Four Months Post Microtia Repair

It's been four + months since the microtia repair, and after a fantastic initial result, we've had a few road bumps including:

• Re-injuring a spot on the rim of his ear at least twice
• A keloid developing especially on the rim of his ear (don't know if it's related to the fact that it was re-injured)
• The surface of the ear isn't as smooth as it once was
• Need for atresia repair revision
• At least one cold/ear infection

So we're still in the Bay Area (now we're in San Francisco) recovering from the atresia repair revision, and we're trying to keep Ben still.  He's doing homework and workbooks and learning about contractions and we're trying to make it so he doesn't miss too much of what was taught in class.

By the day after his surgery, he stopped throwing up and he feels good.  He did not take any of the Tylenol + Codeine - it tasted bad.  After the first night, we removed the cotton on his ear but left the plug in his ear.  He is taking Amoxicillin for 5 days after his surgery, and we're putting 3 ear drops in his ear twice a day, and we're keeping his ear completely dry.  We've been keeping it under the ear cup at night.

This is a picture of his ear - it still has a bit of the iodine stain on it from the surgery.  I compare this picture with some of the photos in September, and the skin looks considerably less smooth (even above and beyond the keloid on the rim.  The "good news" is that his hair is usually hanging a little over the rim of his ear, and you'd never notice the bumps - and he doesn't seem to be self-conscious about it.

Atresia Repair Revision

We arrived at Waverly Surgery Center in Palo Alto at 6:30 AM - we were the first surgery of the day.  The waiting room was full of people.  By 7:00 AM, we were in the pre-op room where the beds with the curtains are.  That place needs a bigger pre-op room!

Ann was the first nurse to help us - she had an Irish accent and was very sweet to Ben.  He had opened up his present from his aunt.  It was an NRG Ben 10 toy with an additional maleable plastic block that's supposed to go into the head - I couldn't figure out what purpose it served.

Ben did not want to change out of his pajamas into the hospital gown (he does not like "wearing dresses.")  Also, he definitely did not want to drink the medicine that makes him sleepy (it tastes awful - and they're not allowed to drink water to wash it down).

Dr. Bowman, the anesthesiologist introduced himself to us.  We told him about Ben's loose tooth and his ear that had been experiencing pimple-like explosions.  We told him about the violent post anesthesia experience he had last time.  He said he'd change up some of the anesthesia (and use propofol instead - yikes!)

Both Dr. Bowman and Dr. Goldstein were mid-range on the bedside manner scale.

I was able to change Ben into his hospital gown, and they wheeled Ben into the OR on time right as he was starting to feel sleepy.

At around 10:00 AM, Dr. Roberson came out and talked with my husband about Ben's surgery.  He said the surgery went well, that Ben was resting in the post-operating room, that he was able to go through the ear canal, that they decided to remove the Malleus and Incus and put in a prosthetic between the Stapes and the ear drum and that they had to use some cartilege which they harvested from the Tragus that Dr. Lewin had made.

We asked the nurse if we could have the Malleus and Incus that were removed but they said that it's against the law to remove "hazardous material" from the site and that in the surgery, the time bones are broken up so there's nothing to see. :(

At around 11:00 AM, we went into the room with Ben where he was waking up.  He was very groggy.  When we asked him if he wanted apple juice, he didn't know what it was.  He didn't want to drink anything.  He saw the bag of pastries that my husband had bought and was very excited about it, but then he couldn't bring himself to take a bite.  Plus the nurse (I think this one was Tess) said to not eat initially.  He discoverd the IV that was in his hand, and he asked that it be removed.  After it was removed, he fell back asleep.

Dr. Goldstein came to tell me what had happened during the surgery (I had not been there when Dr. Roberson explained it to my husband).  During our pre-op visit, when we were asking him about the possible surgical options and then asking him clarifying questions, he had said something like: "I'm answering these questions because you're asking them, but I just want to let you know what most patients don't ask these questions."  He had the same approach this time... When I tried to ask him a question (I forgot what it was - but it was about the procedure) his response was to rub my back and say, "Don't worry about it.  Everything will be fine."  As if wanting to understand what surgical process your 6-year old just went through represents excessive

Ben was sleeping soundly, and I wanted him to get some good sleep.  However, after Dr. Goldstein came by, the nurses were heavily hinting that they wanted me to wake up Ben and leave - so we did.

Ben went to sleep for a couple more hours, and then he woke up very hungry.  He ate some yogurt (liquid food only at first) and then an egg and some apple sauce.  After some time, he started to cling to his head, and he then started vomitting profusely.  Mop up time.

A little later, he tried to eat a little more.  Had some scrambled egg.  Mt. Vesuvius again.

In the evening, he grasped his head, and shortly after, he threw up a lot again.

It was brutal.

He went to sleep feeling pretty lousy and having thrown up a lot and starving hungry - and he was coughing all night - probably from having thrown up so much and also having had a breathing tube down his throat during the surgery.

Pre-Op Visit for Atresia Repair Revision

We had an audiological test first (I think the audiologist's name was XXX).  His hearing tested the same as it had recently - basically pretty serious conductive hearing loss with a well-functioning inner ear.

Dr. Goldstein met us and informed us about the various surgical possibilities - depending on what they see.  Since Ben's Malleus and Incus are fused, he said (1) they might put a prosthesis between the Stapes and the Incus or (2) they might remove part of the Stapes and put a prothesis between the Stapes and connect it directly with the ear drum (and also remove the Malleus and Incus) or (3) they might XXX.

We asked why the consent form included cartilege removal and why skin grafting.  He said that he didn't think either would be needed, but depending on what they find when they are in the OR.  He said that the cartilege removal is used if option 2 were used so that the titanium prosthesis doesn't poke a hole in the ear drum.  He said skin grafting happens if they need to repair the ear drum - which he said we were not doing.  Also, he said that they always intend to go through the ear canal but if it turns out it can't be done easily, sometimes they make an incision behind the ear and lift up the entire ear flap.

Then he took a look at Ben's ear and was amazed at how much goop there was in there.  He suctioned it out with the metal tube and just said that he's the sort of kid who's going to have to have his ears suctioned out a lot.

When we were asking some questions trying to understand the actual procedure, he told us that "noone" usually asks these questions...

Nearly Four Months Post Microtia Repair

Now we were getting close to the date of Ben's atresia repair revision, so we were in contact with Cheryl Medina to make sure we were doing everything well.  We are pretty busy, and Cheryl is pretty busy also, so it's sometimes difficult for us to connect.  These are the things we needed to confirm:

• When (what time) and where the surgery will take place
• Fasting after midnight before the surgery
• No aspirin or Ibuprofen in week before surgery
• Get written clearance from pediatrician on day (or two) before surgery
• Need pre-op visit with Dr. Roberson's office on afternoon before surgery

In the following week, he had a couple of episodes whereby I believe that cysts that developed in his ear canal popped, and they created a bit of puss and blood that dried up in his ear canal, once more alarming us.  This time, I cleaned them up a bit (and they looked a lot better).

We visited Dr. Keene (Ben's pediatrican) on Tuesday, Novmeber 15, the day before leaving for Palo Alto, and he gave Ben clearance for the surgery.  He said there was goop in his ear that he would leave since the ENTs could do a better job of removing it.

Three and a Half + Post Microtia Repair

Ben seemed to be doing well (from the perspective of not having additional blood episodes in his ear - but then he caught a slight cold (nothing terrible - but at this point - we were getting closer to his November 17 surgery date.  So Dr. Keene prescribed Amoxicillin for him so that he'd be clear by the surgery date.

