Wednesday 26 December 2007

The Surgery Day!

This blog will cover all basics of Raymond’s CI journey so you could have an idea what you can expect on the day of your CI surgery. Please keep in mind that everybody is different, every hospital is different, and most doctors have their unique way, but it is pretty well the same routine overall. I won’t go into detail about the technology of the cochlear implant devices. You are more than welcome to visit the following websites:

http://www.bionicear.com/index.cfm?langid=1
http://www.nshsc.ns.ca/programs.html
http://www.cochlearamericas.com/


This is the 'before' picture before the surgery...last time to wear a hearing aid. No more cotton ball jokes :)

On the big day of the surgery, December 12, 2007, Raymond was so excited and was in good cheers. We arrived at the Victoria General Hospital approximately 6:15 a.m. and met the interpreter.

- Registered and filled out some forms, such as getting a semi-private room, etc.
- Went into the “pre-op” room to get ready to go into the operating room. Got him into a hospital gown and lovely foam slippers. They checked his blood pressure, temperature, oxygen level and gave him the required meds.
- Left to the operating room approximately 8:30 a.m.

I, the wife, went into one of the 4 family waiting rooms and mistakenly chose a room without a television! I will be bluntly honest with you, I was very nervous about Raymond undergoing the surgery. It was hard to keep my mind on one track. Your spouse may be fine, everybody is different. This was Raymond's 8th surgery in only 6 years - 4 major ones and 2 minor ones. This one is on the brain, so natually, I was worried. Thank God there was a jig-jaw puzzle on the table so worked on that off & on and it really helped to keep my mind off Raymond for short periods of time. There was a liaison nurse who goes into the OR room to keep updates and would come to see me every half hour to let me know how things were going. This was another big help instead of always wondering how things were going. The interpreter went into the OR with Raymond until they gave him anesthetic and he left the room. The interpreter came to see me for a few minutes and left for about an hour, then he came back to sit with me for a while because he was waiting for the call to go into the recovery room. Ended up having a great chat with him which really helped me to keep my mind off Raymond.

Let’s backtrack a little bit. Surgery started approximately 9:20 a.m. and at 12:45 p.m., the surgeon came to see me in the waiting room. The operation itself was about 2 ½ hours to 3 hours long. The doctor called me out of the room, which had me thinking twice because there were other people in the waiting room too and their doctors came into the room to inform them of the surgery results, etc. All eyes were on me while I was walking out of the room. The doctor was very kind to get us into a private room and he informed me that the surgery went “ok” or it went well. I have met the doctor on different occasions and he is usually peppy but during this time, he was not. He mentioned that the x-ray they had taken was cloudy and not clear so they were not exactly sure if the wire was in its exact place, so will have another x-ray taken soon and would let me know later on what he thought. The audiologist “tested” the implant in the operating room and it was ‘live’.

The doctor gave me instructions on home care, there are three important things to keep an eye on which are:

- Heavy dizziness – if there’s light dizziness, that is fine
- Lots of pain
- Redness on incision area, which might mean an infection

Any one of the above, I am to call the hospital and luckily I didn’t have to. The doctor said if there was numbness in the incision area, it is normal. Post-op check up is on the following week to have the staples removed and check things out. Raymond had 15 staples, a lovely incision right behind the ear.

The surgery was on Wednesday and he was allowed to have the bandages removed and have a shower on Friday, using shampoo on his head. Dry dab lightly with a towel. Put a little bit of polysporin on for a few days to prevent any infection from developing.

Raymond has no memory of being in the recovery room so I can tell you what happened in there. When he woke up, they asked him to move his face as in facial expressions to ensure there was no paralysis. All went well.

Arrived into his room around 2:45 p.m. and this was the first time for me to see him since 8:30 that morning. I can tell you this much that he not himself at all. He had a very difficult time to stay awake for the remainder of the day. Not long after that, he went down for a CT scan as the second x-ray did not show up clearly as well. He has no memory of the recovery room or going into his room or even going for the CT scan.


The above is a picture of Raymond after his first surgery. Grumpy he looks, eh?

They gave him anti-biotic to prevent infection from developing. Remained on IV and gave him Tylenol #3 for pain.

That evening, Raymond still had difficulty to stay awake, did not eat much for supper and started having double vision. When Raymond had his workplace accident 6 years ago, he had double vision and it was the same thing happening all over again. He needed to rest completely so I left around 7:30 p.m. and stayed overnight at friend’s house.

