Revision Surgery (Part 3): Post-Op

Although I had a difficult time sleeping through the night, I woke up the next day feeling pretty darn good and in minimal pain. No "day 2" vomiting and nausea like last time. My neck wasn't killing me; I could actually move it and could easily lay up and down without wanting to scream. And I was surprisingly hungry! Really hungry! It may have been the Vicodin but I was feeling pretty darn good.

The entire morning, all I could think about was my post-op appointment with Dr. Murray that afternoon as I was excited to find out what he had discovered and what he thought about everything. Dr. Murray had debriefed Fraser and Lydia after my surgery but did not give them any of the details. Just that the surgery went well, I was doing great, and that they only found scar tissue so the full revision surgery of replacing and reconnecting the driver to the Stapes did not happen.

While I was very happy to hear that everything was connected properly, I was scared by the fact that all they found was scar tissue. Was there a lot or a little bit of scar tissue? Where did they find it? Would the removal of this scar tissue be enough to fix the problems I was having? Were the problems I was experiencing real or just the limitations of the device? Did I make the right decision in pushing for this full, behind the ear surgery? I had a million questions running through my head and was so scared that I would forget them all in my Vicodin haze. As I laid in bed, I opened the notes app on my iphone and started typing out all my questions and concerns. Once I felt more prepared for my appointment, I was finally able to relax and rest a little, which I needed.

Next thing I knew, Fraser was waking me up for my next round of pain meds and we were off to my post-op appointment. It was typical that my pain meds were due right before the appointment. I had a lot of ground to cover with Dr. Murray and I wanted to be focused, alert, and, well, conscious. As I stepped out of the car, I remember feeling the Vicodin haze set over me. Woah! This was going to be an interesting appointment…

After checking in, Rebecca took me back to get my blood pressure and temperature. I was then taken to a room where Lydia and Fraser were waiting. Dr. Murray followed a couple of minutes after. It was time to get down to business.

Dr. Murray first removed the helmet-like bandage that was protecting my ear. Ahh! Finally, my ear could breath again! I was getting really sick of that thing… He took a look inside my ear and said that everything looked great. While he was doing this, he was attempting to ask me some questions, but Hello! I only have one ear and not a great one (you have seen my test results) and you are not on that side of me nor are you looking at me. I CANT HEAR YOU!!

I gently reminded him (I think I was nice…) that I could not hear him and that I was going to have to look at him to hear. He sat me up in the chair, rotated it about 90 degrees so that I was facing the chair he would be sitting in, sat back down, and rotated his chair so that it was facing me. He laughed, smiled, and said, “Better?”. Yes, Dr. Murray. Didn't you know that trying to listen, while loopy on Vicodin with only one ear is quite a challenging task?

Okay. NOW it was time to get down to business. I told him that I had some questions but would ask them after he updated me on everything that happened yesterday. 

The surgery was about 2.5 hours long and he found absolutely nothing wrong with how my Esteem was surgically implanted. Everything was connected perfectly, and he actually mentioned that he thought Dr. Marzo had done a “beautiful” job. He did, however, find scar tissue, but in only one spot that, he said, is almost impossible to prevent. He showed us the diagram to the right and circled the general area of where the scar tissue was found. I am not very familiar with the anatomy of the inner ear but it looks as if the scar tissue was found around where the sensor and driver are located. I only remember asking him if there was scar tissue on the driver and his response was “Yes”. While he did not mention the degree or amount of scar tissue that was found, he did say that the scar tissue was located in a place that was likely affecting the functioning of the device and thereby, my hearing.

Dr. Murray, unfortunately, did not conduct any test on the Esteem before removing the scar tissue, but once the scar tissue was removed, he performed a test on the driver and it was a “perfect A”. He was so surprised by how well it was functioning that he had to test it a couple of times just to be sure. He also pointed out that we now have a baseline for what my driver scores should look like which will help them not only determine if the device is functioning as it should when tested at a later date, but it will also help them more quickly and easily detect issues in the future.

When I asked him if he thought this procedure would improve my hearing, he said that we will not know until I turned it on in a couple of weeks. Dr. Murray is always very careful about what he says and I know that he is trying to protect himself and not give me any false expectations, and rightfully so, but I really do hate the “lets wait and see” answers. Don’t get me wrong. I LOVE Dr. Murray as my surgeon and doctor; he really is wonderful and I honestly believe he does his best to answer each of my questions as completely and fully as possible (except, of course, when my ADHD brain kicks in with a new follow-up question that I feel the need to ask before he finishes answering my previous question. Yeah. Fraser totally called me out on this.). But you sometimes have to pick apart his brain to get the answers your looking for. When asked about the gain that people typically see when scar tissue is removed, he said there is about a 30-40% gain on average.

I next asked if he thought there was a good chance that the scar tissue would come back and he told us that, again, he wasn't sure but that in his experience it typically doesn't. He mentioned that I should keep track of my early experiences, especially if I notice a drop at any point during the first couple of months as this may be an indicator that the scar tissue has returned.

I think the most significant question I asked him during my appointment was if he felt that the surgery was “worth it”. He shared with us that without going in there behind the ear, he would never have been able to confirm that everything was connected perfectly; he would not have been able to detect that scar tissue actually existed in this location; and he would not have been able to remove scar tissue in this location through an in-the-canal approach.  Additionally, he again stated that the scar tissue was in a place that was likely affecting how the device was functioning. While he was unsure how much improvement I would see as a result of removing the scar tissue (we would have to wait and see), I think the conclusion was that we all felt the procedure was a good idea.

The last thing we spoke about was what I should expect in weeks to come. In regards to my recovery, he was glad I was feeling well (maybe a little too well during that appointment) and should be able to wean myself off of the pain meds over the next few days; that I should not take any blood thinners (e.g., Advil or vitamins/supplements) for the next 2 months; and that I should avoid strenuous exercise for 2+ weeks. 

In regards to activating the Esteem, he told me that I could turn it on in two weeks. Two weeks? I cannot tell you how THRILLED I was about this! Two weeks is WAY better than two months! It had only been a day and I was already anxious to turn the darn thing on. 

He then spoke a little bit about how the device had been programmed; The Engineer had set the A, B, and C programs to have very generic settings that were similar to my current settings. When I asked if there was a particular program I should start on, Dr. Murray suggested that I spend the next month or so playing around with the different programs, being sure to try them all in lots of different environmental settings. It will not be until my first adjustment that they uniquely fit the device to better meet my needs. Interestingly, he said that I should witness my “best results” 3-4 weeks after I turn on the device and that this is when he would like for me to come in for a check-up and further testing.

As we left the appointment, I remember feeling exhausted, overwhelmed, and overloaded with the copious amount of information I had devoured in our conversation with Dr. Murray. While there were many parts to our conversation that lead me to feel hopeful about my future results with the Esteem, there was a little part of me that was worried if the gain I would get would be enough. Enough to help me hear "normally" again. Enough to reach my high expectations. Enough to put me back to where I used to be before my hearing took a turn for the worst. Removing the scar tissue from one messily little place seemed like something so small and minor. How could this ever make a big impact? I wasn't sure. 

But I sure as hell couldn't wait to find out...