Some babies who have been on ECMO have experienced hearing loss. So before Nathan was discharged from the NICU, as part of standard procedure, he had a hearing test to check if he was suffering any hearing loss. The test showed that Nathan may have had partial hearing loss in his left ear, mostly for sounds about as loud as a whisper. But because his shunt was left-sided, there was a possibility that the shunt may have interfered with the results, so they recommended that we have Nathan retested. The re-check was scheduled for the second week of February.
We weren't really worried about Nathan's hearing at this point. We knew that he could hear since his favorite toys were rattles and noisy things. And even if he did have partial hearing loss, at this point there wasn't a lot that we could do about it. So we felt that the hearing test was a little unnecessary at this juncture, but we went ahead with it anyway just to get it out of the way.
In addition to the standard hearing screening, Nathan was also scheduled to have a brainstem auditory evoked response (BAER) test as well. The BAER test measures brain wave activity in response to certain tones.
For the test, the patient is to be reclining and remain absolutely still. Electrodes are then placed on the scalp and on each earlobe. The earphones give off tones or clicks that stimulate the hearing nerves that run between the brain. The electrodes pick up the brain's responses to the sounds and records them.
The responses are involuntary, so it is an effective way to test the hearing of those who are unable to respond to a hearing test -- such as babies. And since the responses are involuntary, the patient does not have to be awake during the test. Since the audiologist has to place electrodes on the patient to measure the responses, they prefer that babies be sleep deprived, so that they can place the electrodes before he or she falls asleep.
A day or two before Nathan was scheduled for his hearing test, the audiologist's office called with instructions on how to deprive Nathan of sleep. Basically, we were supposed to keep him up an hour or two longer than normal and get him up an hour or two earlier than normal. Then we had to keep him awake until we got to the hospital...about a 45 minute car drive away.
So to keep Nathan awake during the car ride, Bekah sat in the back seat next to his car seat. She shook every rattle we owned and would shout his name every time it looked like he was starting to fall asleep. Or she would shake his arms and legs like they were dancing. Nathan did pretty well for the first 30 minutes. But then he had had enough. Fortunately we made it to the hospital before he became too cranky!
We only had to wait about 15 minutes before we were taken back to meet with the audiologist. She performed the standard hearing screening on Nathan and he passed perfectly! She then said that we were cleared to go. We said that we thought that Nathan had to take the BAER test as well, but the said that since he passed the first test, the second one was unnecessary. So we headed home, happy and relieved that Nathan's hearing was fine.
A couple of days later, someone from the audiologist's office called and asked us if Nathan had been on ECMO. We told them yes, to which they responded that in that case Nathan would in fact need the BAER test.
To say that we were annoyed or that this was an inconvenience would be an understatement. We were so annoyed! It had not been easy to keep a 5 month old baby awake for an entire 45 minute car ride when we'd kept him up late and gotten him up early and all he wanted was to go to sleep. It felt like torture trying to keep him awake, and we were in no hurry to repeat that process. So we just told them that we would get back to them and left it at that for the time being.
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