I had been out of town, so I scheduled the follow up visit with Dr. Liu (and also saw Dr. Lewin) for Wednesday, November 9.  He took a lot more goop out of his ear but said that Ben was okay to have the November surgery.  Dr. Leewin was a bit distressed about how the ear now looked.  She said it looked worse than when she had seen it a couple of weeks prior.  We briefly rehashed potential treatments - including cortisone shots (but she said that probably would not work) and surgical removal with radiation...

Three Months Post Microtia Repair

Ben's ear had been healing really well and looked great.  With Dr. Lewin's blessing, he had resumed all of his regular activities such as swimming (and taking advantage of the Indian Summer) and AYSO soccer.  Around the time of his 6th birthday, we started to notice that the skin on his ear was looking like it was having a bumpy surface - almost like an allergic reaction.

And on the Monday morning after his birthday, I noticed blood coming out of his ear.  I quickly scheduled the next time I could see Dr. Lewin, and we met first thing on Wednesday, October 20 at Dr. Lewin's "other" office at the Cedar Sinai Medical Tower at 8631 W. 3rd Street.

Dr. Lewin was pretty distressed by how much the outer ear had changed in such a short period of time and said that keloids had developed and that keloids can develop on people as part of the healing process.  She said that the keloid appeared to be under the skin membrane and therefore might not respond to steroid injection treatment which may be tried to reduce the keloid.  She said that probably the treatment (if elected) would be surgical + a light radiation to the site so that a keloid would not re-develop.  I read a little bit about this on the Internet - there are some an interesting video by a Dr. Hill and then an article on the various types of treatments with none being entirely effective with no recurrence.  Obviously, we were more concerned about why the blood was in his ear, so she asked her colleague in this office, an ENT named Dr. Gene Liu, if he would take a look at Ben's ear.

Dr. Gene Liu is the same ENT that Devin (Ben's friend who we met through Dr. Lewin) now used - and it was nice to meet Dr. Liu.  He was very nice - especially for Ben, who hates having people touch his ear and his ear canal on his microtic side.  Dr. Liu ended up looking in his ear and saying it was just an outer ear infection (not something to be terribly worried about) but since our scheduled surgery was happening relatively soon, he prescribed antibiotics for Ben.  In addition, he sucked a lot of goop out of Ben's ear using a suction machine with a long metal "straw."  It was very loud due to the "slurping noises" but Ben was glad to have the "buggers" out of his ear.

Dr. Liu said to check back with him after a week or so to get sign off for the November 17 surgery.

Before leaving, Dr. Lewin showed me photos of the boy who she worked on who developed keloids after his microtia repair.  The keloids removed looked like little slivers of yellow fatty material.  Then, she re-sutered the spots and radiated them so that they would not re-keloid...Another boy, Miles - a patient of Dr. Reinisch, has a blog which includes a reference to his experience with having the keloids removed.  More to consider, but not now...

Three Months Post Microtia Repair

Ben was swimming a lot during the brief Indian Summer we had in early October, and around the week of his birthday in mid-October, we started to notice the outside of his ear looking a little strange, as if the skin was having an allergic reaction to something.  Then, on Monday morning (October 18) I noticed a ton of blood had clotted up in his ear.

I took him in to see Dr. Lewin for the first appointment on Wednesday morning, October 20.  On Wednesdays, Dr. Lewin works out of the Cedar Sinai Towers on 3rd Street with other ear doctors, including an ENT named Dr. Liu.

 Dr. Lewin was distressed about how the external ear skin looked - saying she had never seen an ear that started out so perfect for so long have keloids develop this late in the game.  But she said to focus on what was happening inside of his ear first, and she asked Dr. Liu if he could take a look at Ben's ear. 


Dr. Liu was great with Ben - who doesn't eactly like for strangers to touch his ear and particularly his ear canal.  Dr. Liu said there was a ton of goop in his ear and he stuck a long metal straw down Ben's ear and suctioned the goop out.  It made very loud slurping sounds, so Ben was a little squirmish and not particularly thrilled, but he liked the idea of having buggers removed from his ear.  He said that the problem was just an external ear problem (not middle or inner ear) and that just to be extra cautious, he was prescribing antibiotics and to see him in 10 days.

