Well when we last visited the ENT, they were satisfied with letting Brooke wait on tubes because her ears were draining slowly, but surely, and she hadn't gotten an ear infection for a month. But then just a week later (two weeks ago) Brookelynne got diagnosed with yet another ear infection! :( So we set up our follow up appointment with her ENT instead of her pediatrician because they wanted to be involved and were pretty sure they would do tubes and her neck thing if she got another ear infection.
Today was that follow up appointment with the nurse practitioner. She came in and cleaned out the wax in Brooke's ears (which she HATED) and she saw that there was still liquid in her middle ear. So she got Dr Maddern to come in and look at her ears, and neck and to talk to me about the surgery. He definitely wanted to do the surgery as soon as possible, because as he put it, "Her ears aren't infected but they are 'dirty' and will get infected again". So we went to the surgery coordinator to schedule the surgery. The tubes only take about 5 minutes, but the neck will take another 15 to 20, making the total time in the OR about 30 minutes. Since their average surgery time is 5 minutes, they don't have a lot of 30 minute blocks of time available in the OR. Therefore the earliest that they could do it is August 18th. We won't know the time until the day before at 4. That's when they will call me to give me details about when to be there, what Brooke can eat and where to go (exactly, we know it will be at Wolfsons).
The details that you may we wondering about... What exactly will they be doing? What are the affects? How long will she need to rest/recover? etc?
Well the tubes is what he'll do first, so they will go in and put her under general anesthesia with a gas mask. He'll go in through her ear, cut a hole in her ear drum, and insert a tube that is literally 2 mm long. They will do this in both ears. Her ears will probably hurt for a couple days, which can be handled with Tylonal. They will then change focus (and instruments) and begin to remove her Bronchial Cyst Tract. This will involve them cutting into her neck a quarter to half inch, to the muscle that is between her collar bone. They will remove the cyst that is in there, as well as the tract (which is kind of like a straw made of skin going from the cyst out of her body) They will have to do 2 stitches and then derma-glue the outside opening. This procedure will take approx 15 to 20 minutes. They will then take off the mask, give her medicine for the discomfort and bring her out of the anesthesia.
They will send her home with me as soon as she is completely out of the anesthesia and responding well. She will need to be watched for the rest of the day, but is then free to return to any normal routine. They will put cotton in her ears to soak up any drainage (which may continue for up to 3 days) and they ask that we keep a band aid on the neck to keep her from scratching of the derma glue, but after a few days she'll be set and the stitches will dissolve in a couple of weeks. We'll have a follow up appointment 3 weeks later. (Already scheduled for Sept 7th).
The tubes will stay in her ears for 6-24 months, giving her natural tubes the chance to mature and do their job. At that time, the hole in her ear drum will close up on its own. In the very unlikely chance that it doesn't, they would need to go back in and patch the hole. The purpose of the tubes are to give the middle ear another way of draining, since the tube that drains them into the sinuses is either collapsed or too horizontal to allow it to drain while Brooke is still so small. It allows the fluid to drain out of the ear instead of into the head, and also allows ear drops to be used to fight any possible infection (instead of antibiotics) because the drops would be able to actually get to the infection with the tubes in. The neck will close up and as long as we don't let it get infected, should be invisible to the naked eye as she grows up.
Those are the facts as I know them! :) Thank you all for caring enough to read and pray! We want to make a praise at this time, once again that Brooke's neck thing is not a sinus tract, and while still requires surgery, it is a much less intense or risky surgery. We are confident that the Lord will take care of her! These are very routine procedures and we have confidence in Dr Maddern as an expert in his field, as well as complete confidence in our Lord who "works all things together for good to them that love God, to them who are the called according to His purpose." :)