Will and Anna Esler, Ayla's parents, answered a few questions for us to help us learn more about Ayla and what the family has experienced over the past year.

How did you find out Ayla was deaf?

Ayla failed her newborn screening at the hospital, and after we took her back and she failed it again, we were referred to a great audiologist here in Amarillo who helped us begin to discern the depth of her loss. From there we started working with Early Childhood Intervention, who helped us learn what life is like for kids with hearing loss and introduced us to an amazing community of parents and kids with hearing loss. We also started working with Ayla’s speech therapist, has become a dear friend and has done so much for our whole family—she even came with us to Fort  Worth for Ayla’s surgery and her activation—and she’s helped us learn what Ayla’s loss and now her newfound hearing means for the whole family. After a few months in, we were connected to the amazing team at Cook Children’s, who have gone above and beyond to help our daughter hear. The care that we’ve received from them has been extraordinary, and we’re so grateful for them.

What was going through your mind when Ayla’s implants were activated?

Anna: Every child responds differently when their cochlear implants (CIs) are activated, and so we didn’t know what kind of reaction she would have. And even though I knew it would work, there was still some doubt in my mind, so when I saw her responding to sound I was overwhelmed by thankfulness to God and to everyone else who has been a part of this journey.

Will: Ayla has had a lot of family and friends praying for her, and we saw God answer those prayers when her devices were activated. Like Anna, I was excited and scared and nervous and hopeful all at the same time. I thought she would probably cry and scream when her CIs were activated—and she did do that later when it became overwhelming—but to see her hearing sound and enjoying it was just incredible.

What was it like getting to this point?

Being deaf isn’t bad, it’s just different, and so we had spent a lot of time preparing ourselves for what life would be like without Ayla hearing. We had to let go of some things, like her knowing the sound of our voices, the sound of music, the sound of laughter. We had to prepare ourselves to see her enjoy those things in a different way, through the vibration of them, to “hear” with her eyes. When we found out that cochlear implants were an option for her, sound became a reality for her again, and we are so grateful for that. 

How is Ayla responding now, what kinds of changes have you seen?

She still has challenges ahead of her—we have a year’s worth of catch up to play, and whereas most kids learn to hear naturally we will actually have to teach her to hear, to teach her that sound has meaning. But she’s already responding positively—sometimes she turns to sounds (which she had never done before), she dances to music, she’s starting to calm down when we sing to her if she’s upset. We really couldn’t be more thankful for the new opportunities our little girl has thanks to everyone in her life.

Ear, Nose and Throat Program at Cook Children's

We know it's about more than medical expertise and advanced technology. It's about working together to tackle even the most complex ear, nose and throat conditions. At Cook Children's, our expert pediatric specialists diagnose and treat many ear, nose and throat conditions. The Ear, Nose and Throat (ENT) staff also collaborates with other specialties within Cook Children's system to treat and rehabilitate children with speech and hearing disorders. Meet our team by clicking here. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our offices at 682-885-6850 or click here.

Maybe you thought it was no big deal. Maybe you heard something about it that made you worry.

Here are 4 facts about sugar bugs that you should know:

1.Prominent veins are common in the newborn, infancy and childhood period. They can occur on the face, hands/feet, trunk and extremities (basically all over). If you look closely enough in all babies, you’ll find some veins that are more noticeable than others.

2.One suggested link with sugar bugs has been an association with mutations in a gene known as MTHFR. MTHFR mutations are common, approximately 50 percent of the population carries some type of mutation. The significance of MTHFR mutations is still unclear but no studies link the presence of sugar bugs to these mutations. You can read more about MTHFR mutations and there significance here: A Pediatrician Goes In-depth into MTHFR.

3.While it has been speculated by practitioners of traditional Chinese medicine that sugar bugs might suggest a syndrome (known as Kanmushi) where children show a voracious appetite and severe sensitivity to sugar, I find no evidence that support this is a true connection.

4.Proponents of Kanmushi suggest that you limit your child’s sugar intake, provide a structured environment and opportunities for physical activity. Obviously, these are great ideas for all children.

So, should you be worried about your child’s sugar bug?

It’s always possible that further information could surface, but given current theories and information, I would say that any connection to a more serious issue is unfounded and not a concern.

Learn more about Kanmushi by clicking here.

My son Jack marched up to me this morning and announced, "Mama, there's a raisin in my nose!"

And that sucker was pushed in real deep. 

I didn't have any of my fancy extraction tools at home to get it out, so I'm gonna let you in on a little secret I learned about in residency: the "Mother's Kiss." Google it. It's great for getting out small things wedged up your kid's nose.

You close the "open" nostril and blow into your child's mouth. The pressure pops the object right out. It needs to be the "force of a sneeze"... whatever that means.

It worked beautifully for me today. I actually changed it up a bit and closed his mouth while I blew into his "open" nostril (I know...the things we do for our children). I was able to blow it out just enough to reach in and grab it.

Hope this helps you in your time of crisis 

Hugs,Dr. Diane

The 8 year old woke up in the middle of the night with a nosebleed that lasted 20 minutes. After drenching the bed and several towels, Casey, Carter’s mom, became concerned. Carter tried his best to calm his mom by saying, “I’m going to be Ok mom. It’s going to be OK.” During the nosebleed, Carter became progressively weak , seemed very pale and was complaining of vision changes like he was about to pass out.

Casey called 911, worried that something bad might happen before she could get help. Fortunately, while the first responders were on their way, the nosebleed slowed and Carter started to get back to normal but Casey still needed some reassurance that things would truly be OK.

