Surgery

Yesterday was a very interesting experience for me. As I mentioned in an early post I have otosclerosis in my right ear. This can be cured by removing my stapes and replacing it with a plastic bone made of teflon. After some prayer and study I decided to go ahead with the procedure. Even though I have a high deductible  it wasn't much more than a good hearing aid would cost me and it should be good for the rest of my life. The success rate for the procedure is 99% but it was the 1% that bothered me. The most common reason for failure is if the patient catches a bad head cold in the next week or two the infection can go to his inner ear and damage the cochlea. The hearing loss is then complete and incurable. I finally decided that my hearing in my right ear was so muffled that it was useless anyway so in the worst case I would pretty much be where I am today.

During my pre-op visit I asked my doctor if I would be awake, asleep or somewhere in between. He told me I could be what ever I wanted. I told him I definitely wanted to be awake because I would love to know what he was doing. He liked that I think partly because he liked that I was interested by also because if he needed me to do something I would be able to respond. 

Yesterday was the big day. I was Dr Cueva's first patient of the day which was good because I want my doctor to be nice and fresh but the down side was that Lisa and I had to be there at 6:00. The surgery center was also in Chula Vista which is the better part of an hour away. I was up at 4:45. Groan... The surgery center turned out to be a large and beautiful place and very modern. Everyone who worked with us was very nice and it was a very good experience. Once I was all prepped and ready to go they let Lisa come in and visit with me until it was time to take me away. She got to meet the anesthesiologist and the nurses and then Doctor Cueva came in and she got to meet him. He is a very nice man. He put his initials on my ear to make sure they operated on the correct ear. It would be a bummer to ruin my one good ear. 

They laid me on this tiny little operating table than wasn't even as wide as my back. I was afraid I was going to fall off. They then tied me down and strapped my arms down and I was sure I was going to get claustrophobic but amazingly I felt extremely comfortable. They had a hose blowing warm air up between my legs and being wrapped up like a burrito felt very reassuring. I was really surprised. They had me on my back and turned my head about 45° to the left and the doctor sat in such a way that he looked right down my ear canal. They knocked me out for just two or three minutes during which time they anesthetised the right side of my head and then I woke up again. I was a little disappointed to see that my head was covered up with a blanket so I was unable to see anything and to make it worse, my good ear was stuffed in a pillow and with the blanket it was difficult to hear what they were saying. The good part was that the doctor was explaining everything to the student so I was getting a pretty good description of what was going on but it was incomplete because I could only hear part of it. 

I think the doctor was beginning to regret having me awake though because I did keep asking him questions and finally he told me that they were at a delicate moment and I should probably quit talking for a while. The nerve that senses taste in your tongue just happens to run next to the stapes and they need to move it away from the bone before they remove the bone. I heard the doctor mention the nerve to the student so I asked him if he had moved the nerve. He said that they had so I told him to make sure that they don't break it. He assured me that they wouldn't. I was warned that because they have to move this nerve just the very fact that they move it might cause me to lose the sense of taste for several months. I think for me the effect is very minor. I do have a funny feeling on the right side of my tongue but I can tell right now that it is minor and won't last for more than a day or two. I still can taste everything and I enjoy my food as much as ever.

They then detached the stapes from the incus. All they do is break it off at the footplate. They like to leave the footplate in place now days and they drill through the foot plate and attach the prosthesis to the foot plate with a piece of skin that they cut from the under side of the flap of ear that is just outside of the ear canal. That is actually where most of the blood comes from I think. Dr Cueva warned me that I would hear a snapping sound when they broke off the stapes and then "snap" my stapes was gone. He then warned me that he was going to use the micro drill to drill into the footplate. That was VERY loud. I'm sure the sound level violates some OSHA regulation but it only lasted for a minute. I'm sure I started hearing from my right ear the moment he attached the prosthesis.

And then it was just a matter of putting everything back together again. Once the eardrum was folded back in place the doctor leaned over and asked me to repeat what he was saying. He whispered four or five words into my ear and it was like a miracle. I heard every word very clearly. I'm sure I haven't heard a whisper in that ear for a decade. It wasn't to last though because he then filled the entire ear canal with an antibiotic ointment, stuck in a cotton ball and then put a band-aid over the cotton ball to hold it in place. I think even with the band-aid and all I can still hear better from my right ear than I did before but at the moment it is still pretty much useless. I am told to just let the ointment ooze out over the next week or two and to keep a clean cotton ball in place until my follow up appointment in three weeks. 

There was really no recovery period because I was already awake. They lifted me onto a gurney and rolled me into the next room and then Dr Cueva went and got Lisa. They sat there worrying about my blood pressure for about ten minutes and they told me to get dressed. 

They insisted that they take me out in a wheel chair which was rather embarrassing because I could walk just fine but apparently it is hospital rules. It reduces liability. Lawyers are ruining our country but that is another topic. No offense Brandon and Trevor.

Since we got there before six in the morning we parked right by the front door so Lisa didn't even need to go get the car. The nurse wheeled me right to the car door and wouldn't leave until she saw me in my seat. I had been told to ease into a normal diet. I'm not sure what that meant. I wasn't allowed to have breakfast but other than that I had had no diet restrictions. I had been awake the whole time so my stomach wasn't messed up with drugs of any kind so since I was hungry the McDonalds across the street looked very enticing. That sausage-egg-McMuffin looked very good. 

We picked up a prescription of NORCO (the modern day Vicadon) at the pharmacy and headed home. I should have taken one right away because by the time we got home the anesthetics were wearing off and I was in pretty bad pain. I couldn't take my pill fast enough. I was hoping it would kick in within twenty minutes but I sat there for over an hour writhing in pain. It was the worst ear ache imaginable. I tried to sleep and couldn't for the pain but miraculously after about an hour and a half the pain died down enough that I slept. I dosed off and on the rest of the day and after about five hours Lisa warned me to take another pill before the pain came back. I did not want a repeat of my earlier experience so I did. I was in virtually no pain the rest of the day and just for good measure I took a third pill before I went to bed. This morning I feel no pain at all. I haven't taken so much as a Tylenol. I feel a bit guilty for not going to work today but the doctor asked me not to and Lisa wouldn't let me anyway so I'm sitting here resting. In all probability, if I wasn't resting I probably would not be feeling as good as I am. I will give myself this weekend to take it easy and then start into the real world again on Monday. 

So that was my Thursday. Now I just need to not get sick in the next week or two and I will be fine. I will keep my distance from all other human beings and wash my hands often and I should be fine.

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Reptiles have 1 ear bone and three jaw bones. Mammals have three ear bones and one jaw bone.

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