Hear No Evil: Chuckles
Speak No Evil: Bobo
See No Evil: Mama
Do No Evil: Google
I’ve been working on this post for almost two weeks now. I just don’t know how to write it and not sound superficial and bitchy.
As you know, Chuckles was diagnosed with a slight hearing loss due to his chronic and recurrent ear infections. Bobo, on the other hand, has not yet been diagnosed with the hearing loss. He needs to get ear tubes first. Basically, they are pretty sure he can’t hear (much). He doesn’t really turn his head to look at you when you talk, and he doesn’t talk himself. This means he can’t hear and hasn’t learned how to talk because he can’t hear you and can’t imitate what he can’t hear. But, a lack of language acquisitioin can also indicate possible autism spectrum disorder. We have a plan.
Consult with ENT next Friday
Ear tubes, if deemed necessary
Hearing test, regardless of ear tubes
possible re-evaluation on ear tubes if there is hearing loss
speech-language pathology exam
autism screening M-CHAT
Bobo has some risk factors for autism spectrum disorder. He is a boy with digestive and sensory issues who was breech at birth, with a highly educated mother, and whose parents are both in occupations of a highly analytical nature who are socially awkward and dislike people, in general. There is also a pretty strong family propensity for the disorder in the current generation.
Some of these risk factors seem a little dubious to me, though. Really? I mean firstborns are 1.8 times more likely to have autism. Isn’t it possible that parents who had an autistic child first chose not to have a second child thus depriving the pool of possible second (or even third) children with autism? For example, in our family, there is one third child with autism (last child) and one first child with autism (also the last child). And there are two first children with no autism and two second children about whom the jury is still out. So, we have one in four first children with it, and one for one third children. But if we look at “last” children, we have 2 out of 4.
Children with autism are more than twice as likely to have been breech. Well, OK. That could be true. I’ll assume it is. Bobo was breech. He was breech because of placental issues, so I suppose it is possible that poor blood flow during pregnancy can relate to autism later on. I’ll buy that, but it seems like the better thing to look at would be placental issues instead of breech presentation. And yes, I get that breech presentation may be the proxy for placental issues and that the relationship is correlative not causative, but it doesn’t even seem like a worthwhile thing to publish at this point.
Age at first childbirth and level of education attained are strongly correlated, so I would believe that my education level has less to do with autism than the fact that I delayed having children until I was done with school, and hence, older.
Let’s assume that certain personality traits are heritable. Given that, it would make sense that two people who are highly analytical classifiers would have children with similar tendencies. Mr. Long-Suffering and I are terribly resistant to change, engineers, ruthlessly analytical, logical, and repetitive. We are Bo-ring. It would make sense that we have children who are like this but moreso (since our kids have two parents like this instead of one or none).
Anyway, the closer I pay attention to Bobo, the more I think he’s unable to hear and not affected by Asperger’s though. Poor kid. Meet with ENT on Friday.
Also, during the Day of Not Terribly Reassuring Encounters with Medical Professionals, I had an ultrasound to ensure my Mirena is in position. The answer is “probably”. It wasn’t really visible because apparently my uterus wasn’t where it is supposed to be (also, plenty of cysts on my ovaries and endometriosis visible on ultrasound…plus the missing uterus). I’m still waiting on the radiologist’s official report on this, but it ought to be a good read.
Instant Update: Because it’s taking me so very long to write this: The Mirena is going. It’s getting pulled, and I am going back on The Pill. I’m going to wait out another cycle and see whether the acne comes back, but the hair that is growing along my jawline is not my friend, so I need some estrogen. STAT.
Instant Update Two: We had the appointment with the 70-year old ENT. Bobo is getting ear tubes. On Wednesday. They had a cancellation. The Wednesday surgery patient is getting a kidney transplant and so she’s cancelling whatever ENT-related surgery she had. So, congrats to her and her new kidney, and congrats to Bobo who gets tubes.
Instant Update Three: Bobo was at Urgent Care yesterday as is his custom (at 9:58 am, per my theory) for an ear infection and pink eye. Wednesday is still surgery though, and all the infections should end then. Man, I hope they do. They will still operate with the infection, and the doctor specifically mentioned what to do in this case. So, we’re doing that. Why the ENT didn’t just prescribe antibiotics while we were there for Bobo to take until the surgery, I don’t know. That would have been the prudent thing to do since he had a subacute infection on Friday which turned acute on Sunday. But maybe kids who need tubes are always subacute. I don’t know. But I do know who gave Small the pinkeye….Thanks to Katie’s mom for sending her to school with crusty stuff on her eyes which she assures us is not pinkeye. Yeah, right.
