Second Surgery (part 1)

March 3, 2009

A terrible snowstorm arrived the night before the second surgery covering the streets in a foot of snow and blowing angry winds throughout the city. The weather closed New York City Schools for the first time in five years as people struggled with commuting and removing snow from entryways. Despite that, Northside car service got me to the hospital perfectly on time and there seemed to be no delays for my surgery as I feared. In fact, the hospital looked a little less scary, a little less colorless than last I remembered. They even had new purple paper gowns ("Bair Paws" -- why "Bair"?) with little pockets in front for hands and a plastic connector that could be hooked up to a heating apparatus to blow warm air up the skirt.

I've never felt as human and vulnerable as walking around that hospital in nothing but a thin paper dressing. It was hard not to look in on other people to gauge how they were feeling, listen to their conversations, wonder what was going on with them. I could overhear a young man in the curtained room next to me describing open sores on his chest, the various medications he took daily -- none of which I recognized, how he only drank alcohol once every two weeks. Does he have AIDS? Why so much medication? What procedure is he having done? He seems familiar with all of this, talking so casually to the nurse, sounding so comfortable compared to my stumbling, my questioning, my obsessive need to know why they were asking me these things.

I climbed back into my familiar position on the gurney, luckily facing a corner so I didn't have to look at the familiar faces undergoing procedures probably much more severe than mine. The anesthesiologist introduced herself, a blond Russian woman with make-up looking a bit like Bridgette Nielsen from that vantage point. She was intrigued that I worked at Google asking if any Russians worked there.

"I think they tend to take the best and brightest from all countries."

"Oh, thank you very much. You didn't have to say that."

I didn't actually mean it as a compliment to the Russians specifically, but it doesn't hurt to get in good with your anesthesiologist.

"Don't worry, I give you good drugs. Make you feel good."

At the last minute they opted for the general anesthesia, over the twilight, without much explanation, despite my pressing. I passed through the familiar sensation of winding down and waking up heavy and unexpectedly in my curtained room. This time was different though. I felt sickeningly dizzy if I shifted my head the slightest bit. I couldn't do anything but close my eyes hoping this would go away. I found all sort of hallucinogenic thoughts intruding in on one another, strange collapsing disturbing dreams that I couldn't make go away. I was partly fascinated by what a sick bastard I was that I was capable of creating such detailed, disturbing images gnawing away at one another. The nurses kept prepping me to leave but I was unable to stand. I told them I felt nauseous. They handed me a little plastic container and I vomited. Then another one and I vomited again. Then another and a little later I vomited again. Sarah, who was picking me up, walked up her usual smiling self and I quickly banished her, hoping she wouldn't see me holding a bowl of my own throw-up. The nurses seemed confused as to why I was so dizzy and I had the panicked thought that maybe this was my new permanent state. That I would be a dizzy, retching mess after this.

I told Sarah she should go back to work as I would likely be there for a couple more hours. But almost immediately after I sent her back I began to feel better. The dizziness subsided slowly, but Sarah had a 2:00 meeting she couldn't miss. A nurse was nice enough to retrieve my cell phone from a locker and I preoccupied myself recuperating nicely until she returned. By the time she arrived I had even dressed myself. I called Northside to send their $45 luxury SUV so I didn't repeat my mistake of the rattling cab ride home and made it back in much better shape than last time. Although I still had the ringing in my ear and the slight rushing, it felt diminished and I didn't have the strange sense of hearing in mono. The ear seems like it's back to the level from before the first surgery, though it's too early to tell. I can't imagine having to go through this ordeal a third time, though it's a very likely possibility.

The Story of the Surgery (part 5)

"So as it turns out, you don't have otosclerosis."

Confusion. Shock. "What? Really?"

"Yes, when I got in there it looks like the anvil in your ear had been moved to the side. The kind of thing that happens with blunt force head trauma. I went ahead and tried to move the anvil back into place, but was unable to. So I took it out and put in a prosthetic."

"But I thought Dr. Nambar said you could tell from the MRI that I definitely had it. That it was actually rare for it to show up on an MRI.

"Yes well, sometimes those MRIs are a little muddy. It's hard to tell."

So as it turns out, my suspicions were confirmed. I did not have otosclerosis, but what was more disconcerting is that I had apparently had some kind of blunt force head trauma and that Dr. Jahn decided to go ahead and remove a different part of my ear without asking me. Had the aliens been experimenting on me again? My only recollection of abnormal injury occurred a couple years ago while dating Suzan. I was playing soccer with students from ITP when I ran into this hulking guy full bore. It was a solid hit as I recall, but one that left me still standing. I even walked across the Brooklyn bridge and back the next day to have pizza at Grimaldi's, so sore I didn't notice the pain in my chest that lingered for days afterward. I went to see a doctor who found I had broken my topmost right rib. The first bone I've ever broken. Evidently, I had also dislodged the anvil in my ear, for it was a few months after that that the ringing started and a few months more that I realized my hearing had been compromised. Talk about random accidents.