Before leaving, Dr. Lewin showed us what she did with another patient who developed keloids.  They surgically removed them and then radiated the spot so that keloids did not re-develop.  She said it worked well.  Of course, those are two things I want to not expose Ben to - so I'm not thinking about it for now.

Finally, Dr. Liu said that we'd probably be just fine to go ahead with the atresia repair revision on November 17 but to check back with him in 10 days.

Two and a Half Months Post Microtia Surgery

The drive from LA to Palo Alto has gotten to be second nature for me.  Ben and I leave at around 6:00 AM, we wave goodbye to the other kids, we put Star Wars on the truck's DVD player, and I hear him cute sounds (sometimes giggles, sometimes gasps while he's hiding under his blanket) coming from the back seat.  We stop at around 8:30 AM for McDonald's pancakes, sausage, eggs, yogurt, hash browns (him) and coffee (me).  And he takes a nap for an hour and a half.

We schedule our appointments with Dr. Roberson for around 3:30 PM, so we have a couple of hours of rest between when we arrive in Palo Alto (around noon) and when we need to go to our appointment.

At the appointment, Dr. Roberson looked at his ear drum and said it looked really good.  (Dr. Putnam had also said it looked great.)

He explained that he won't go through the actual ear drum for the surgery but along the side of the ear canal.  He also repeated the prognosis - pretty good.  He wouldn't know until he goes in there exactly what he would do - probably putting a titanium prosthetic onto the Stapes so that it touches the Incus.

After the doctor visit, we went to Create It Ceramics and Glass Studio at the Town and Country Mall in Palo Alto and made a shiny black spider with white dots and beady red eyes.  That place is like Color Me Mine but even better!  Lots of fun!

Two Months Post Microtia Repair!

September 18, 2011.  Today's the 2 month mark from when Ben had his microtia surgery.  Since the past post when Ben's brother repeatedly re-injured Ben's new ear, Dr. Lewin put his ear on lockdown under an ear cup for the following week.  After checking it last week, Dr. Lewin gave him the go ahead for any activities that he wants.  Soccer?  Sure!  Swimming?  Sure!  Ben had his first foray back into the soccer world yesterday and was a champ - he loves soccer.

His hearing on right side reverted to sub-par levels, so we talked with Dr. Roberson this past Wednesday.  He said that there could be problems with the ear drum, the stapes or both.  We'll go see him in person at the end of the month for an in-person assessment.

We've also scheduled an appointment for the surgical repair - he said there's a 50% chance that the surgery will result in restoring Ben's hearing to normal levels whereby he would not have to wear a hearing device.

Above is a photo of Ben today.  He was in the middle of eating, so that's mid-bite.  There are still a few tiny bumps in his ear, but his ear is looking really good overall.

Eight and a Half Weeks Post Microtia Repair

We visited Dr. Lewin, and she said that the ear was healing pretty well.  We removed the ear cup, and Ben resumed his regular activities - including his AYSO soccer.

By now we were also thinking about making sure that we scheduled Ben's atresia repair revision (his hearing had improved after the surgery in March, but then was back to its previous level after a while).  We wanted to schedule the surgery in 2011 if possible because we had already gone through the entire deductible as well as the maximum amount that a family pays in one year - so if we waited until next year - we'd have to pay the deductible all over again.  (See notes later on how this became a very fortuitous decision, as we later received a letter from Dr. Roberson's office that he was going to no longer be in network starting 2012, and also my own insurance policy raised its deductible and maximum amount that a family pays considerably for 2012...)

