Table of Contents
ANSWERS TO COMMONLY ASKED QUESTIONS
Introduction
By the time your child is a year or two old, you are probably a veteran of several middle ear infections and many sleepless nights.
Middle ear infections are of particular concern because even after the infection subsides with medication, fluid often remains behind the eardrum, causing hearing loss. Even temporary hearing loss, we now know, can seriously affect learning and speech development in young children and also cause behavioral and discipline problems. Remember, a young child can’t verbalize hearing loss and simply adapts to a problematic situation.
For this reason doctors today often recommend the placement of tiny ear tubes—PE (pressure equalization) or tympanostomy tubes—to ventilate the middle ear. This procedure involves a small incision in the eardrum (myringotomy) to drain the ear. A hollow ear tube the size of this “o” is then inserted. It is a simple, short operation performed at day-surgery centers that has successfully and dramatically improved hearing for thousands of children.
Because this procedure requires general anesthesia and a hospital setting, there are concerns for both parent and child alike. Knowing what to expect can help prepare your child and reduce anxiety for both of you. We believe that this story about KoKo Bear’s ear tube surgery will help insure that your child has a positive experience.
It’s the middle of the night. KoKo is crying.
“MaMa, MaMa,” says KoKo, “it hurts!”
“Oh dear, where does it hurt, KoKo?” asks MaMa.
“It hurts inside my ears,” says KoKo.
“Oh, KoKo, it sounds like another ear infection. We’ll go see Dr. Polar in the morning. She can help make you feel better,” says MaMa.
• Ear infections are often more troublesome at night because your child is horizontal and fluid behind the eardrum creates pressure and pain. Small children with ear infections often pull on their ears or cry when they cough.
• For nighttime relief, try a nonaspirin pain reliever or a hot moist towel against the hurting ear.
KoKo usually likes to visit Dr. Polar’s office. Dr. Polar has lots of books and toys, and best of all, a large aquarium with pretty fish and plants.
“Hi, KoKo,” says the nurse at the desk. “I’m sorry you have a problem, but I know Dr. Polar will be happy to see you.”
“What?” says KoKo. The nurse’s voice is hard to hear.
• Hearing loss clues to watch for: you must speak louder; your child uses the word “what” more frequently and also turns up the volume on a TV or tape recorder.
• Avoid promising your child that doctors and nurses will not cause discomfort. The mention of “no pain” may give a child concern where none existed before.
The nurse takes KoKo and MaMa Bear into the examining room to see Dr. Polar.
“Hello, KoKo,” says Dr. Polar. “I understand your ears are hurting you again. I need to use my otoscope—this special ear flashlight—to see inside your ears. Now let’s have a look. Do you think there are some butterflies hiding in there?”
“No. That’s silly,” says KoKo.
• Your attitude at a check-up will be reflected in your child. Be relaxed and positive. It is normal for a child to resent and resist ear checks because of the pain. Do not become upset with this behavior and thereby add to the unhappiness.
• Encourage your child to role-play the visit to the doctor. Most children’s medical kits include a toy otoscope.
“I need to check both your ears,” says Dr. Polar. “Some bears think this tickles. What do you think, KoKo?”
“Yes,” says KoKo. “The otoscope tickles.”
“I can see your eardrum and now I know what’s causing your earache,” says Dr. Polar. “You have an infection, but I can fix that with some medicine. Here’s my otoscope, KoKo. You can look into Chumley’s ears now that I’m finished.”
• Administer antibiotic medications exactly as prescribed by your doctor. Even when the pain has subsided, the infection is still there and needs to be treated.
• Role-playing and role-reversal often help children have a sense of control over their environment,