to Ward

Very familiar with Joe- sorry you had to ask me this question.I am (as you may already know?) a board certified Neurotologist. LVA is something I commonly discuss and scan folks for.Basically Joe it is an abnormality of the drainage duct(vestibular aqueduct) of the inner ear. In some kids this duct is for some reason larger than normal and because of that fact the inner ear(hearing) is more brittle than is standard and nerve hearing loss develops early in life.It is the most common abnormality noted on a CT scan when a child is diagnosed with nerve hearing loss and an abnormality is found on CT.Of course the majority (93%) of kids with nerve hearing loss dont have an abnormal CT despite having hearing loss.This abnormality doesnt predict for other abnormalities usually.The big question in LVA children is whether or not they should avoid contact sports and woodwind or other wind instruments. There are some reports of sudden drops in hearing when exposed to head knocks in some sports and playing woodwind or other wind instruments. The vast majority of LVA patients dont experience this but a very small number have been reported to. Having a female child with this disorder of course makes this a little easier but hardly easy(I have two girls).The key to me Joe is for her to see a reputable Neurotologist where she lives that can follow her. Unfortunately Joe a number of kids with this disorder progress to very significant hearing loss and many require cochlear implantation at some point in their lives. Forunately these implants have progressed tremendously over the past 20 years and I would expect any of my girls to do quite well despite having to have one. I know of at least 1 ENT doctor with a cochlear implant in her teens. I would expect her to make good/great grades, perform at as high of a level as anyone in her life but need hearing aids at a young age. If she wants to goto Cornell she will! (provided someone can choke down the tuition!)If you have any other questions Joe you can im me and we can discuss- lotsa good Neurotologists in NY. Ian Storper is in the city still I believe. Ian is 10-12 years ahead of me but we both trained in Nashville at the second oldest training source for Neurotology in the US.This image from NIDCD Last edited by clownshoes on December 4th, 2011, 4:08 am, edited 1 time in total.C.O.D. Jr. III

Cotton I know Bryan and his wife very well. We were in residency together here at UAMS- same year and everything. LOTSA Mississippi guys trained in AR as the UMC program in Jackson had its “moments” at times. Bryan practices down on the coast now(as you may know?), Stephen Lee in Jackson, Ryan Simmons in Tupelo, and a good buddy of mine Raymond Orgler practices gen surgery in Tupelo too. Great guys.Last edited by clownshoes on December 4th, 2011, 1:38 pm, edited 1 time in total.C.O.D. Jr. III

Dang Ward small world. Raymond, Brian, and I were all Sigma Chis together at MSU. Good Times!! You might know the Pillow boys from Helena too – Gill, Ned, and Jim? Gill was over there with us. Jim lived across the street from me before I got dovorced and moved back to the Delta. All really good guys. One of the scariest moments of my life was when my ex-wife called me outta the field and said we had to rush my 6 month old son to Childrens in Little Rock. He had been projectile vomiting and exrays showed he had a pulmonary stenosis (sp?). Any way we got there and I was a wreck. They had him hooked up to all these tubes and stuff and my little boy was fighting it!! Then this Dr. comes in and says Mr. Graves I will be doing the surgery on your son in the morning. I look up and its Raymond!! Immediately I felt better!! Anyway off the subject.BTW you Arkansas boys doing a good job keeping Chicot on the down low. We had a little fruit jar over there day after Thanksgiving just to get a bunch of there to fish and nobody had been there in about a year. I smashed em. 18 lbs. caught ten overs that day and a few more unders. Love that lake.

Had one of those carps land on the front deck runnin up Mellwood ditch the other day with my son. He thought it was cool – Im still trying to get the smell out. Ahhhhhh Mellwood – lake was ver good to me this year. Cant wait to try to figure Ferguson out this weekend – river rising like hell and temps dropping. Fun times. Tell them two guys I said the Delta boys rule and I said hello for me if you will……………..