Instant Update Four: So, when the hospital called to give us the run-down for Wednesday (he goes in at 6:30 and bring a bottle so he can have clear liquids (which they will supply) afterward since they don’t supply bottles or sippy cups), I asked if he needed to wear anything special. The answer is NO because he will be wearing an itty bitty teeny tiny hospital gown. And that’s the thing that made me cry at my desk.
Instant Update Five: Happy Casimir Pulaski day. He died so you could have light traffic.
Instant Update Six: So, with the tube surgery on Wednesday, I haven’t spent nearly enough time freaking out about how I also am registering Chip for big school kindergarten on Wednesday. OMG, my first baby!
My first baby is going to kindergarten, and I have to prove residency. That ought to be fun. I’m sure I’ll end up having to produce my marriage license at some point because, MY HEAVENS, your names are different and where does the boy live and with which parent?
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OMG. What an awful two weeks.
ReplyDeleteI wonder about the bloodflow issue for autism. My bro-in-law (1st born male) was born blue -- not breech, but wouldn't come out -- and he is autistic (with slight mental retardation). I agree with you that the stats saying it's more common in 1st borns is very faulty.
Same was done with Down Syndrome way back when saying older women were more likely to have a DS baby -- the percentages seemed higher because there were smaller numbers of women having kids at 40. All the women I know who have a DS child had the pregnancy in their early 30s.
The best of luck for Wed. We'll be thinking of you.
Thought of teeny tiny hospital gown made me cry too. So sorry that you are having to deal with all this. Good luck on Wednesday.
ReplyDelete@Geeks in Rome - More babies with Down Syndrome are born to women in their late 20s-early 30s than in their 40s, but that's only because most babies are born to women in that age group.
ReplyDeleteLet's say that (and I am making this number up) women 27-33 have a million babies a year. And their rate of having a baby with DS is 1 in 950 (which is not made up). If every person continues their pregnancy, there would be about 1,053 babies with DS born to that group each year.
Now, let's say that women aged 42-45 have a 1 in 45 risk of DS (not a made up number) and have only 30,000 babies per year (made up). They would only produce 667 babies with DS per year. The risk is higher, but there are fewer.
Risk chart here: http://downsyndrome.about.com/od/diagnosingdownsyndrome/a/Matagechart.htm
In one of my weak public moments I looked over at an older woman and said that being a mom was so hard. She said, "No, actually it isn't," and before I could punch her in the mouth she said, "Being a good mom, however, is painfully so."
ReplyDeleteWe have friends with a child on the spectrum and I think that you would know. But I say this as a mother who knows very little about autism but a lot about being a mother to her own children.
I just finished reading Nurture Shock (highly recommend it!) and there's something in there about a 3 yr old who was able to catch right up once his hearing problems were diagnosed - I think it's in the chapter about the importance of imaginative play.
Also, in all my digestive issues research, I remember reading that they suspected that the highly educated part was only a factor because highly educated women had the resources and the know-how to get an autistic child diagnosed.
Good luck tomorrow.
@anon. thank you. I stink at math!
ReplyDeleteI got confused with risk vs. total population stats.
Based on total population more DS babies are born to younger women not because they are more at risk, but because younger women have more babies. 75% of DS babies are born to younger women; 25% are born to older women (based on total pop) even though the risk levels are higher for older women.
BTW when I was looking this up I came across this which I never heard about (it's old, 1991, so who knows what happened to this person's theory):
http://findarticles.com/p/articles/mi_m1200/is_n19_v139/ai_10816583/?tag=content;col1
"what was surprising was that we didn't see a difference in maternal age according to the stage of meiosis where the chromosome error occurs." If mothers of all ages have similar chromosome errors leading to Down's, he reasons, older mothers might have more Down's babies because their bodies fail to recognize an egg with an extra chromosome as abnormal. In other words, "It's possible that older mothers could carry a Down's baby to birth better," he told SCIENCE NEWS.
The headline was misleading saying "older women have a greater risk of giving birth to a Downs' child because they are more likely to carry them to term." which at first glance I thought meant older women were more likely to voluntarily carry the baby to term since it would probably be her last chance to have a child while a younger woman might be more likely to opt for termination. But reading it the article says the older woman's body is more likely to not miscarry the baby.