My Version of Surgery Day

I know it was 10 days ago, but I still feel like I need to post my version of the surgery.  Maybe for my own family members who decide to get an implant one day.  I have dozens and dozens of family members with severe to profound hearing loss.  Not one has gotten a cochlear implant.  I hope with my success, others will be more willing to consider it.

As Evan said in his post we arrived to the hospital at 10 am.  The first thing they did is a pregnancy test.  Though they wouldn't tell me that.  It doesn't take long to put two and two together.  The nurse asked if I had a hysterectomy.  Uh....no.  She said they would need a urine sample.  I told her I wasn't pregnant.  She said "we don't do social health histories."  Hahahha.  Cracked me up.

They weighed me (which I found out later is how they determine the amount of anesthetic you need), took my blood pressure, all that jazz.  I had to strip down and put on the lovely hospital gown and accessories, including booties and a cap.  I was looking HOT.  Especially since you can't have makeup, anything in your hair, or wear contacts. 

And then we waited.  And waited.  And waited.  My Doctor came in and reassured me he got a good night of sleep (he has a new baby and I told him at our appt last week that I hoped he slept the night before surgery).  We talked a little bit about the devices and about surgery.  He said we had to wait for the operating room to become available.  We waited some more.  Finally the anesthesiologist came in and asked me some questions.  I can't remember any of them.  They must have been about my history with anesthetic.  She waited as I said goodbye to Evan and then walked me into the OR.  It was weird to just walk right into an operating room.  I couldn't see because the nurse took my glasses.  But it was so bright.  The last two times I've been in OR it was to have a baby and I was wheeled in and stayed awake the whole time.  I knew I would be put under for the implant surgery but I was not sure exactly what to expect.  I hopped on this tiny operating table myself.  Doctor came over and said hi and confirmed something.  Of course I have no idea what any of the medical staff were saying because they all had masks on.  There were a ton of people in there.  At least 10.  A nurse asked me my birthdate and what surgery I was having (I had to answer that probably at least 6 times that day, guess they wanted to make sure they were operating on the right person).  I was laying down looking up at the lights while the nurses wrapped me up in blankets.  My last conscious thought was "that's so nice of them to put blankets on me."

Then I woke up.  Just like that.  I was in recovery.  I immediately knew two things.  One, was that it was late.  Two, that I only had one implant.  I had gone over this moment in my head probably ten times before having surgery.  Every time I saw myself wake up in recovery, my left hand went to my left ear and there was no implant.  I never saw it any other way.  I think this was God's way of preparing me for only one.  So when I woke up in recovery, I heard the nurse say my name.  That only meant one thing.  My left hearing aid was in.  Or else I wouldn't have heard her.  I put my hand up to my left ear.  No implant.  I asked her what time it was.  She said "you were in there a long time, it's 7:45."  I went in just before 1:00.  So I knew there had been complications.  The nurse was asking me all kinds of questions which I couldn't seem to make sense of.  I just wanted to know what happened so I asked her "why one?"  She said something about the Dr telling me in a bit.  She asked if I was dizzy.  I wasn't.

The Dr came in and I grabbed his hand.  I don't know why I did that.  It's like I felt connected to him and wanted him to know how thankful I was.  He asked me if I was dizzy.  I didn't answer him.  I asked him "why one?"  He said he would tell me later when I was more with it and asked again about being dizzy.  I wasn't.

Evan came in and I asked him "why one?"  He said he would tell me later.  He may have asked me some questions but I don't remember.  All I wanted to know was why I only had one implant and no no one would tell me.  I began to get scared that maybe I didn't have either implant.  That they had opened me up but couldn't put one in.  People kept trying to talk to me and keep me awake.  All I wanted was an answer and then to sleep for the next three weeks.  I was so tired.  I just couldn't keep my eyes open.  And I couldn't comprehend what people were saying other than repeatedly asking me if I was dizzy.  No, I am not dizzy!!!

I was in and out of it.  A different dr came in and I tried talking to him but he spoke too fast.  I wanted to tell him he was talking to a deaf person who was recovering from surgery and he needed to learn how to speak better.  But the words wouldn't come out, darn it.  After he left, I told Evan I couldn't understand him and he said he answered the questions for me.  I still don't know who was.  I keep forgetting to ask Evan.

Finally my doctor came in and I again asked him "why one?"  He began to explain what happened.  About damaging two devices and not wanting to risk operating on my left ear.  I told him he owed me.  Hahahaha.  He cracked up and said "people on anesthetic say the funniest things."  I wasn't joking and I wasn't high.  Well, I was high but that was a conscious thought.  I remember telling him thank you.  Next thing I remember he was back but was wearing his street clothes, not his scrubs.  So some time must have passed between.  He again asked if I was dizzy.  He said he would be sticking around for a few minutes to see if I needed anything.

