a Southern Girl........

....well, not exactly. This week Bama Ears was able to peek into the life of Assistant Director and Pediatric Cochlear Implant Audiologist at the Children's HEAR Center, Mandy Mahalak. Mandy may not be an Alabama native but she sure knew how to make herself feel right at home here in Bama. Since moving to Alabama years ago, this volleyball/tennis playing gal has not only been seen eating a fried green tomato but fried okra as well. And now that she's eating for two (again!) you may see her sampling more of what Alabama cuisine has to offer.

Mandy doesn't quite have the Southern accent down yet but we are working with her on that so hopefully by the time baby number #2 gets here (it's a boy), she'll be speaking right along with her Southern peers. You may find us in the booth working on Spondee words such as "hot dawg". Her receptive skills are fantastic and her speech is bound to catch up sooner or later. She's very proud that she's adopted the word y'all already into her vocabulary. We gave Mandy a Southern Vocabulary test just to see areas that may show weakness and here are the results. Right away Mandy knew the words doohickey saying it was the same as thingamabob and that dad burn it means darn it. However, she did have problems with the word orta, which we all know means should, and the term walla go obviously means a while ago. I did go over the results with her and since we are not bound by HIPPA privacy treaties here at Bama Ears, she does understand the results would be displayed.

We asked Mandy why she chose pediatric audiology and and she claims she loves to work with children. She likes the challenge of working with kids and says it's never a dull a moment when you work in pediatrics. We asked if she had experience working with children with multiple needs as well since almost half of all kids with hearing loss experience other issues also.

"I am fortunate enough to be able to work with children with many special needs. Children with short attention spans are not uncommon in our patient base. We also work with many patients with different syndromes, vision impairments, cerebral palsy, and autism to name a few. This is part of the challenge that keeps me going on a day to day basis. You really have to be patient and creative to get the information and participation you need from any child, then add on an additional impairment other than deafness and the challenges becomes greater. I love my job, and I am blessed that I have the opportunity to make a difference in all types of children's' lives."

We thank Mandy for letting us peek inside her life a bit. When not at the HEAR Center helping our kids hear better, she's at home with Brian, Lucy, and their two dogs watching Jon and Kate Plus 8 when she's not rocking out to Guitar Hero. This cool mom of soon to be four (if you count her dogs...and she does!) tries to stay current by keeping up with the latest top 10 songs on the radio but she really prefers listening to Billy Joel, Jimmy Buffet, any song from the 80's and Veggietales (a true mom). This audiologist is determined to prove that you don't have to be Bama born to be a Southern girl.


Bama's Bright Light

Every so often Bama Ears would like to shine the Bright Light on an exceptional parent. Our first to highlight is Mrs. Jennifer Andress. Her two children are hearing impaired due to Connexin 26. John (age 6) is currently using hearing aids, and Will (age 4 ½) wears bilateral cochlear implants. Jennifer serves as V.P. of the Service Guild, which is a service organization solely dedicated to The Bell Center’s Early Intervention Programs. When she’s not running marathons chasing after her two boys, she's running them for The Bell Center partners-in-training program for the Mercedes Marathon. She and husband Keith also run in Atlanta’s Thanksgiving Day Marathon as well as other races in our area. Looking at her active lifestyle you would never guess her past. Here’s a little hint ...

(She and her son John are closing the van's back door.)

When her first child, John, was 11 months old, he needed tubes for his ears, and this is when they found out he had a hearing loss. With Jennifer already carrying baby number two, John was fitted for aids and soon after, she found out she had precancerous growth in one of her breasts. She has a long history of breast cancer in her family so while 24 weeks pregnant and a 1-year-old, she had a mastectomy. A few months later baby Will was born, and she soon began radiation. But before that treatment began came Will’s hearing tests, in which he was also determined to have hearing impairment just like his big brother.

A few months after completing her radiation, Jennifer had a second prophylactic mastectomy and breast reconstruction with an eight-week recovery period. Remember, Jennifer also has two hearing-impaired children to care for, but she manages along with her very supportive and loving husband. Within weeks of her final recovery, baby Will had his first cochlear implant surgery and a year later had his second.