Anyway, we scheduled for Thursday, November 17.  In order to really know what we were doing during the revision, we talked by phone with Dr. Roberson.  He indicated that the hearing loss could be due to two things: (1) a "lateralized" ear drum and/or (2) conductive hearing loss due to the connection between the three tiny bones or ossicles (Malleus, Incus and Stapes) in his middle ear not having the connection they need in order to conduct sound.  According to the surgical notes from March surgery, there was a "fibrous" connection between the Incus and Stapes - so that, at a minimum was a problem.  In order to know whether the ear drum were also a problem, he'd have to see Ben.

Seven and a Half Weeks Post MIcrotia Repair

Ben's ear was healing really nicely, so with permission from Dr. Lewin, he started to enjoy the few remaining days of summer.  School was starting on September 7, and unfortunately, I had to be out of town on the first day of school!

September 6, 2011.  After the Labor Day weekend which included Ben's brother kicking him in the ear and knicking his ear, we paid a quick visit to Dr. Lewin who confirmed that we are doing the right thing with the Bacitracin and yellow tape, and that we're basically back to square one on that spot for Ben and need to wait for it to heal...

September 7, 2011.  Another bump on the road to recovery...While traveling, I received a text from my husband that Ben's younger brother (yes, the same one who kicked him in the ear a couple of days before) had wrestled him to the ground in the playground right before school, and Ben landed on his ear in exactly the same spot busting open the wound.  (Groan!)  Here is a picture (left) of what it looked like after the tumble in the play yard.  Thankfully, we now carry Bacitracin and yellow tape with us...

By the next day, the ear had healed a little and looked like this (right).

Ben returned to Dr. Lewin that day, and she re-bandaged his ear and said that it had to be kept under the plastic ear cup until it was completely healed.  We did not put any ointments on the ear, just let it heal under the ear cup.

Seven Weeks Post Microtia Repair

Ben after his brother kicked him in the ear

September 5, 2011.  Two steps forward, one step back.  Ben returned from a wonderful slumber Labor Day weekend nonchalantly mentioning that his brother had kicked him in the ear with his shoe - so in the same weak spot as before - his ear got banged up.  Back to the Bacitracin and yellow Xoroform tape.  (I went ahead and bought a jumbo pack of it online.)  The other parts of his ear are healing nicely, though...Tomorrow we'll be seven weeks out.

Six Weeks Post Microtia Repair



September 1, 2011.  As Francesca promised, Ben's ear continues to gain definition.  You can see the "Y" there.  Ben took a bath tonight, and I mistook his new ear with his "old" ear.  Not the greatest photo of Ben, but here's how his ear is looking.  We are going to the audiologist and Dr. Lewin tomorrow.  He's had a cold, and I think it's affecting his hearing in both of his ears.

September 2, 2011.  Since Ben was saying, "What?" quite a bit, we took him in for an audiological test with Dr. Sol and Dr. Avila (his new associate) who confirmed that he has a little "pressure" / fluid in his left ear and bone conduction loss in his right ear.  They set us up with a visit with Dr. Michelle Putnam (an ENT) with Westside Head and Neck for later in the day.

We had set up a visit with Dr. Lewin next.  Dr. Lewin who said that the ear is healing well, that we should continue with Clobetasol on the front for just a little longer but stop the Bacitracin, that Ben can do anything that the ENT OKs, that the ear will continue to heal and stabilize over the next few months and that we'll see Dr. Lewin next in December!

When we visited Dr. Putnam, she confirmed that the left ear had some pressure and that there is bone conduction hearing loss in the right ear (most likely the 3 bones in the middle ear have re-fused together and are not conducting sound) and that the ear drum looks good/intact.  She prescribed Afrin, Ocean's nasal saline solution and Nasonex (prescription) for Ben to take to try to clear up the liquid.  Also, she said he's cleared to swim but that he should dry out his ear after swimming.



