Daily Archives: July 29, 2008

Cochlear Implant Surgery, Part 1

It’s been one week since my cochlear implant surgery, so I thought I’d honor the day by writing up the actual surgery experience. This is the kind of thing I really wanted to read before my surgery, so I hope it might help anyone who might be considering this surgery and wonders what it’s like. I know it’s different for everyone, of course, and we all have different surgeons and different bodies and different recovery periods. (That’s my little disclaimer!) Still though, it’s nice to have some of the mystery removed.

Just to recap — I had Advanced Bionics HiRes 90K cochlear implants placed in both ears during this surgery. I’m completely deaf (since April of this year) so I had no residual hearing in either ear and it was an easy decision to have both implanted at once. I was just extremely lucky that my insurance company approved it without a fight!

3:50 a.m. on July 22:
The alarm shakes me awake. As I suspected, I had a hard time going to sleep the night before. I planned to go to bed around 9 or 9:30 pm and I think it was closer to 11 pm before I finally drifted off.

I jump out of bed, adrenaline pumping, and throw on my shorts and t-shirt. Dave is still in bed and I decide to let him sleep. He did kind of wake up when the alarm went off but he really doesn’t need to be up yet anyway.

Originally I thought we would leave at 5 am, since the hospital is about a 45 minute drive from here and I really doubt we’ll hit much traffic at that hour. However, Dave is concerned because we’ve never been to this hospital and they stressed that we need to be standing at the desk, ready to check in, at 5:45…not pulling into the parking lot at that time. He wants to make sure we have time to navigate parking and find where we need to be, so he suggests leaving at 4:30 instead.

4:30 was my original wake-up time, so I’ve bumped it back to 3:50. This is really kind of silly since I can’t eat or drink, can’t wear make-up, can’t wear my contact lenses, and although I could do my hair that would really be pointless. All I need to do is put on fresh clothes, wash my face, make sure we have everything we need (camera, case for my glasses, contact lenses in case I feel like putting them in afterward) and go. I can do this and be sitting in the car in 10 minutes, max.

But I’ve found a new thing to worry about. I’ve become paranoid that I’ll go to the bathroom on the operating table. I confessed this to Dave the night before and he laughed and assured me that it wouldn’t happen – I don’t know if they put something in the IV or if it’s the effects of the anesthesia or what. Still though, I’ve got my regular routine and figure if I give myself about 30-40 minutes of being up and around, even without eating and drinking, maybe I’ll be able to take care of things (ahem) before we leave. So that’s my crazy reason for waking up so early today.

4:50 am:
We are leaving the house. I did not accomplish my mission and have stopped worrying about it. I spent my time online, going “no mail” or on digest for my mailing lists, checking up one last time on the blogs I read regularly, and visiting the Hearing Journey forum. It’s been kind of nice to have this time instead of just rushing right out the door, so I’m glad I got up a little earlier than necessary.

5:45 am:
We literally walk up to the registration desk at exactly 5:45 am. We ended up leaving later than we planned but the drive was seamless and parking was easy. It was a little alarming walking into the hospital and seeing all the “You Must Have A Visitor Pass!” signs though. All of the information desks were empty and I wasn’t sure if we should stop at one and ring a bell or something. Dave, being more of a rebel, was confident that we should ignore the signs and push on without Visitor Passes. We walk along until we find the Ambulatory Surgery department.

First there’s some general paperwork to sign. I notice that the doctor listed on the bottom is Dr. Wiet, not Dr. Battista. They both work in the practice that I go to though, and I figured maybe the hospital just puts everything in Dr. Wiet’s name since he founded their Center for Hearing Restoration and Ear Research.

We are directed to the elevators and the second floor. Before we get there, we find bathrooms but I hesitate…what if I have to give a urine sample? Oh, what the heck. I really have to pee!

We finally meet up again and head upstairs. As soon as we get to the counter, there is a gentleman confirming my name, doctor and something else…not my social security number, but I know there’s a third thing they keep asking. Every professional that I come into contact with asks me these things and I finally realize it’s to make sure they’ve got the right person. It makes me think of nurseries and baby switching.

We mention to him that my doctor is Dr. Battista, not Dr. Wiet, but he says that Dr. Wiet is doing the surgery. That’s news to us but I figure maybe because it is simultaneous bilateral surgery, which they don’t get a lot of just yet, he wanted to be in charge. Whatever – I trust them both implicitly so I just shrug and smile.

He points around the corner where there’s a little desk and tells us to go there. I realize right away that I didn’t need to bring my purse – they never did ask me for identification or my insurance card. Everything is already in the system. Poor Dave – he’s in charge of my purse for the day!

I sit down and a nice nurse comes over to take my blood pressure. It’s astronomically high – 163/104. This is actually very typical for me, since I’ve dealt with high blood pressure for years now—it started during my pregnancy with Eric in 1990. It runs in my family and I’ve been taking medication for it since 1994. Still, though, when I’m nervous like I am today, my blood pressure shoots up. I explain all of this to the nurse and tell her that I did take my BP medication this morning. Thankfully she seems unconcerned – if she’d freaked out over my blood pressure reading, I would have become even more nervous.

