I called the doctor's office and was informed that children with tubes sometimes describe hearing a popping sound. Hmmm, why was I not told of this before the tubes were placed? Why , why, why ?

The passageways inside children's ears aren't fully developed until about age 12. For some, that means air doesn't circulate properly, and fluid can build up behind the ear drum. If that fluid becomes infected, the ear drum gets inflamed and swells, which is why it's so painful.

In a recent study it stated that there's a group of kids who get ear tubes but don't need them. They don't have chronic, painful infections. Instead, they've been prescribed tubes because fluid frequently builds up in their ear drum, often after a cold. This fluid can muffle sound. In the past, doctors have worried that this temporary hearing loss might lead to speech and learning problems. But, in a recent study from the University of Pittsburgh, about 400 children were followed for 10 years. Researchers found that those who got ear tubes did NO better on speech and language tests than those who didn't get ear tubes. "I think we can be totally reassured now that those children are not going to have bad effects from having that degree of mild or moderate hearing loss."

A study looked at two groups of toddlers: those who got ear tubes after three months of fluid in their ears — the standard guideline — and those who waited up to nine months before tubes were inserted. The children were tested for speech, language, learning and behavior when they turned 3."The bottom line was there wasn't any difference in the developmental outcomes as best we could measure them at age 3," said Dr. Jack L. Paradise of Children's Hospital of Pittsburgh.

"If tubes were absolutely harmless and free, then I think you might say, 'Well, let's have the tubes to be sure,"' Paradise said. "But tubes themselves carry risk and, of course, there's cost involved. So it becomes a matter of ... which set of risks would you rather take? So again, I have to ask why was I, a concerned and educated mother, not informed of the "risk" or lack of documentation to support tubes helping with fluid by the best children's hospital in the country three years in a row? This surely does not make me feel very confident in the pediatric medical community.

I am going to hang my hat on this statement from the study, "at age 3 it's very difficult to test developmentally." I am hoping and praying her tubes fall out very soon (like today or tomorrow) so I will not have to make a decision about the doctor taking them out at the two and a half year mark, August 2009. Really, I don't know which doctor is right, or if either of them are right. Most likely in ten years from now there will be a new study out and a different opinion about when to take the tubes out...or even if to put them in. This is the worst part of motherhood, playing the role of a fortune teller, doctor, and mother. (And, yes, my husband is a medical professional who should have an important opinion of his own. He does: trust the "best" doc. Thanks, hon.)