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Playing percentages with our kids

My daughter had what was supposed to be a routine follow-up for an ear infection on Friday. She's been feeling fine. Not complaining about her ears like she was. Maybe a bit of a runny nose and cough, but previously she'd mentioned her bad ears at least once an hour. So I figured it would be a quick look to confirm that the infection was gone and we'd be on our way. But this was her second ear infection in a row and we weren't taking any chances.

The infection isn't as horrible as before, but she still has fluid and problems. 

So we spent our Friday afternoon hunting down a progressively stronger antibiotic--her 3rd now (all stronger than the last)--that is difficult enough to find that a number of mainstream pharmacies did not have it in stock. We ended up at our small, local shop who happened to have the generic on their shelves. She's on another 10 days of it and then we'll be referred to a specialist if she's not better.

In the old days, we would have handled a child with ongoing ear infections differently. I told the story of my extended treatment with antibiotics...or so my mother says. Our pediatrician said it wasn't uncommon to simply keep a small child on preventative antibiotics for months. Just to make sure infection stayed away and ears drained. Today, we're much more likely to recommend drainage tubes. For those not familiar, they're surgically inserted into the eardrum to stop fluids from building up. Tubes are frequently done in connection with surgery to remove adenoids, too. 

Which is where the title of this post comes in. The thinking about ear tubes is that they're especially needed in cases where there are speech problems, hearing loss, sleep problems, balance problems, etc.. There are more reasons--such as physical damage to eardrums--so we don't really know if ear tubes would be the recommendation for my daughter. But I'm reading up on it anyway since it was mentioned as a possible outcome.

The surgery itself is fairly minor and can be done in the office if your doctor is highly skilled. Usually, general anesthesia is used. It heals. Often the tubes fall out on their own. Doctors are less concerned these days about water in the ear so you can still bathe and swim. But sometimes another minor surgery is needed to repair the eardrum. Sometimes the patient still gets ear infections. The frequency of complications from the anesthesia is about 1 in 10,000.

Granted, we trust doctors with giving us advice and answers to these complicated situations. We certainly, as a society, now understand the risks to us all from overuse of antibiotics. But when you talk about my individual kid and measuring out the necessity, risks, and rewards of a given procedure or course of action it is a struggle. It's still one of the least-appreciated aspects of being a parent--that your responsibility for another person exists in a grey area of not knowing the best choice. Hopefully, the easy solution is that her ears heal with this new antibiotic and are fine when we re-check in 2 weeks. If not, it will be interesting to hear what the ENT has to say...especially considering new guidelines released in 2013 and the possibility that tubes may not even help and kids tend to get better on their own. A discussion I'd rather not have to have. 

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