I saw Carter soon after that night. As we talked, it became clear that, while had a history of nosebleeds, things were worsening in both how often they were occurring and how severely his nose was bleeding. We decided to keep a close eye on him and monitor when the nosebleeds were happening. Later in the week, she contacted me to let me know that his nose had bled for over an hour the previous night. During this nose bleed, he didn’t have any of the other more scary symptoms, but we both felt it was time to get him some more help.

Fortunately Natalie Roberge, M.D., one of Cook Children’s Ear Nose and Throat doctors was able to see Carter the next day. Dr. Roberge described what she discovered, “His nose bleeds were unusual because they lasted so long (up to 1-2 hours), and blood would also come out his mouth when he pinched his nose.”

The day following his appointment, Carter was scheduled for a surgery in which she “cauterized a little artery on each side of his nose to seal up the blood vessel and prevent bleeding.” He did very well with his procedure and has had no further nosebleeds since.

Nosebleeds are very common this time of year and it’s very unusual for children to require a procedure to help control nosebleeds. The blood usually comes from dry, cracked skin and fragile vessels in the nose especially in dry seasons. Even minor trauma like nose picking can cause significant bleeding.

Most nosebleeds can be controlled by applying pressure to the bridge of the nose for 5 minutes (and don’t check every 10 seconds). You can prevent nosebleeds by applying some nasal saline or Vaseline to the nose at night time, especially during dry seasons.

Dr. Roberge states that parents should “seek care for nosebleeds lasting more than 10 minutes, when the amount of blood is concerning (more than a quarter cup), more than twice a week or associated with other concerning symptoms.”

The vaccine is only in the beginning stages and part of ongoing research, so it will not be available to the public any time soon. But if a vaccine does become available, it has the potential to be a lifesaver for children across the world.

NBC News reports that a team at the National Institutes of Health has genetically engineered a virus that should be safe and effective against RSV, which kills 200 U.S. children a year and hospitalizes 75,000 more. RSV can lead to several types of diseases, ranging from a cold to pneumonia.

So how big would this be? Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s says a vaccine that can prevent RSV will be a difference maker for all of us.

“In terms of preventing hospitalizations, emergency room visits and outpatient clinic visits, it would be huge for infants and toddlers,” Dr. Whitworth said. “Everyone has RSV at least once in the first two years of life. It may just be a minor cold or it could progress to involve the lungs and cause wheezing. We then acquire it regularly throughout our lives as some of our winter colds. In older children and adults, who are generally healthy, it is just a mild respiratory tract infection. But we are all impacted in some way by RSV.”

A new vaccine for RSV is the latest in a line of vaccines that have helped fight against diseases such as the flu and the whooping cough. Dr. Whitworth hopes that this latest medical breakthrough serves as a reminder of the importance of vaccines and why the medical profession seeks them out.

“Scientists all over the world dedicate their lives and careers to developing vaccines because they feel passionate about preventing disease and death,” Dr. Whitworth said.

In the meantime, Dr. Whitworth says families can help prevent the spread of RSV through good handwashing, cough hygiene (covering your mouth with your elbow), using tissues, etc.

About the source

Mary Suzanne Whitworth, M.D. is the medical director of Infectious Diseases at Cook Children’s, which offers care for children and teens with diseases caused by bacteria, parasites, fungi or viruses. Our team provides a broad range of services including diagnosis, inpatient and outpatient consultations, immune deficiency evaluations and treatment of recurring infections.

“He snores just like his daddy.”

Are these things that you have said about your child? If so, you may want to ask your doctor if your child might have sleep apnea. Because pediatricians often forget to ask about snoring during checkups, it is not uncommon for the diagnosis of sleep apnea to be significantly delayed or even missed altogether.

It is probably more common than you think. I spoke with Natalie Roberge, M.D., an ENT (ear, nose and throat) doctor with Cook Children’s, who estimates that obstructive sleep apnea occurs in 1-5 percent of children.

Snoring alone does not make the diagnosis of sleep apnea. Here are some of the other symptoms that could be present:

1. Pauses in breathing. (If your child snores, it might be worth listening to them occasionally to see if you hear these).

2. Bed-wetting.

3. Mouth breathing (at night or during the day).

4. Daytime sleepiness.

After discussing symptoms and examining your child, the doctor may recommend a sleep study. During a sleep study, a child will be observed for many different characteristics of their sleep including: apnea, excessive movement and level of oxygen in the blood during sleep.

There are many causes of sleep apnea but according to Dr. Roberge, “The most common cause in children is large tonsils and adenoids. The next most common, potentially treatable cause is obesity. Other causes include craniofacial, genetic and neurologic disorders.” If your child has any of these risk factors, it is important to pay closer attention to his or her snoring and quality of sleep.

Sleep apnea is treated differently depending on the cause of the apnea. If large tonsils are the problem, the pediatrician and ENT might recommend having them removed. If the child is obese, addressing healthy lifestyle and decreasing excess weight may help to improve the apnea.

It is important to address apnea for many reasons. You can find many different conditions associated with sleep apnea such as bed-wetting, ADHD and other behavioral problems, as well as hypertension and other cardiovascular problems. The consequences of untreated sleep apnea can be missed because they are common in many children.

Despite the fact that it might be fun to tease your child about his or her snoring, it is important that we consider the serious consequences of snoring and sleep apnea. If you have questions, please discuss them with your pediatrician and they can recommend a referral to an ENT if it is necessary.

About our sleep lab

The staff in our Ear, Nose and Throat Center collaborates with other specialties within Cook Children's system to treat and rehabilitate children with speech and hearing disorders. At Cook Children's, we can diagnose and treat many ear, nose and throat conditions. Our expert pediatric specialists have access to many services within Cook Children's system to provide your child with the best care.

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joined Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.