Dr. Putnam and Ben



Five Weeks Post Microtia Repair

August 21, 2011.    Yes - that's his new ear!  It's been one month and three days since Ben's surgery.  Ben's ear is really coming around.  When Ben saw this picture of his ear (above), he insisted it was his old big ear.  There is still some raw-ness in the same spot and along where the sutures were along the rim of the ear, but the ear is looking less and less swollen.  For the past week and a half, since Dr. Lewin told us she was concerned about the healing in that one spot, we've been putting Bacitracin Zinc ointment on the raw spot, Clobetasol on the front surface of the ear and Neosporin gel on the part of the ear right at the entrance to the canal where there had been some cyst-like bumps.  The cysts at the front of the canal that I was worried about seemed to have resolved themselves and gone away.

I created my own way of wrapping his ear so that it's protected and is kept moist with the ointments, but he doesn't have to wear the cup.  So most of the time, Ben's ear is enjoying healing time under wraps.  He's not a big fan of wearing the cup, but he's fine wearing the bandage.

August 26, 2011.  It's been five weeks and four days, and Ben's ear has healed an incredible amount in a short period of time.  Here (to the left) is a photo from today after I cleaned his new ear.  As you can see, the swelling has decreased a lot.  It still has a ways to go.  The skin is still raw and a little pink.  Dr. Lewin says that it'll take a few more months for complete recovery.  Francesca said that it will get a bit more definition, which you can start to see already.  I'm also including (to the right) a photo of his "old ear" - his left side non-microtic ear so that you can see the comparison.

Here are also some pictures from the past few days.  When we went to visit Francesca on Wednesday, Francesca said that the cool thing is that while the ear first had only that one blood vessel providing the blood, by now vessels from other sides of the ear have grown into the membrane and so the ear is being provided with blood from all directions.  She said that the original vessel feeding the ear could be cut, and Ben's ear would be just fine.  Amazing!

Four Weeks Post Microtia Repair

August 10, 2011 - before bed time.  By week 3, Ben's ear was healing nicely.  So after our August 10 visit to Dr. Lewin, as per her advice, I gave my first crack at cleaning Ben's ear with hydrogen peroxide.  Bad idea.  Immediately, the hydrogen peroxide made some of the skin on the ear turn white, and there was a slightly "raw" spot that became an open wound by the morning.  I sent Ben to summer camp with no cup or bandages on his ear because I had thought it was OK to do so.

August 11, 2011.  I sent the photo to the right to Dr. Lewin because I was concerned about the open sore.  She called me back and said to keep the spot  moist with vaseline and to not worry about it.  That was on a Thursday or Friday.

 

August 15, 2011.  By Monday, the ear looked a bit better (see photos above from Dr. Lewin's office), but I was going to travel for the week, so I brought Ben into the office.  I actually thought the ear looked pretty healed up by the time of the appointment, but Dr. Lewin saw it and was quite concerned about how raw the skin looked in that one spot. 

Dr. Lewin put us on a new regiment using the special yellow tape + the Bacitracin Zinc ointment.  (They say it's basically the same thing as Neosporin.) 

August 18, 2011.  Exactly one month post surgery.  As per Dr. Lewin's advice from our previous visit (see below), we had been checking and re-applying Bacitracin Zinc ointment to his ear twice a day for the past few days, and the open sore on his ear seemed to make good progress healing.  By the time I returned from my work travel, it had improved further (left and below).

Three Weeks Post Microtia Repair

<August 10, 2011.  Ben's ear is looking less and less swollen, it's coming closer to his head, and almost all of the sutures in the front are gone.  There are some small signs of irritation (tiny bumps/cysts) in the canal; Dr. Lewin and Francesca say Ben probably had a reaction to the sutures there and that it will go away.  (You can see the tiny bumps in the second photo below.)  Dr. Lewin was really busy during this appointment with tons of patients in her office.  Another nurse (Cheryl?) washed Ben's hair and prepped him, and then he had his photo taken by Francesca.

