What Ariana's Been Up To: Long Road to a Baha

7/9/13: Ari had a hearing test. We needed to document an air-bone gap (that she can hear via bone conduction better than by air) to fight with insurance about coverage for a Baha (bone anchored hearing apparatus).

7/17/13: The results of the first hearing test were worrisome. They showed an air-bone gap, but they also showed significantly poorer hearing than her previous test. We were sent for a CT scan to look for possible complications. She was all clear.

Then, there was nothing to do but wait. Oh, and wait again because insurance (for so many) changed dramatically on 1/1/14. Finally, we got the call that she had been approved for the procedure, and they scheduled it within 2 weeks. It seemed really abrupt after such a long wait.

3/28/14: Surgery day.

The little ear that will soon be able to hear.

Brave girl all ready to go.

She had a couple days of pain - more than I expected since she came out of surgery asking to go to a restaurant and eat. She was fine for several hours before she started to hurt. :(

3/29/14: She ended up having to have a 2-stage procedure. Her skull was not thick enough that the doctor felt comfortable doing the Baha abutment (we call it her button). The plate was put in the skull, and then the skin closed over the top of it to allow osseointegration to occur without danger of the external portion being bumped, dislodged, etc. It was a small, innocent-looking incision.

7/31/14: Finally, it was time to have the button put on. It went smoothly.

Button, immediately after placement.

A healing cap. This would not stay on (and caused some pain each time I had to push it back into place for her.)

8/7/14: I gave up on the healing cap. It was healing beautifully without it.

8/11/14: Washing Ari's hair in the shower, she yelped when I touched the side of her head. I looked and found, instead of a well-healed button, a hole where the button should be. A not-healthy looking hole.

Her doctor was out of town for a week, so we went to an emergency appointment with a different ENT.

After it was cleaned up, it was a great relief to find that the button was not missing (!), and a great mystery as to how the skin came up over it. (?)

They sent us home and asked me to clean it several times a day with hydrogen peroxide. She was supposed to lie still with gauze soaked in hydrogen peroxide for 15 minutes or so. Instead, I soaked cotton and held it on with a stretchy headband so she wouldn't have to stay still. (This is how she came to have that coppery highlight that goes around where the band wicked the peroxide. Whoops.) I was worried about the peroxide drying/damaging the skin, so I stopped the peroxide and started irrigating it with saline and covering with antibiotic ointment (bandage held in place by the handy headband.)

8/13/14: The doctor decided to put in a longer abutment (10mm as opposed to 6mm) so that the skin could not creep up over it again. We were given the OK to see the audiologist to at least get the Baha set up. It is possible (and as time passes, becoming probable) that they will have to replace this with a smaller abutment again at a later date. I am promised that this is a very simple and pain-free process should it be necessary. (Part of the hydroxyapatite on the "stem" of the abutment is visible above the skin line, and it should all be under the level of the skin.)

8/15/14: We have a Baha! Actually, when we arrived at the audiologist (at 8:00 am after an hour drive), I was told that she was uncomfortable seeing us after getting doctor's account of the adventure with the disappearing button. I'm afraid that I was not as nice as I could have been. In my defense, it was the 6th medical appointment of the week, and I had already been told that this was the only time available until the end of September . . . I made them call the doctor who put in the longer abutment and get clearance because we wanted to be seen. We were.