Hope the tubes in the ears goes well for Nathan. I had them in a few times when I was younger... still have ear issues, but at least I can hear now! He'll be fine! All you have to do is be careful about getting water in his ears. Mine came out on their own, so he shouldn't have to go through getting them out or anything. They're super tiny too.

Big hugs to you guys.. sounds like there's a lot going on, and your brother needs to realize being a dad is not something you decide to do only when it's convenient.