We're told that he looks great and that we can start washing his ear on our own.  Also, we're told that with the split graft (which Ben had), they recommend putting a dollop of Clobetasol on the front (split graft) side of the ear.  In addition, Dr. Lewin recommends that I put Neosporin in the entrance of the canal where there are a few bumps/cysts.

Ben in the photo booth.  Francesca behind the lens.  This is his new ear at three weeks.  Yes, that is his new ear.

Two Weeks Post Microtia Repair

August 3, 2011.  Same wonderful, exclusive Dr. Lewin / Francesca Jahns spa.  (Photo of spa treatment to the right.)  Ben's ear is looking a lot better quickly.  Francesca puts a cotton with vaseline on it in his ear to prevent water from getting into his ear during the shampooing.

There is still dried blood, rawness, stitches and quite a bit of swelling.

I love this picture of Francesca painstakingly cleaning his ear.  It's apparently important to keep the ear cleaned and work the stitches and grime out to help the ear heal and look good.

One Week Post Microtia Repair

A day or two after the surgery, Ben's right eye was very swollen - so we went into Dr. Lewin's office - and they said that was typical and that the swelling would get a little worse first and then better.  Indeed, within a few days the swelling in his eye was gone.

In addition, at first, it was very difficult for Ben to sit up and go to the bathroom because his abdomen hurts from the skin graft taken from that area.  After just a few days, he's able to walk upright and within two weeks, he can wear normal pants (and it doesn't hurt his scar on his abdomen.

July 27, 2011.  It was amazing seeing Ben's ear (above) for the first time.  Dr. Lewin's office and lovely Francesca Jahns provides a wonderful shampooing (regular baby wash) to help wash the hair where there is still a lot of healing going on.  The shampooing also reduces the itchiness from the graft site healing.  They also clean (with regular liquid soap) and re-dress the ear.  Dr. Lewin and Francesca provide the much needed "touch."  Not much you have to worry about!

Above is a picture of Francesca cleaning off some of the dead skin on his new ear.  It has stitches and is somewhat swollen but looks pretty amazing for one week out. 

Also, due to the swelling the ear sticks out.  Dr. Lewin says that it is impossible to make the ear stick out too much because it always becomes closer toward the head when the swelling goes down.  Just to set expectations, she says that the ear won't be healed until about four months.  Ben won't be able to get his ear wet at all (sponge baths) for one month.  He won't be able to swim for two months.

They put a certain ointment/substance on his ear to prevent fungal growth in this early summer weather (see above).

During this visit, Dr. Lewin says that she sees a first...I cut Ben's long hair while we're there and before they put the bandages back on his ear.  That way, his hair won't be in the way when they try to put on and remove the sticky bandages.  Then, Dr. Lewin re-dresses his ear and puts back on his ear cup and red cap (and shares a red vine with Ben).

Microtia Repair - July 18, 2011

Ever since the canalplasty, we had scheduled the microtia repair with Dr. Lewin to be in early summer so that Ben would have as much time as possible during the summer to heal.  School ended at the end of June, and then I took the kids to NYC to see the Statue of Liberty, Lion King and meet up with lots of great friends.

July 18, 2011.  We arrived at 6:30 AM at 310 N. San Vincente Blvd, the Cedars Sinai Surgery Center which is in the Outpatient Services Building north of the Cedar Sinai hospital high rises.  There is plenty of parking in a big parking lot in front of the building.

We waited for what seemed like a long time, especially since Ben hadn't eaten or drunk anything since the night before.  When we went upstairs and then to the pre-surgery room.  Dr. Lewin greeted us in her scrubs, and introduced us to the anesthesiologist, Dr. Karen Butterworth (see photo below with Dr. Lewin).  When we were showing this picture of Dr. Lewin and Dr. Butterworth to our youngest son (four years old), he said, "Wait.  The doctors are girls?"  Clearly, we need to work harder on breaking down their mental barriers on gender-appropriate professions... There were also several great nurses as well as the assisting male nurse who was terrific and called us frequently during the surgery which lasted until around 5:30 PM! 