Jennifer says she’s had great support throughout from all of their doctors, health care professionals, church, friends, family, and notes “God is great!" Today when she’s not making commercials for Breast Cancer Awareness, or helping with the Bell Center’s service organization, or running half-marathons, she’s preparing John for first grade and still has a year to prep Will for kindergarten. Congratulations, Jennifer, Bama's Bright Light is shining on you, a true inspiration.

If you would like to nominate someone as an exceptional parent for Bama's Bright Light, please email us at bamaears@yahoo.com . They need to be an Alabama Parent of at least one child with hearing loss.


Under the Microscope

When you find out your child has hearing loss, often times you are offered genetic counseling/testing. Why would parents want to have their genes or their child's genes put under the microscope? Should we just accept that “it is what it is” or “it was just meant to be?” It is a very personal choice, and we wanted to give you our thoughts on why we chose genetic testing. There are several benefits of genetic counseling:

1. As children get older, they will have questions such as “Why me?” or “Why don’t my ears work?” or a number of other questions that you need to be able to answer.
2. Also, when children become adults and want a family of their own, is there any likelihood that they too will have deaf children? Or was their hearing loss an isolated case?

3. Having the counseling can also help you answer questions such as, "What is our risk to have another child with hearing loss?" "Should we have more children? Do we want to have more children?” Some people really struggle with these questions that can be an emotional concern as well as a financial and a major health concern.
4. Health! Up to 40 percent of children with hearing loss have other issues, which is almost half of the kids with hearing loss (according to www.raisingdeafkids.org/speical)! Sometimes children may have an underlying syndrome, and hearing loss is secondary to that syndrome. Many kids with syndromes may appear to be fine to the untrained eye, but with a full exam from a genetics specialist, it may be determined that the child has syndromic hearing loss. Finding this out ahead of time can really be beneficial. A child with a syndrome may need other testing to determine if there are other complications or concerns that need to be addressed. Sometimes as a child with a syndrome ages, other things develop that can cause concern that could possibly be addressed earlier. The child could develop cognitive delays, growth abnormalities or visual impairments, ADHD, or even more serious developments such as kidney or heart or spinal problems. Having these issues addressed in the beginning can help you decide which follow-up care or continuing care to pursue for your child. It helps you be on the lookout for certain issues to develop, and if they do, you’ll know whom to contact.
5. Relief. Genetic counselors can also test for nonsyndromic hearing loss. For example, a mutation in the connexin 26 gene (called GJB2) causes only hearing loss, so if your child has that gene mutation and nothing else, you’re pretty well assured that hearing loss is all you’re dealing with. Mutations in other genes can be associated with other medical problems.

We wanted to talk more with Dr. Nathaniel Robin, Professor of Genetics and Pediatrics at UAB, on the subject of genetics and here’s what he says...

"As you mentioned, there are many benefits to a visit to the geneticist. But because very few people even know what a geneticist is, they are often nervous about coming to see us. A visit to the geneticist is very similar to any other doctor visit in some ways, but very different in others. For example, we spend a lot of time getting background information on your child as well as your family. Then, when I examine your child I look for very subtle things, like facial characteristics. Are the ears and nose normal in appearance? Are there unusual birthmarks, or fingerprint patterns? This is mostly done just by looking and observing, very little poking. If there is no other unusual findings, we often recommend testing for isolated hearing loss genes. However, if there are other findings we discuss what they mean, and what testing if any should be carried out. Genetic testing typically involves nothing more invasive than a simple blood draw.
All in all, most people find these visits helpful, as many questions are answered, or at least addressed.
A visit can get very emotional, and parents will often become upset because we are discussing potential health risks for their child. We always follow up each visit with a comprehensive and detailed note, as well as additional reading material as appropriate. Another often unspoken concern is if a genetic evaluation and testing is covered by insurance. The answer is almost always yes, but if that is a concern we can check before your visit.
To make an appointment with UAB's Genetic Clinic call 205-934-9528."

So you can see, at least in our opinions, a visit to the genetics office can be quite beneficial. Talk to your audiologist or ENT about genetic testing if you are interested and they will surely point you in the right direction.


Miss Kate Morris

Kate is a precious 20-month-old who loves chasing after big sister Maggie, rocking her baby dolls, dancing to music, playing outside and getting into whatever she is supposed to stay out of. At first glance she seems just like any other 1-year-old. She loves to run, climb and blow bubbles. What makes Kate special? Many things actually, but among them are her "ears." Kate received bilateral cochlear implants when she was 10 months old at Children's Hospital in Birmingham. The surgery was done by Dr. Audie Woolley.