Me being a smaller city version gal, I arrived at the VG hospital around 7:30 a.m. as I wanted to beat the bigger city traffic rush and get a good parking spot as we have a huge truck. Raymond looked a lot better than the day before, but still was not feeling “A1”.

They changed the bandage on his head and replaced it with another one.

The surgeon and his assistant came to see us later that morning and spoke to us. He looked at the CT Scan and noted the wire of the implant was “bent” at the end of the cochlea. He was not too happy about that as it is not totally guaranteed if the implant will work at its best level. He wants Raymond to have the best benefit of the cochlear implant so he gave us two choices:

1) Leave it as it is, try it out when it is activated and if it does not work, re-surgery again at a later time.

or

2) Do the surgery over again “today” as he was available after that morning.

Raymond decided to re-do the surgery the same day and I agreed with him. So it will be done that afternoon or evening, meaning no food for Raymond for nearly 48 hours. He was dreaming of all kinds of food all day long – nice, thick and juicy steak, Tim Horton’s coffee, submarines, etc…. poor guy! I was mean to him during one point, not thinking what I was doing...drinking a Tim’s coffee and eating chips in front of him. Sigh, I’ll know better the next time. I am going for the implant myself in the near future and he said he’ll pay me back by eating in front of me. All in fairness :)

The surgeon’s assistant came to see us at 4 p.m. telling Raymond, “We have not forgotten you!” There was an emergency came up that afternoon, so they needed the OR room, so Raymond’s surgery was delayed to that evening. He thought, “oh no, more waiting time for food!”

They came to get Raymond at 6 p.m. and went directly into the OR room. Surgery started at 6:45 p.m. Thank goodness I had the support of a good friend who stayed with me during this time, went to have a bite to eat and a good chat. Went up to Raymond’s room to chat more and watch some TV. I will never forget this.

The surgeon came to see me around 9:45 p.m. and said he was very happy with the surgery this time. The testing of the cochlear implant was much better than the first time around. They replaced the whole thing and got the wire in the right place this time. What happened here is they “forgot” all about Raymond’s workplace accident 6 years ago and the insides of his head was shifted some, making the surgery a bit difficult the first time around.

Raymond arrived into his room at 10 p.m. in a very cheerful mood! A complete turnaround from yesterday! He immediately asked for food, so he had some toast, milk and water. He even asked for a beer, nah!! No more pain, no nauseous, no double vision and he slept very well that night.


The above picture is after his second surgery, looks a bit better.

Now I can relax and arrived at my friend’s house at 11:30 p.m. and made the usual phone call to Mom.

The following morning, they changed the bandage and replaced it with another one because of the 2 ½ hour drive back home, wanted to keep it nice and sturdy. The surgeon came to see him and said all was well. Two more rules:

- No blowing nose
- No coughing, sneezing at all possible, if needed, open your mouth to get the pressure out (suggestion – lightly cover your mouth with a Kleenex)

Gave us meds for pain and infection prevention. Off we go!

Arrived home just before supper and very happy to be home. Raymond slept most of the way, which was good. He noted that he was a little dizzy, not bad at all. On the following day, he noted his balance was off a bit and gradually got worse after that for a few days. He needed my support when we are outside in the open space. He was okay at home. He felt when he put his foot down, the floor would appear to come up and when he put his foot up, the floor appeared to go down. It was a strange sensation for sure. That did not stay with him long and gradually got better.


This was the day the bandages came off at home.


This was after his shower.

He prefers to sleep on his left side and that is where the CI implant is so he had to sleep on his right side most of the time. Just a couple of days ago, he was able to handle sleeping on the left side but only for a short time. As for pain, it was very minimal – it was more like “sore”.

Staples and post-op check up was on December 20th. Dad took him down for me as I didn't want to take too much time off work. I will go to activation day tho'.


This is after the staple removal. Keep in mind surgery was done twice in the same area. Not a bad job, eh?


Raymond is proud of this one!

His left ear was the “good” ear, and he is really surprised that he is now completely deaf in that ear. It is because the wire has destroyed the nerve “hairs” in the cochlea. He knew that would happen but never “realized” it until he experienced it. He tried to listen into the phone, nothing. He tried to listen to my voice, nothing. I called his name last night loudly and nearly busted my voice, nothing! His right ear is the “poor” one, so he does not hear well out of that one. He is now craving for sounds. He is anxiously waiting to hear something soon.

Activation date is January 8, 2008.

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