see it. The eardrum is very dull and looks indrawn. She definitely has glue ear.â
âGlue ear?â Heather frowned. âWhat exactly is that?â
âItâs a condition where the child has fluid deep in the ear,â Anna explained, âbut without signs of infection. Itâs called glue ear because the fluid tends to be like runny glueâthick, clear and sticky.â
Heather pulled a face. âSounds awful. But why does that make her shout?â
âBecause I suspect it is affecting her hearing.â Anna reached for a pad and scribbled a simple diagram. âPeople can hear because sound waves are transmitted via their eardrums and tiny bones inside the middle ear. The eardrum and bones vibrate.â
Heather stared at the diagram and pulled a face. âI was always bottom in biology.â
Anna smiled and put the pencil down. âDoesnât matter. All you need to know is that in glue ear the middle ear, which is usually full of air, becomesfilled with a sticky fluid and that damps down the vibrations.â
âAnd stops the child from hearing?â
âIt can do.â Anna stood up. âItâs very common in children so donât think Grace is the only one. Speech is affected because she isnât hearing well.â
âSo what do we do about it?â
âFortunately glue ear almost always settles down of its own accord but if Graceâs hearing gets worse then we may need to look at referring her to an ENT specialist. But at the moment I donât think we should do that. Iâm going to refer her to the audiology department for an assessment of her hearing and weâll take it from there.â
âSo she doesnât need antibiotics or anything now?â
Anna shook her head. âShe doesnât have an infection so they wonât work. Iâm fairly confident that if we leave it alone it will go by itself, but weâll keep a close eye on it and if weâre worried at any point then we can refer her.â
âIâm not wild about her having an operation,â Heather admitted, and Anna smiled sympathetically.
âI doubt it will be necessary so letâs cross that bridge when we come to it. Iâll refer her to Audiology today and youâll get a letter from them in the next month or so, inviting Grace to come for a test.â
âThanks, Anna.â Heather stood up and brushed her curls away from her face, her cheeks slightly pink. âI heard a rumour that our Samâs back. Is it true that heâs going to be working here for the summer?â
Anna stiffened. Not if she could find a way out of it. âWell, heâs here at the moment, but he may not be able to stay for the whole summer.â
At least, not if she had anything to do with it.
âOh, I hope he can,â Heather enthused, shifting the toddler more comfortably in her arms. âI mean, itâs so brilliant having him. I never miss him on the telly. Heâs so sympathetic, isnât he? So warm. Canât believe itâs our Sam, really.â
Our Sam.
Anna clamped her jaws together and resisted the temptation to point out that Sam McKenna was a gifted actor and was warm when it suited him to appear that way. With her he was about as warm as the polar icepack.
Then she remembered that Heather had had a massive crush on Sam when theyâd been at school. As had most of the girls. Except her.
Anna rolled her eyes. She and Sam had been thrown together a lot because of their parentsâ working relationship and at one time she knew that both sets of parents had harboured a fond hope that they might take over the practice. But that had never been an option for Sam. He hadnât been able to wait to get away.
And just as well, she thought briskly, otherwise there would have been bloodshed. She and Sam would not have made a good partnership. They clashed on just about everything.
Heather was still talking.