Eyes, Ears, Mouth, and Nose...

I have been meaning to update on this for quite a while, but it never seems like we've reached the "end."  I guess I was trying to wait until we closed the book on some of these issues, but it seems like they are still ongoing.

So, here's Luke's update on all of his "stuff:"

EYES

Luke continues to do great with his glasses.  Really, he couldn't be easier or more relaxed about them.  He happily puts them on the in the morning, and wears them all day long.  Throughout the summer and fall we patched his right eye daily for 1.5-2 hours in an effort to strengthen that left eye.  At our most recent appointment last month (November 1st) we received the good news that the patching has continued to make a positive impact and that when wearing his glasses, both eyes are very close in visual strength.  This is exactly what we were hoping to have happen.  So, as of November 1st, we are only patching 3-4 days per week, and will likely be finished with patching completely at Luke's next appointment in January.  At that time he will also be re-examined for a new prescription.  All in all, wonderful progress.

EARS

Unfortunately, this is the thing that I was hoping we could close the door on, but it appears that we can't.  Luke had an ear infection just before we left for Cabo - his first of the season.  When I took him in because of drainage from his left ear, we walked out with both oral antibiotics and ear drops.  Poor guy - apparently it looked pretty bad.  The good news:  the tubes seemed to be working since he didn't have a ton of pain and there was drainage.  He took the full round of antibiotics, but I continued to notice blood in his ear for weeks afterwards.  I took him back in only to find out that the ear was still very infected and was referred to the ENT.  After then paying a visit to Luke's ENT, we now know that the actual tube (which was still in the eardrum) was infected, causing the continued bleeding.  The Dr. immediately removed the tubes from both ears (NOT comfortable for Luke on the side that was infected ... poor guy), and we will be visiting the ENT again for a re-examination of that eardrum once the inflammation is down.  Of course, we're hoping for the news that it is healing normally now that the tube is out.  In the meantime, I'm on the hunt for a new ENT.  I've never been super impressed with Luke's and now I'm noticing that he seems to have issues hearing me (now, whether that's a HEARING problem, or a LISTENING problem ... one can't be too sure!), so want to take him to have his hearing re-checked.  Ahhh ... the ear drama continues.  I'm keeping my fingers crossed for no more ear infections this winter.  Without the tubes in, he will definitely feel them again.

MOUTH .... well, SPEECH
The update on Luke's speech is that he was re-screened by the local school district in October.  The speech pathologist thought without scoring the test that he would end up being "borderline" on whether or not he would qualify for services.  So, as one option we were offered an interim 4 week small group class to work on specific sounds for kids with similar articulation issues to Luke.  I took him on the first day, and he completely blew us all out of the water.  Answered and clearly articulated every single word correctly.  Every. Single. One.  It was laughable.  SO ... apparently, he is able to articulate with some support, but it just has not yet become habit.  Needless to say, he did not qualify for any special services through the district and we didn't go back to their class.  In the meantime, Mandala (Luke's preschool) offered a speech screening through an outside company and I requested that he be tested.  Of course, their results indicate that Luke may benefit from speech therapy, so I may be looking into that further after the first of the year.  As a side note, Luke's scores for language skills overall (comprehension, vocabulary, expressive language, etc.) on the assessment administered by the school district placed him in the 97th percentile :).  No issues there!

Luke's newest accessory

I've been waiting to update the blog on this topic until I was able to snap a picture of our cute boy in his new glasses. I'm excited to share how darling he looks sporting his new green accessory.

For several months the teachers at Luke's school had expressed some concern about his ability to focus on objects at a particular distance. They described behaviors that indicated he was having difficulty focusing (blinking and one eye turning in). In response to their concerns (none of which we had noticed at home), I took Luke in to see his pediatrician. She did a simple eye tracking test and found everything to be normal, but suggested that we see a specialist given my family history of strabismus.

The most wonderful pediatric opthamologist ever, Dr. Norman Fisher, is no longer with us, so I jumped into high gear contacting everyone that I knew, reading and researching online, to find the next best person to take Luke to. We ended up going to see Dr. William Good in February. He came very highly recommended and regarded as a pediatric strabismus specialist. In fact, I made appointments for both kids, just be safe. He examined both Luke and Mias' eyes and happily reported to me that all was normal and looked great. I felt relieved, but somehow still uneasy. I had had enough appointments with eye doctors in my time to know that his exam was far from comprehensive, but I tried to brush this off knowing that I wasn't the expert and that I am highly sensitive to all of this given my history.

It wasn't long later, perhaps a month, when I started to see some of the same eye behavior in Luke that his teachers had described. It seemed to occur most often when he was attempting to focus on the TV, or even on the camera when I wanted to take a picture of him. I knew then that we needed another opinion. After speaking with Luke's pediatrician, she agreed that our initial eye exam was not comprehensive and that we needed to see another Dr. She recommended Dr. Deborah Alcorn who is head of pediatric opthamology at Stanford.

Dr. Alcorn did a full eye exam (vision test, lots of tracking tests, observation of his eyes, and then dialating them) and diagnosed Luke with accommodative esotropia. This is different than what I had as a child, yet is similar in that it is a form of strabismus. The good news for Luke is that at his vision test at Stanford his eyesight was still stereoscopic, meaning that most of the time his eyes continue to work together. This is important and something we want to be sure to preserve. In most children with accommodative esotropia, their farsightedness begins between the ages of 2 and 3, and tends to get worse until around age 8 when it tends to begin to improve.

So, for now Luke is in glasses full time to correct the farsightedness and preserve his stereoscopic vision. The best guess now would be that Luke will wear glasses until he begins to outgrow his farsightedness (after age 8). In about 75% of children with accommodative esotropia that has been treated with glasses, the child's vision will improve until is it no longer necessary to have glasses and the eye will remain straight. We will revisit the Dr. at the end of May for an update.

So, as you can see, Luke is sporting a pair of very cute, very green glasses. We decided to go with a pair of Miraflex glasses because they are so stylish (ha!) and practical for preschool aged children. They are virtually indestructible, are all one piece (no screws for Mia to swallow), and are made of a material that allows kids to play in them without worry about the glasses causing any harm if they fall down with them on, or are hit in the face with a ball, etc. After we had to break the sad news to Luke that his size/shape of glasses did not come in the powder blue color (thank goodness!), Daddy and Mommy suggested a dark blue or navy pair, which Luke quickly dismissed. He wanted green ... and so green it was. After all, he has to wear them. And so far he has been great about keeping them on with no complaints, and I even think he is liking the new found attention that they bring.

I don't think he could look any cuter ... and the green is growing on me :)!