Sunday, January 29, 2012

What? What Did You Say?

About a month ago, Sophia visited our pediatrician for a routine, yearly check up. Now that she’s four, the doctor administered a hearing test for the first time since her birth.

Sophie eagerly followed the nurse into the small room at the end of the corridor. She hopped into the chair, allowed the nurse to set a pair of large headphones over her ears. Sophie listened eagerly as the nurse instructed her to point to a picture when she heard the word.

She loved the game of it. Her face was screwed up with concentration. On the first couple of trials, I watched as she happily pointed to each picture.

Then she waited. She glanced up at the nurse to see why the game had stopped.

It hadn’t.

My heart sank as I watched Sophie fail her hearing test. The nurse did four sets of multiple trials, each time the decibel level dipped below a certain threshold, Sophie showed no indication of hearing.

An expert in catastrophizing, I quickly flashed to a deaf future. A world without music, without voice. Of having to learn sign language. Of accommodations and devices.

And it all made sense to me. On some preconscious level, I knew she hadn’t been hearing well. Asking me to turn up Beauty and the Beast in the Car because she couldn’t make out what Chip was saying (though I could hear him, plain as day). Or the fact that she says “What? What did you say?” a lot.

I thought she was just tuning me out.

When we met with the doctor, I tried to keep my distress at bay, while I asked her about the test. She was unconcerned. “Oh, lots of kids fail the test. It’s hard to keep kids focused on the task at this age.”

Not Sophie. She was into it.

I pressed. I told her about the recent discovery of fluid in her ears at her last appointment. Of her cough that lasted two months. The doctor obliged me with a tympanogram, which passes a sound wave through the ear to see if the ear drum would vibrate.

When it didn’t, my wonderful doctor drew a quick diagram for me, explaining how fluid in her hears was preventing this vibration, that the hearing loss was likely due to the fluid and not to worry. It would resolve. Still, she sent us for a more detailed audiogram, that would help us determine the degree of loss (if it hadn’t resolved by that point), and to discern whether it was an inner (equipment) or outer (conductive hearing loss because of the presence of fluid) problem, and give us a baseline for comparison in a couple of months.

We saw the audiologist at CHOP a few weeks later. She was friendly, and engaging. Sophie took an instant liking to her. After taking a history (Did she have a hearing test at birth? Pass it? Yes. Yes. Any history of hearing loss in the family? Yes. Kevin’s side. How old were they when they lost their hearing? Older. 40’s 50’s 60’s . Had we noticed a difference in her hearing? Yes, I did. For how long? Within the past year. It’s so hard to pinpoint these things, in hindsight.

She began to test Sophie, “I’m going to put these headphones on you. When you hear a sound, I want you to put a peg in the pegboard. Okay?”

“Okay!” replied Sophie, enthusiastically. She carefully watched the audiologist’s face. I watched Sophie’s. It was clear she heard the first few tones, giving a slight nod or announcing, “I heard it!” as she jammed a peg into the board. Then, her face dropped. She didn’t look quite as sure. The audiologist looked at her expectantly, and Sophie put the peg in the board.

“Good!” said the audiologist, unwittingly rewarding Sophie for attending to her prompt. On the next several trials, the same thing happened. Sophie watched the audiologist, the audiologist unconsciously signaled her with eye-contact when she played the tone, and Sophie, wanting to do it right, stuck a peg in the board.

I said, as gently as I could, “I think she’s looking at you for cues. Could you not make eye contact with her?”

Wordlessly, she immediately broke eye contact. And that’s when Sophie began not hearing, again.

Later the audiologist explained that her hearing loss is slight and conductive. She’s guessing at what we’re saying when we’re whispering and its probably a little worse when she has an active cold. When I was a child I had three myringotomies—tubes placed in my ears. Kevin had them once. Looks like her genes were stacked against her.

I am relieved. I wish that I could stay cognizant of how magnificent it is that we have our senses to perceive the wonders of the world. It is a shame that it takes a small scare to awaken me to how precious our hearing is. Today, I am listening with gratitude to: my daughter’s voice singing in the back of the car, the whisper of “I love you” in my ear, and even the pesky birds that greet the day with such joy in the tree beside my bedroom window.

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