June 17, 2017

I Got a New Ear (part 1)

I was born with Grade 3 Microtia and aural atresia on my right ear. That means my middle and outer ear did not fully form. I have single-sided deafness, but the deafness is due to inefficient conduction of sound to the inner ear, since the middle ear’s tiny bones weren't fully formed, and the outer ear canal was blocked. My inner ear works fine; something I didn't know until I had hearing tests specifically to test it last year.

I've lived with this problem my whole life. I had a rudimentary surgery in early childhood in which the doctors used cartilage and skin tissue to give me a sort of rough gesture of an outer ear, but even a pair of sunglasses wouldn't sit securely on my head. When my eyesight began to deteriorate as an adult and I needed eye glasses, this became increasingly frustrating. I had to either wear a headband, or wear my hair up and kind of hook my glasses into it, or risk them falling askew (which they often did, making me look like an idiot). Usually, I just didn't wear them unless it was necessary, such as driving, watching movies, or sightseeing.

On March 14th, I underwent an Ear Reconstructive Surgery. We had to get up at 4am in order to arrive at the hospital by 6am. I was going to be worked on by one of the best ear reconstructive plastic surgeons in the state, and assisted by one of the other best ear reconstructive surgeons in the state, who normally only worked at Children's Hospital performing this surgery on children. Turns out ears are really complicated; probably the most complicated physical part of the body (just look at all those delicate curves), and no other attending physician was qualified to help the primary surgeon apart from the *other* surgeon who does these surgeries. They normally perform this surgery together on children.

I was prepped and ready to go by 7am, and the last thing I remember was being wheeled down the hall on the way to the operating room. They sliced off the old skin and cartilage tissue that had been a poor semblance of an ear, and then implanted a new ear form made out of a polyethylene material, called a Medpor device. They took temporoparietal fascia flap (basically the tissue that lies under your scalp), sliced into it, and then folded it over the Medpor device. Then they took skin from my upper thigh/groin area and grafted it over the fascia tissue. The procedure took ten hours (longer than most, due to my previous surgery creating scar tissue), and I was required to stay overnight in the hospital so they could monitor me. To get a rough idea of the procedure, check out the slideshow of a child undergoing the surgery at http://microtiaearsurgery.com/treatment-microtia-ear-surgery/medpor-ear-surgery

Of course I was under general anesthesia for the entire procedure, and I remember coming out of it with a great pain in my…arm?! I was disoriented and panicky, because I couldn't figure out why my left arm was hurting so bad, right in the crook of my elbow. Turns out, lying motionless for over ten hours while fluids are being pumped into your arm has a detrimental effect. I was also hooked up to drainage tubes coming out of my head to collect blood and other fluids as the skin and tissues around the incisions were swollen. Half my head was shaved and I had a pink protective cup molded onto my ear and stitched to my head. They pumped some sort of pain reliever into my arm to stop my yelping. According to my husband, as I made the slow, careful journey back to full consciousness, I was alternately crying, apologizing, and trying to crack wise at the attending nurses. I threw up quite a bit due to the anesthesia and whatever pain medications they had pumped into my arm (hence apologizing to the nurses), and my blood pressure was dangerously low. I was put on "low blood pressure watch" for the night.

That was the longest, scariest night of my life. I was exhausted from not having slept much the night before my surgery, and then my body had been subjected to a traumatizing ordeal while I was unconscious. Being under anesthesia is not at all restful; it's more like an outside force has put your body on Pause. I was also weakened and famished from not having eaten for over 36 hours. But I couldn't eat because I kept throwing up, and I couldn't sleep because I was in too much pain. And they couldn't alleviate my pain because the pain medication made me throw up. I could only sip water, since the nurses were afraid I would throw up if I drank too much at once. And since my blood pressure was so low, and I was so weak, I was experiencing symptoms of severe exhaustion, such as chest pain and shortness of breath. I was alternately too hot or too cold. I experienced vertigo, which contributed to my feeling of being nauseous.

The first time I had to use the bathroom, two nurses had to help me out of bed, attach a strap around me that they held onto in case I fell, and I had to use a walker to support myself. The bathroom was a mere six feet from my bed, but it took me several minutes to make the slow journey. The room kept spinning and I had to rest every few steps, panting as if I had just ran a mile. "This must be what it feels like to be very old and frail," I thought to myself.

But that wasn't what made the night scary. There was a patient somewhere on the recovery floor, a man, who was screaming and cussing at the nurses. I heard one of the nurses say to the other, "bring the anger stick!" And routinely throughout the night, I heard this man yelling, cursing, and hitting the "anger stick" against something metallic (probably his bed rails). He sounded like a horrible person who was in a lot of pain, and I thought he *must* be tied down or otherwise incapacitated, because if he was this angry and mobile, he would be running through the halls, wreaking havoc and terrorizing other patients. In my near-delirious state, that was a real fear of mine, that he would somehow break free of whatever his confines were, and start trying to kill people. I tried to get out of bed, to see if I could lock myself in the bathroom, my fear was so great, but some alarm started beeping when I sat up too much. I was hooked up to an IV and a monitor. I hoped that the man only sounded dangerous, and that I was actually safer than I felt.

The night progressed very slowly. I tried to sleep, but woke up constantly to see that only a minute or two had passed. The man screamed obscenities and thwacked his stick against the bed periodically (probably during routine blood pressure checks and medication dispensations) which also kept me from sleep. I was hungry, but there was nothing to eat; the hospital cafeteria was closed. My arm hurt worse than anything. My husband had left sometime after midnight, and returned early the next morning.

Various doctors came in to see me that next day. A group of three arrived around 5:30am and said they had been in the OR during my procedure. I had never seen them before. They pulled the drainage tubes out of my head. Then another doctor whom I had never met before came by and said he had also been present. My, that OR was getting pretty crowded. How many people had seen me naked? He checked my vitals and asked to see my skin graft incision. Finally, THE doctor came by and observed as the nurses helped me out of bed to the bathroom. He said I was recovering remarkably well, considering how low my blood pressure had been.

I finally was able to eat a piece of chewy toast for breakfast. Later in the day I could go to the bathroom with minimal assistance. Finally, I ate two bowls of chicken noodle soup. It was tasty, and I was hungry, but I kept almost face-planting into the bowl from sheer exhaustion. All the motions of eating took effort and I had to stop after every bite just to catch my breath.

Finally I was able to go home. After more soup, I crawled into bed and was able to really rest at last.