She hands me a cup and a gown and booties. I have to give a urine sample. I laugh nervously and explain that I just went to the bathroom, but she pats my arm and says they only need a couple of drops. She tells me to remove all of my undergarments and put the gown on with the opening in back. I am a little horrified that I have to be completely naked under the gown. :o  Then she tells me to go over to bed 7 when I’m done. I think, “Too bad it’s not bed 8.” Eight is my lucky number.

I’m able to give a decent-sized sample, surprisingly. I set the cup on the ledge over the sink and set to tying the hospital gown so my whole backside isn’t exposed during my walk over to my bed. I realize I’m able to tie it up so that it completely wraps around with nothing hanging open in back – what a relief!

I head over to bed 7 and sit down. Dave is already there and we chat for a little while. Another nurse comes in, goes over the info with me (name, doctor, ??? birthday? What is that last bit of information?) She asks if I gave a urine sample and I realize with horror that I left it in the bathroom. It’s been a good 10 minutes or so by now – did someone dump it out? Is it still there?

She goes over to the bathroom and all is fine – she’s got the sample. She sticks stickers with my name, doctor, etc. on the bag holding my clothing. She sits down to ask me a huge list of questions – the ones about whether I have epilepsy or stomach problems, whether I drink alcohol or smoke, etc. The only question I have to repeat back to her is the sleep apnea one – it’s not something that usually comes up in conversation so lipreading that question was a little difficult! I realize that so far, I’ve been able to lipread everyone really well and haven’t been worried at all about communicating like I did during the pre-op testing. I guess I have other things to worry about!

We are in this area, pre-op, for quite a while. The nurse re-checks my blood pressure and it’s come down quite a lot – still high, something like 130/92, but definitely better than before. She puts on the ID bracelet, takes my pulse, then tells me that she has to measure my calves for pressure stockings to prevent blood clots. She disappears for a while, then reappears with a package and IV stuff. She starts pulling things out of her pockets and setting them on the bed.

First the stockings – she tells me she’s going to put them on and get them started, and then I can pull them up. I’m thinking to myself, “Do they go up obscenely high or something, where it would be improper for her to pull them up?!” I’ve never worn anything like this before and wonder if they’re going to be uncomfortably tight. She starts each one and then puts my bootie on over the stocking. They are white and I look ridiculous, like I wore tights to my CI surgery in July. I pull them up to my knees and they don’t hurt at all; I actually forget I’m even wearing them.

The IV is next. I’m glad I’m lying down for this. The few times I’ve had IV’s it’s been a little bit of good, little bit of bad – some of them have been fine, a few have been so difficult to place that they tape them to high heaven and beg me not to move my hand, and one time they just couldn’t even get one started. (I was in the ER for dehydration and my veins must have collapsed.)

I close my eyes, feel the sting, look over at Dave. He’s giving me a thumbs up. The nurse starts taping my IV and I glance down to make sure it looks okay. I see the liquid starting to drip down the tube – it must be saline or whatever they use in IV’s. It’s nothing that makes me sleepy or relaxed.

After a couple of minutes I realize that there’s pain pulsating from my vein, I’m assuming as each drip goes in. It’s starting to make me feel woozy and lightheaded. I mention it to the nurse and ask if it’s normal for the IV to hurt; she reassures me that the pain will go away in 5 or 10 minutes and yes, it’s normal. That calms me down a little bit.

She goes off and we’re alone for quite a while, talking. She comes back and asks about the pain – yes, it’s gone. She’s got a green bracelet for me to wear that identifies my allergies to penicillin and sulfa drugs. Then she says that they need to give me a new ID bracelet because Dr. Battista is doing my surgery. That gets cleared up and she tells us that I’ll be going down to the pre-anesthesia area around 7 am or a little later. We explain about Dave being my interpreter, for any people that I have trouble lipreading, and she says it’s not a problem for him to come with me. I think normally at that point, the family members have to leave so I’m glad we cleared this beforehand.

We take some pictures and talk some more. There’s about 10 beds in this area, in a circle around the nurses’s station, all with curtains that can be pulled around for privacy. My curtain is open a bit and I watch various people get wheeled off, wondering what type of surgery they’re having and if they’re scared or excited.

7:15 am:
Another person comes in, introduces themselves, goes through my ID routine (name, doctor, birthday – I checked the bracelet to be sure because it was driving me crazy!).

They pump something up on my bed and I rise in the air. We’re on the move, being wheeled out of the pre-op area and over the elevators to go down to pre-anesthesia. I wait for my bed to hit the walls on the turns but the ride goes smoothly. I’m a little embarrassed in the elevator with other people looking at me but it’s a short ride, thankfully.