The next thing I remember is the nurse making me drink water.  Do you know what happens to me if you have made me fast for 24 hours, have pumped my system with drugs that have put me in a stage 3 of deep sleep for nearly 7 hours and then make me drink water???  Yeah....we'll skip that part.  :)

The surgical center was totally empty.  I was the last patient.  It was just the nurse, Evan and me.  When I could finally open my eyes long enough to recognize how late it was and how long it was taking me to get with it, I asked if I could go home.  Apparently that's what they were waiting for, was for me to ask.  So somehow I got dressed.  I don't remember how.  That husband of mine sure comes in handy!  I think they put me in a wheelchair but I don't remember going from the hospital to the van.  I do remember that we couldn't seem to leave the hospital parking lot.  I opened my eyes to an orange cone blocking the exit again and again and again.  I asked Evan if I was just dreaming that part and he laughed and said all the exits were closed and it took him a while to find a way to leave.

The next thing I remember I was at home in bed thinking about that 2nd implant and feeling a deep sense of peace.  I felt like I needed to tell Evan about it.  He already explained that part in his post.  But I just knew.  I knew that everything had happened the way it was supposed to.  I knew that the doctor needed me as his patient and I knew I needed him.  And I knew that with all of the prayers and miracles that have allowed this all to happen, God was in that operating room.  And he could have allowed that second implant to happen but He didn't.  I'm not sure why.  But I was overwhelmingly happy for the one implant I did get.  After all this processing, my brain went quiet and I fell into the best sleep I have since had!

I've had lots of time to think about how things went down in that operating room.  I've grieved a little bit.  But that's just part of my journey, to allow myself to feel whatever it is I am feeling.  I have worked through it and continue to feel that this is all in God's hands.  It feels like another set of miracles is being reserved for a second implant at a later date.  I'll trust in that.

Sheesh, I am getting long winded.  I told you I have much to say.  I do!!

Day after surgery in my lovely head band :)

Confidence Restored

Today was my Post-op follow up with the surgeon.  I am very happy with the way it went!  We took the doctor's whole morning talking about lots of things, including what happened in surgery.  And the end result is that both Evan and I again feel this was the right doctor for me.  We think as he continues to gain experience, he will be absolutely fantastic.

Basically, there was a very high chance I would have left that OR without an implant.  Dr acknolwedged that the problem was he did not make the hole big enough in the cochlea as he was trying to do the "soft approach" which means he was trying to preserve my hearing.  He said he made the hole 5 millimeters.  I just looked that up.  It's .019 of an inch.  When he put the first implant in, it started to go in but he met resistance.  He said that if you meet resistance, you have to stop.  And once you start to put an implant in, taking it out damages it due to the wire in the electrode array.  Apparently you take the wire out as you insert it but can't put the wire back in.  All very interesting things to learn.  So anyways because it started to go in, he thought it was a problem with the device.  So he tried the second one.  It wouldn't go in at all.  That's when he knew he would have to make the hole bigger.  So he made the hole 1 millimeters big.  Which is .039 of an inch.  Who on earth came up with this device??  Gotta research that one.  This is crazy stuff to insert a device through such small openings!  Anyways, the 3rd device went in wonderfully.

The Dr talked about his feelings in the OR (which I eat up cuz after all I am a therapist and always feel more comfortable with a person if I know how they are feeling :).  He was supremely frustrated with himself for not figuring out the hole was too small after the first implant.  I love that he admitted this.  And I think that's why when he went to speak with Evan, he was shaky.  He told me to ask the Audi, when I see her next week, about how he was feeling.  She was in surgery with him the whole time.  He said she commented "Well, I am glad you kept being diligent."  I don't know if he wanted to give up, but I wonder how many surgeons would try again?  He tried again and of course everyone knows that worked well.

He also said he's gone over it and over it in his head and on paper.  He talked about what he learned and totally validated my feelings when I expressed how I was feeling about it.  I am mourning that 2nd implant a little bit but I truly do think everything happened as it needed to.  My time for the 2nd implant will come.  I need to focus on healing and hearing with the first!

We also talked about the facial nerve and the taste nerve and how close they are together and how he has to drill in between these two nerves.  That caused a little complication as the space between mine is very narrow and he was super concerned about the nerves.  He was also concerned about my inner ear causing balance issues, especially with 3 tries of an implant.  There was a super, super high risk of my inner ear being damaged, causing vertigo.  When I told him I haven't been dizzy at all, he was very relieved. 

Random side note, but I'll bring it back, don't you worry.  I remember when an airline (Jetblue I think) had problems with their landing gear.  They weren't able to land properly.  But the pilot still skillfully landed that plane and everyone was safe.  Lots of people said they didn't want to fly that airline after that because of the damaged landing wheels could mean a bigger problem with the planes.  But one of my dearest friends said "I am always going to fly Jetblue now.  I want an airline that can handle equipment and technical problems, because of course they are going to happen!"

I've thought a lot about that pilot landing that plane.  I agree with my friend.  I would want a pilot skilled in handling issues as they arise over a plane that seems to be perfect but has a pilot unskilled in equipment issues.

