Thursday, April 28, 2011

Why?

Some days I wish I'd gone to medical school. Over the last two years, Abby's asthma has often left me wanting more understanding about lung function, pharmacology, and accurately assessing respiratory status. Of late, we are navigating a series of question marks about her hearing, which for weeks at a time suffers significantly enough that the poor girl says, "What? What did you say? I can't hear you," to any statement issued at a normal volume.

This noticeable hearing loss coupled with the fluid that comes and goes in her ears and her giant, golf-ball sized tonsils landed us in an ENT's office this morning, where Abby zoomed trucks across the floor while I attempted to remember from my mental catalogue of doctor visits when fluid has appeared and disappeared from her ears, how many ear infections she's had in the last year (not many), and which antibiotic she was given for said infections. 

The audiogram--dubbed "a hearing game" for Abby's benefit, which she giggled through as she put bears in cups every time she heard a "little birdy"--showed "significant, mild hearing loss" in her fluid-filled right ear. And for the record, her hearing currently is much improved from a few weeks ago when she was sick and it felt like I had to shout every question, answer, and direction to be heard. The audiologist wants to see her back when her ears aren't fluid-filled to see if the hearing loss is, in fact, a result of the fluid. 

We spoke with the ENT about her other symptoms. I did my best to assure the doctor that Abby does not, in fact, show signs of sleep apnea, but we get to do a sleep test anyway. He audibly gasped when she opened her mouth to show him her tonsils; his skepticism at my insistence that she does, indeed, sleep soundly--without the tell-tale apneic episodes I've observed in Josh--was palpable. Sigh. We'll follow up with him, too, in two months to see if the fluid has resolved and to review the results of the sleep study.

And to top it all off, the doctor prescribed a nasal steroid to use everyday until we return to help with some of her persistent congestion. If her congestion worsens, he recommends a nasal wash. Uh-huh. I can just see Abby's enthusiasm at having a saline solution squirted into her nose each day. I couldn't even do it to myself a few years ago when I was fighting a terrible sinus infection.

On most fronts, I'm happy to wait and see and do tests to gather greater diagnostic information, but in the meantime, I can't help but wonder why her body struggles in these ways. Is there an underlying condition? Is it simply a case of genetics predisposing her to some anatomical challenges? Is it the result of something in utero or environmental?  

I suppose to some degree, my frustration stems from my struggle to follow blind instruction, a remnant of my authority-challenging inner self. The need to understand why and to argue the counterpoint of a decision before accepting the outcome began when I was about Abby's age (insert laughter of my parents here) and hasn't diminished with time. But without the benefit of a medical education, I'm left to draw my own semi-educated, self-informed conclusions. And so, in the absence of evidence to the contrary, I'll fall to the default explanation of genetics and anatomy and fill that prescription for the nasal steroid. 

Such is the challenge of parenthood--moving forward in faith, even when I harbor so many questions.  


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