We wheel into another room full of beds and curtains, this one longer and without a nurse’s station in the center. There’s a little computer on a counter behind my bed. Right away another woman comes up, does the confirmation dance (I’m getting used to it now), and starts talking. She’s very nice but oh my gosh. She smiles constantly…big huge smiles, stretching her lips, even when she’s talking. When she finds out I’m lipreading she slows down just a little too much. I have to ask her to repeat a lot, but we get through it. She ends up being the most difficult person for me to lipread that day.

Her questions were mostly about allergies and if I’d had anesthesia before. We mention my problems with nausea in the past and she tells us to make sure to tell the anesthesiologist about it.

It’s not long before the anesthesiologist comes in, and I’m actually surprised at the fact that she’s a woman. I’ve always had male anesthesiologists in the past; I used to wonder if very many women even went into that field! She seems a little…I don’t know, hesitant?…when she’s talking to me. I’m not sure if it’s a personality quirk or if she’s just not sure I’m understanding her, so I make sure to repeat back what she says to me so that she can see I’m comprehending it all.  We talk about the nausea and she tells me that she can give me something through the IV, but because of the nature of my surgery she can’t absolutely guarantee that I won’t be nauseous when I wake up. That makes sense to me and I tell her that’s fine, I totally understand.

We ask about my glasses, since I need them to see to lipread. Dave explains that he’s going to modify them for me while I’m in surgery, so I can hold them up to my eyes in recovery (since I can’t wear either of the arms on my ears – both ears are being worked on and the bandage will cover them). We work it out so that they know to ask Dave for the glasses when I get to the recovery area after surgery.

I get asked questions about my dental work – do I have bridges, caps, dentures? I’m getting a breathing tube, apparently. This is general anesthesia, and she explains that I might have a sore throat afterwards but it won’t last long. She reassures me that I’ll already be asleep when they place the tube and I’ll still be asleep when they remove it, so I won’t even be aware of it.

She asks me if I’m nervous – do I need anything in the IV to relax me? Since I need to be alert to lipread, she’s hesitant to give me anything like that because I might be too sleepy when they take me over to the operating room. I assure her that I’m not anxious at all and it’s fine to do without the stuff, whatever it is.

She leaves and Dr. Battista comes in. It’s great to see him, and he’s smiling, very upbeat. He asks how I’m doing and I give him a big smile, tell him I’m really excited! I realize that I am – I can’t believe it, I’m almost in surgery, and I’m not scared! We talk for a little bit, and he tells us the surgery should take about 3 hours. I’ll be in recovery for at least an hour, and then back to the original pre-op area for 1 or 2 hours, however long it takes for me to feel strong enough to go home. He asks if I have questions and I don’t. I feel like I should have questions but really, I’m drawing a blank. He tells us the stitches will be ‘under the skin’ (I think that’s what he said) and I assume he means the dissolvable kind that don’t need to be removed.

He leaves and another guy comes in. He introduces himself, shakes my hand, does the ID stuff, and I have NO idea who he was. He did a few things at the computer and left. I think he might have been an assistant or nurse – Dave thought he mentioned he would be there during the surgery. The smiling woman comes back with a special antibiotic bag that’s placed on my bed. (Because I’m allergic to penicillin I’m getting something different.)

My anesthesiologist comes back, no more hesitation in her demeanor. She tells me that once we get to the operating room they’ll have masks on so she wants to go over everything with me now, while I can read her lips and she can answer any questions I have. I want to hug her – this was the thing I was wondering about the most…how would I lipread when everyone has masks on? So she goes over the procedure with me: I’ll have to move from the bed I’m on to a smaller operating table; there will be a foam headrest there for my head. They’ll start the anesthesia and the breathing tube will go in after I’m asleep. I can’t even remember if she told me anything else – I just remember the relief I felt that she took the time to consider this and come talk to me before I got wheeled off. It was a small gesture that calmed me in a huge way.

8:10 am:

Suddenly I’m ready to be moved to surgery. My glasses come off; now I can’t hear and can barely see. Someone says something to me and I laugh, wave my hand and say “Whatever” because I have NO idea what they said – we all crack up. (I think Dave handled that question, if it even was a question.) Dave gives me a kiss and I’m wheeled away, down the hall to the operating room. I give in to the fact that I’m pretty much helpless to communicate, unless someone gets inches from my face and pulls down their mask to talk to me.

The room is bright and bigger than I expected. I see the operating table and it looks so small. Can I really fit on that?! My bed is wheeled next to the table, dropped down to the same height and I easily scootch over. Whew. I was a little worried that I’d screw up and fall between the two tables onto the floor. (I wonder if anyone ever does that?!)

My head is situated on the foam pad and I see Dr. Battista giving me a big thumbs up – I smile back and do the same. Yay! The nurses start wrapping blankets around me tightly, arranging my hands and IV so they don’t slip off the table. The anesthesiologist pantomimes something for me that I totally understand, but I can’t remember now what it was – probably something to do with the fact that they were going to start the anesthesia. I remember getting drowsy and then…

Stay tuned for part two, recovery and going home. :)

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