Kate is profoundly deaf and has sensorineural hearing loss in both ears, and the cause unknown. She is the only child with hearing loss in our family. Kate failed her newborn screening test and was referred from the hospital for a followup with our local ENT. She had an ABR at 2 months at our local ENT’s office, and we were then referred to Dr. Woolley at Pediatric ENT and Associates. In December 2007, at 3 months of age, she had an additional non-sedated ABR that confirmed the hearing loss. Kate received her first pair of hearing aids at 3 months from the HEAR Center and wore them almost up until her surgery in August 2008. Kate receives Auditory-Verbal Therapy (AVT) at the HEAR Center twice a month.

Kate has made amazing progress. After testing a few weeks back, I was told that Kate’s scores match those of her peers. Her language skills have caught up to her chronological age. Her speech has blossomed in the last two months. She now has over 50 words and is putting them together to make short phrases.
I will never forget the look on her face at her activation. It still takes my breath away to see her react to the simple sounds that I have taken for granted like a dog barking, the birds singing and giggling of sisters. One of my greatest joys is watching her dance to music. She also loves to point up at the airplanes flying overhead.

Here she is singing with her older sister in the car.

Kate is a gift to me and all those she meets.

Written by Kate's mom Ashley


Chronicles of an Extreme ENT II

If you haven’t read the first chapter please click HERE and read that article first.

Continuing our series on one of Alabama’s most beloved ENTs, Dr. Audie Woolley, we promised to give reason for the name, Extreme ENT….
We start with the question “How does one become an Extreme ENT?”

Do you think it’s his medical training? After all, he did learn to improve the health and lives of children. Not everyone can do that. He received his residency in Otolaryngology-Head and Neck surgery at Washington University in St. Louis and then did a pediatric fellowship with concentration in ear surgery and cochlear implants. I mean he is Clinical Associate Professor of Otolaryngology, Surgery and Pediatrics along with several other medical related titles he holds. Hmmm…

Cholesteatoma Surgery, tympanoplasties, ossiculoplasties, he can say them and perform these surgical procedures without expecting the parents to spell them, say them or even know what they are. Yet he can explain with patience and regular vocabulary each medical term so that the parents are confident and trust his skills even if he still looks as if he’s fresh out of med school…(he’s not by the way!)

Nope!! We parents sort of expect that from our doctors; we all want the best, seek the best and hope we have picked the best. We are certainly relieved when the surgeon who is about to attempt to help a deaf child hear, or maybe help a child breathe easier with airway reconstruction, or even placing simple ear tubes, has earned scholarly awards (oh yeah, he entered college on an academic scholarship and graduated Magna Cum Laude, we’re talking BRAIN POWER here)….

He’s earned this title of Extreme ENT only partially for those reasons; it actually has a little to do with this…

…his gorgeous family, with wife Ally holding everyone and everything together. They were college sweethearts and eventually married and had three sons and a daughter ranging in ages from 8-21. He says that she’s a great mom and an awesome wife. He notes she has always supported him both professionally and recreationally…and what he does recreationally has officially earned him the title of Extreme ENT. Truth be known, the whole clan is a little extreme with Ally being queen of the slopes and Emme (8) the little princess is taking horse riding lessons. As for Dr. Woolley and their three sons…well, you’ll have to stay tuned to find out what all they do! Here’s a hint: Adventure and danger…they love it!

Sometimes it helps learning more about your doctor to have that trust and understand that he/she too may have a family…children. Maybe the doctor realizes being a parent himself/herself, how difficult some decisions can be. Stay tuned to learn more, you just might have more in common with this doctor than you think! We’ll find out next about those extreme adventures and what he does for recreation, we’ve already ruled out line dancing…but some things just might surprise you, when Extreme ENT continues…


Tiny Dancer

Riley and her six Little Mermaid classmates pranced onto the stage in front of about 2,000 at the VBC and did their routine to "Kiss the Girl" like it was no big deal. She knew the dance better than her teacher, who told me as much after the show. She didn't miss a beat or a step ... not bad for a deaf girl! Those cochlear implants really work.

Here are a couple of pics, and a video from the dress rehearsal (complete with curlers).