On the one hand I was relieved that I didn't have some disease that could potentially affect my hearing in both ears. On the other hand, Dr. Jahn tested my new prosthesis only to find that my hearing had actually gotten worse. The ringing and the deep rushing sound in the background had now grown louder, making it incredibly hard to hear in large spaces with ambient noise. I was panicked wondering if I would have compromised hearing for the rest of my life. Dr. Jahn gave it another 5 weeks to see if anything settled. When it didn't, he thought that perhaps the new anvil wasn't in the right position (a tricky business) and we scheduled another surgery to make it right. Although I was dreading the process, at least I knew what I was up against. Still, I had this lingering suspicion that perhaps there was a larger diagnoses to be considered. I had also been having shooting pains in my left jaw and a clicking sound occasionally in my left ear. Dr. Jahn said there was no doubt that the displaced anvil was a significant part of the problem and that he thought we should have a second surgery before considering further diagnoses. He said that this time we would use "twilight anesthesia" which wouldn't put me under so totally and allow us to test the ear on the operating table. We scheduled the surgery for March 2.

The Story of the Surgery (part 4)

March 1, 2009

I arrived at Roosevelt Hospital before ambulatory surgery had opened and had to wait around about 15 minutes before heading up. As the waiting room filled up, I noticed how miserable everyone looked. Like they were walking (and in many cases limping) to their deaths. I realized how completely alone I felt, more alone than I had felt traveling through India on my own. There was no one to feel what I felt at that particular moment in that dilapidated hospital with the worn furniture and stained ceiling tiles. No hands to hold or arms to take shelter in. I found myself missing my family in a way I hadn't in years. Missing the security of people that would see me through my crises and ordeals. But in this I was on my own.

After signing numerous dubious consent forms ensuring I wouldn't sue, I put my clothes and belongings in a narrow locker and changed into a loose-fitting paper gown and thin cocoa-brown ankle socks with rubber adhesive underneath. I padded my way through the hallway looking at concerned families crowded around their sick relatives in curtained rooms or patients stranded on gurneys in the middle of hallways. Soon I found myself stranded as well, staring up at the disintegrating ceiling across from an obese black woman looking sad and lonely. I began to tense up feeling as if I were in the movie Jacob's Ladder, having a hallucination of someplace that I absolutely should not be. My panic settled as a beautiful Indian anesthesiologist took my hand softly and introduced herself. She had an enormous diamond on her finger and I thought that she had an extremely lucky husband. Though self-conscious in my plastic robe and convalescing state, we talked about India which made me feel better and gave me solace that even if I die in this horrible horrible place, one of the last images I will have looked on is an absolutely beautiful woman. They laid me out Christ-like on the operating table remarking how I wouldn't even remember this part of the surgery. I did, even if I didn't remember the actual fading into a gentle sleep.

I came to in a reclining chair with a blanket. Cold. Very cold. They turned on a heat lamp leaving me basking in its glow and brought me some milky tea in a styrofoam cup and graham crackers. I couldn't remember the last time I had graham crackers and had the sense of being a child again. I dozed off and woke up to Jesse working on his laptop beside me. I felt immediately self-conscious at my pitiful state, unable to converse or move properly. Jesse remarked in my bearded state that I looked rather like Van Gough and we waited for the drugs to subside as he snapped occasional pictures of me, documenting the experience. We took a cab the long way home which seemed to hit every pothole in New York. My head was spinning, hurting, jostling, vibrating. I felt like whatever they had put in my head had surely rattled out by the time I got home. I felt nauseous and my head was throbbing. I laid down to bed as Jesse ran out to fill my prescription. Once the medicine kicked in I thanked Jesse profusely and fell into a deep sleep.

The Story of the Surgery (part 3)

Dr. Jahn seemed a pleasant enough fellow, older with resigned drooping features like a basset hound. He discussed my options: do nothing in which case the ear would likely get worse and possibly affect the other ear; get a hearing aid (give me a break, I'm in my thirties); or have an stapedectomy. In an stapedectomy, the stapes (one of the smallest bones in the human body roughly the size of a grain of rice) is removed and a prosthetic fitted into place that would vibrate more easily. Jahn has performed hundreds of these microscopic surgeries over 27 years and has only had three cases that were unsuccessful. Typically the success rate is around 90% with 5% having no difference and 5% of cases whose hearing actually gets worse. These seemed like pretty good odds considering I may have to do the exact same surgery on the other ear eventually, so I scheduled the precedure for mid-November. I would be required to take a week off work and I figured the Thanksgiving holiday would give me additional time to recuperate.

As the date approached I was fairly nervous. I had never been to a hospital except for once when I was four and cut just above my eye on the corner of a sharp, rusty metal stairwell in our apartment building. Like my father, I'm not a fan of doctor's or hospitals and didn't know what to expect. I've also been put under general anesthesia only once when getting my wisdom teeth removed and didn't like that lack of coordination, that absence of memory. I arranged for Jesse to pick me up and followed all the pre-operative guidelines. My surgery was scheduled for 7:30 am meaning I had to be there at 6 in the morning. Being not at all a morning person either, I prepared for my personal descent into hell.