That's how I feel about my surgeon.  He tried 3 devices but did not damage my inner ear.  He had a very narrow space to work with in between nerves but did not damage or negatively affect either one.  I feel like he is skilled and that he can handle issues as they arise.  I would prefer a surgeon who takes the time to know me and work in my behalf (remember he called my insurance company) as well as not give up in the operating room over a surgeon who has done 500 implants and doesn't give me the time of day.  So all in all, we are happy.

Now......8 more days until activation!  Bring on the shrill voices, beeps and electronic noise!  And by the way, I am feeling better.  Still can't handle the demands of my toddlers (as was proven just today) for longer than an hour or so.  But this will get better.  Dr told me to not do a thing for 2 weeks.  That's hard to do when you have young kids!

God's Plan For Us

Well we are safely home and Kristel is all snug in bed resting. She was able to eat a few saltine crackers and some water to take some pain meds, but soon became wide awake where at the hospital and on the way home she tried, but couldn't. I guess the anesthesia are finally wearing off. Kristel was able to read all of my text messages that I'd sent out to the family and the previous blog posts.

When I went to see Kristel in the recovery room, the first thing she asked me was, "why one?" Meaning, obviously, why only one implant. She was very groggy and totally out of it and didn't want to overwhelm her so I waited for the doctor and for her to wake a little more. When the doctor did come in, he explained everything to her and the difficulties of the surgery. He said it was a combination of her anatomy and his technique. From what I gathered, he did the surgery a different way than the traditional way, which tries and saves some of the residual hearing and not having such a large incision. He admitted his mistakes that were done and how he was able to "figure it out" the third time around...which solidifies my belief of his inexperience.

Leave it to Kristel to look for a Higher meaning of why things went down the way they did. She told me that she felt everything went exactly as it was supposed to. She continued to say even though that our doctor was young and inexperienced he was supposed to perform the surgery. For some reason Kristel needed him and he needed Kristel. Then she gave me some insight that I hadn't thought of before. She said, "I am SO THANKFUL that we were approved and decided upon the bilateral implants because we had a total of four devices [a backup for each ear]. If we had only decided on one implant initially, he would've messed up the one and the back up leaving me without an implant!"

One of the things that attracted me to Kristel so many years ago was her spirituality and ability to feel God's guiding hand in her life. I have no doubt that God is and was fully aware of what did and is going to happen, and such, laid out a plan to have it work out for Kristel to have at least one implant. She feels that she was only meant to have one and it worked out according to God's plan. I am thankful that there was no damage to the facial nerve or otherwise and trust God that she will have a speedy and healthy recovery.

Surgery Update

Hello. It's me Evan again. I just got done talking with the doctor and there were some complications inserting the implant into her right ear. There was a total of four implants, two for each ear in case of any problems. Two of the implants were damaged when trying to insert them. The third was able to go in just fine and is currently being tested. All is well with that one and Kristel is also doing well. Since there is only one more implant device left, without another backup, the doctor wants to play it safe and only do the one ear. He said it is possible to still do the other ear a few months down the road, but that won't be an option since our insurance runs out at the end of the month. My new insurance provider that we're forced to change to with my employer doesn't cover cochlear implants.

The doctor explained that the initial problem was that the drilled hole wasn't large enough and the cochlea was in a different position than normal I guess. Not sure how the implants became damaged. So the surgery took twice as long as planned and should have been done with both ears at this point. I am just glad Kristel is doing fine and the implant in the one ear is also doing fine.

The doctor is stitching her up and will dress the bandages and will soon be in recovery. She'll be in recovery for at least an hour before going home. There may be a possibility she may need to stay overnight, but don't think it will happen. If we do go home tonight, the doctor wants to see her in his clinic tomorrow.

On a side note, the doctor seemed really nervous and almost shaky to a point when talking to me. I probably would be too, but I don't know how he does what he does! I certainly wouldn't be able to...but it made me question his experience with this procedure and am not too fond of the possible "educational/learning" surgery for the doctor (i.e. that's good to know for next time).

Just got done visiting with the doctor again. Kristel is in recovery and awake and responsive. I will be going to see her soon. More to come...

Surgery

Kristel asked me to keep her blog updated today. Hello, I'm Evan...Kristel's husband. We were to arrive at the hospital today at 10 a.m. for all the prep stuff, which took about an hour. By 11 a.m. we were ready to go, but the surgical room that was reserved for us was still in use for an "emergency repair" of another patient/doctor. The nurse said it would probably be about another hour before they would be able to get Kristel in for surgery. Almost two hours later of waiting, the anesthesiologist came and got Kristel and took her in to begin the surgery!

Our doctor blocked out 7 hours of his day for the surgery, but is only planning on 4-5 hours of actual time to perform it. He will be starting with the right ear and if all goes well he will then do the left ear. I am still amazed that this is an OUTPATIENT surgery and will be taking her home tonight. It kind of freaks me out and have had butterflies for the past week. I've been more nervous than Kristel, who has been totally calm and collected since Sunday. We both feel that everything will go as planned without a hitch. She's been in surgery for about an hour now so still plenty of waiting time to go!