As was the case with the canalplasty, at least one of us had to be on the premises the whole time.  I took a trip home during the surgery.  When we finally got to see Ben, we were so relieved.  He did really well, and though his ear was completely covered up and would remain that way for a week, Dr. Lewin showed us pictures from the surgery that she had taken.  (She thinks of everything!)  He did not have to have tubes for drainage.

Our beautiful son was asleep for a while, and when he woke up, it was much less traumatic than it had been with the canalplasty.  He did immediately ask if we had gotten him the Kevin Levin Ben 10 action cruiser that he had requested and seemed pretty pleased with the Ben 10 Mack 10 car we got him instead.  I thought the stuffed bear that had a head bandage and was labeled "Ben" was a really nice touch.  We went home and had a welcoming home "party" with mac and cheese.

Doctor's Orders:

• No getting the inner ear wet
• If in pain, take prescription Codeine - but it tastes so bad the kids would rather be in pain
• Don't sleep on the Medpor side
• Use shirts that button in the front
• Keep the ear cup on for the first couple of weeks.  Thereafter, the ear cup is only needed at night.
• After the first couple of weeks, try to clean the ear and encourage the stitches and dried blood to go away

Removal of the Plug (April 25) and 1st Cleaning (May 13, 2011)

April 25, 2011.  In April, at the recommendation of the Calfornia Ear Institute, we saw a local ENT, Dr. Lei Zhuang, at Cedar Sinai for removal of the plug.  Dr. Zhuang is a beautiful doctor with a no-nonsense approach that did not jibe with Ben.  (We decided that we need to seek out a more kid-friendly ENT in the long term.)

We continued to put drops into Ben's ear.  Still not exposure to water: sponge baths only.

May 13, 2011.  Then in May, we returned to the California Ear Institute to see Dr. Geoffrey Service an ENT fellow with Dr. Roberson (I don't think that Dr. Roberson is in the office on Fridays) for removal of the last piece of packing and little clear plastic disc (looks like a tiny contact lens) that keeps the ear drum in place and a cleaning of the canal.  Dr. Service had these super precise and long angled tweezers for getting in there.  I believe that this was also when the clear disk was removed from his ear canal.  Although Ben was very sensitive about anyone touching his ear, Dr. Service was very good about connecting with Ben (he has sons the same age) and telling Ben what to expect and showing Ben the stuff he was removing from his ear.

In addition, we had another audiological exam - and the results were much closer to what we were experiencing with Ben.  The results indicated that the surgery had helped close about half of the gap of hearing loss that he had.

Water Filled Family Vacation

We had long-planned a family vacation at a big resort in Cabo where the main features are hanging out in various fun swimming pools and going to the beach.  Needless to say, Ben (and his brothers, too) were quite understanding of the need to not get his head wet.  Dr. Roberson would probably have a heart attack seeing these pictures, but we did stay true to our commitment to keep his head above water.

Trimming of the Plug - April 6, 2011

April 6, 2011.  A week after the surgery, we were thrilled to make it through the first gauntlet - keeping the plug in his ear canal.  I honestly don't know how we did it.  We told him no running around and jumping.  We returned to CEI to see Dr. Roberson so he could trim the plug and infuse it with more antibiotics.  Ben was sensitve around his ear and was not happy about having a stranger touch his ear.

It was also at this time that we did the second of three audiological tests at the CEI.  The results indicated that Ben's hearing was pretty much unchanged from prior to the surgery.  The results didn't make any sense, because we were certain that he could hear us from his new right ear.  Whereas before the surgery he could not hear at all from that side, after the surgery we could whisper on that side and have a conversation with Ben...

We were to continue putting Tobramycin drops in his ear canal twice a day.  His healing was going really well - no signs of infections or stenosis.