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Tanya calls the on-call ENT resident five times that first day to report Noah’s worsening symptoms. He develops a slight fever, begins a constant cough as if he is clearing his throat, and stops urinating. Noah continues to vomit at home, and refuses all drink, food, or medicine by mouth. Even though the surgeon tells his parents that he will not be released from the recovery room until he is drinking, Noah is discharged a few hours after surgery. Noah is in the recovery room, but refuses to drink. The care team reports that the procedure is uneventful. On June 11, 1999, Noah undergoes the outpatient procedure. Was the ENT specialist listening to her? Why or why not? Discussion Question: Tanya has made an extra trip to express her concerns, brought new information and family history, and made it clear that she did not want Noah to have an unnecessary surgery. The ENT specialist adds that “it would be cruel to subject him to two separate procedures,” so he might as well have them both out. He tells her that if they wait, she will be returning in six months to get the tonsils out. She reminds the ENT specialist about her sleep apnea assessment in Boston and asks to only have tubes inserted and the adenoids removed. She adds that Noah had been snoring at the time of their last appointment, but it was only because he had been congested at the time. Tanya explains that, as a child, she had symptoms similar to Noah’s and only had an adenoidectomy (adenoid removal). A week before the scheduled surgery, Noah and Tanya once again meet the ENT specialist.
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She is concerned about the upcoming procedure, and schedules another appointment to discuss her questions. What else could you have done at this point to advocate for your son?Ībout a week later, Tanya calls the ENT specialist. Confused but determined to help Noah and not stunt his progress, Tanya signs the consent forms for the surgery.ĭiscussion Question: Pretend you are Noah’s mother. The ENT specialist determines that Noah needs another set of ear tubes, and that he needs his adenoids and tonsils removed, too. Lately, Noah has been snoring on and off, so Tanya answers, “Yes, he snores.” Tanya also offers the information that she had observed Noah’s sleeping patterns two years before in Boston and explains he did not have sleep apnea. At the initial appointment, the nurse asks Tanya about Noah’s sleep patterns and, specifically, about his snoring. However, his ear infections begin again and, in the spring of 1999, the family consults another ENT specialist in Philadelphia. Now that Noah is 4-years-old, his speech has improved to the point where he is ready to graduate from his special needs pre-school and speech therapist. In 1999, Noah and his family move from Boston to Cherry Hill, New Jersey. After watching Noah for several nights, she is certain he does not have sleep apnea and reports this to his ENT specialist. At home, Tanya picks random times at night to listen to Noah sleep, and records every time he snores or takes a breathing pause.
#Are you listening how to#
As Noah recovers from surgery, the ENT specialist teaches Tanya how to evaluate her son for obstructive sleep apnea. Noah undergoes surgery in 1997 and, slowly, his speech improves. Getting rid of the fluid, the ENT specialist hopes, will increase Noah’s hearing and improve his speech. Noah’s otolaryngologist (ear, nose, and throat (ENT) specialist) decides that Noah needs a set of ear tubes to allow drainage of fluid. A hearing test and other evaluations show that Noah has mild hearing loss due to chronic ear infections and fluid buildup in his ears. He speaks, but only his parents are able to easily understand him. This means that Noah is not making the normal babbling sounds expected from an infant, but this a minor concern.Īt 2-years-old, Noah develops an extensive expressive speech delay. He is a healthy baby, meeting all his milestones except for expressive speech.
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Noah Lord is born - by Cesarean section - on January 25, 1995. The patient story includes several discussion questions and concludes with an emotional video that gives readers Tanya’s perspective on the devastating experience.
#Are you listening series#
A surgery, a series of miscommunications, and an early discharge from the hospital contribute to an adverse event that changes the family’s life forever.
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Recognize the importance of clear communication with patients and their families during a care experience.ĭiscuss how everyone in a health care organization - from physicians to housekeepers - can contribute to better patient care.Įxamine the importance of following organizational protocol when caring for patients.ĭescription: This patient story follows the care experience of four-year-old Noah and his mom, Tanya. Learning Objectives: At the end of this activity, you will be able to: