blind insight

I feel great.

Sometime during the course of the weekend, while we were hiking and climbing and camping and drinking and relaxing, my right ear finally stopped feeling congested and weird.

I was a little more wobbly than normal while navigating approaches and walk-offs, but I felt strong and competent on the rocks and had an awesome time pushing myself in the tough cracks at Turkey Rocks. I also did yoga this morning, and didn't have any more difficulty with the balancing poses than I usually do two-eared.

The great big scab behind and above my ear is almost entirely healed.

I'm all ready to start hearing with this thing tomorrow!

Much, MUCH better.

I have truly turned the corner in my recovery from surgery. I felt nearly normal all day yesterday, and even went for an easy swim with Michelle after work. Tonight I’m planning to climb at the gym, and I’m looking forward to a camping and climbing trip, and hopefully a day of triathlon training, over the upcoming holiday weekend. I am pretty sure that by next Wednesday, when the implant is activated, I will be done with the healing process and can focus on the hearing process.

I keep forgetting to mention that having only one working ear hasn’t been as difficult as I feared. It does make me a little nervous when I’m walking around alone, and it makes it hard for me to regulate my voice on the phone, when I have my hearing aid turned to the telecoil function and can’t hear anything outside the phone, but I’m not having much trouble hearing people in normal conversational settings. The biggest problem, and one I hadn’t anticipated, is that any loud-ish background noise completely overwhelms all other sound.

For example, if I’m in a loud restaurant, or outside in a high-traffic area, all I can hear is the conversational buzz or the roar of passing cars. Given that nothing is different about my left-ear hearing aid, and that I previously heard almost nothing in my right ear, this is a strange and interesting discovery. I guess that when I had two functioning ears, I was able to absorb a fair amount of background noise in my right ear, which couldn’t understand speech anyway, freeing my left to do more of the auditory heavy lifting. With the right ear out of commission, the left ear has to hear EVERYTHING, and it isn’t capable of filtering out much of the background noise on its own. This is fascinating, and it has me very curious to see (or, well, hear) how this phenomenon is affected by the initial activation.

Much better.

Today was much better. I’m still dizzy and queasy, and I spent most of the morning hacking up globs of blood again. But I had virtually no pain all day, despite taking only two Tylenol first thing this morning and nothing else for the rest of the day.

I returned to my office today, and was able to file a brief, catch up on correspondence, and make some progress in researching the next brief on my docket. It felt good to get back into my normal routine, and I appreciated how solicitous of my well-being everyone in the office was today.

Also, my doctor has cleared me to resume exercise as soon as I feel up to it, and has assured me that everything I’m experiencing is normal. I’m planning to climb on Wednesday night with my regular climbing crowd, which surely will do wonders for my mood. I’m starting to feel better about the whole CI experience already.

Two steps backwards.

I've had a rough couple of days. Yesterday, a glorious, sunny, Saturday, we went downtown to stroll around the Farmer's Market and the Pearl Street Mall. I wasn't feeling great when we left, but figured the fresh air would help. Alas, no. After an hour or two of feeling sharp, spasmodic pains around the implant every few seconds, I was dizzy and nauseated and fighting back tears. Steve got me home before I totally fell apart, and I spent the rest of the day on the couch.

By early evening, the pains were driving me so crazy that we called the on-call doctor. She said they were normal, and I should take pain-killers and, if necessary, a muscle relaxant. With the help of Vicodin, I eventually fell asleep, but the spasms awakened me at 7 this morning.

I tried Tylenol, stretching, massage, and a shower. For now, the pains have subsided (although I can almost feel one waiting to strike). Instead, they have been replaced by the worst nausea I've felt since the surgery, and another wave of dizziness.

I'm frustrated. I've had surgery before, and have always bounced back quickly. Yet here I am, nearly a week post-op, and I feel far worse than I did a day or two after the operation. I'm annoyed at the doctor, who didn't give me any information, written or otherwise, about what I might experience during this recovery period. I'm annoyed at my body, for not being able to do anything other than mope and sleep. And I'm annoyed at myself, for making this decision that so far has brought me only pain and discomfort.

I expect that in a few months, when I'm hearing more and better than I ever have, that I'll look back on these days as a mere blip on the screen. Right now, though, it sucks.

Report from the recovery room.

My ear, both in the interior and around the incision behind it, hurts. I've been spitting up bloody phlegm since yesterday morning. And every time I cough, sneeze, or move my head quickly, I feel and hear an almost unbearable buzzing behind my right ear.

The nurse tells me that all of this is to be expected. The pain is mostly controlled by Vicodin, although it has woken me up around 3:00 a.m. each of the past two nights. The blood in my mouth is draining out of my ear, and also coming up from my ventilator-abraded throat, and should go away soon. And the buzzing, apparently, is caused by blood moving around the implant.

Aside from these annoyances, I'm feeling fine. I've been relaxing at home, getting a fair amount of work done, and watching a lot of Veronica Mars on DVD. Because it is so difficult for me to find a comfortable position for sleeping, I'm a little tired and draggy today, so I may take it easier than I did yesterday, when I went out for a walk with my parents in the afternoon.

I am so appreciative of all the cards, flowers, cookies, and blog comments I've received from thoughtful friends and family. My wonderful imaginary internet friends even managed to replicate my bridal bouquet, bringing bountiful color to the house and a great big smile to my face. I'm not a pray-er, myself, but I do believe in the power of good wishes, and I feel very lucky to be receiving such an abundance of those.

All is well.

The surgery went beautifully. I'm home, resting, and generally fine. The anesthesia withdrawal and the 4:00 a.m. wake-up are catching up with me, and the Vicodin is wearing off, so I'm feeling a bit of discomfort and dizziness, but mostly, I feel pretty normal.

I worked myself into a bit of panic last night, wondering whether I was making the right decision, after all. The same set of doubts reared their little heads this morning, as Steve and I rode along the silent early-morning highway. Why was I doing this? Why undergo a surgical procedure that would destroy my residual hearing and put me out of the office for a week during this crazy-busy stretch? Why set myself up for a long and uncertain relearning process, complete with frequent schlepping out to Aurora? Why take myself out of athletic commission for at least a week or two in the middle of the climbing and tri-training season? For what benefit? When would it come? Why, why, why? Could we still turn around and go home, and back to sleep?

But Steve reminded me that neither the surgery nor the recovery would be so terrible, and that hearing more, and better, has the potential to significantly improve my life. Plus, he said, how cool would it be to tell people he was married to a Bionic Woman?

I took some deep breaths, wiped my eyes, and did my best to let go of the fear. By the time I was lying in the pre-op bed, IV in my hand, goofy-looking shower cap over my curls, and a crew of nurses and doctors bustling in and out of my curtained space, I really was ready.

I don't remember the rest of it, of course. Perhaps 3 hours later, I realized I was floating on the edge of consciousness. I wanted to dream a bit longer - I was in Sardinia, rock climbing with Steve, and I hated to leave that idyll. When I did surface, my head was fuzzy and my throat raw. The nurse had remembered my request to return my left hearing aid after the surgery, so at least I could hear. I babbled something about rock climbing, and then I started to cry.

I tried to tell the nurse that it was "stress crying," residual tears left over from my pre-surgery anxiety. I don't know if my words were coherent, but she was patient and kind and brought me a box of tissues. Another nurse came over and chatted with me about climbing in Eldo. I'm not sure whether he was genuinely interested, or just trying to help me relax, but the conversation cleared my head.

Dr. Cass arrived, beaming and energetic. He said everything had gone perfectly. I tried to ask him questions, but started to cry again, and again apologized incoherently for my tears. The doctor bounced away, heading back to the OR for another surgery.

The nurse wheeled me back into the pre-op room. Another nurse, a guy with just the kind of sarcastic sense of humor I needed, finally allowed me to drink some ice water, which soothed my parched and tube-ravaged throat and, more than anything else had, helped calm me. My head was hurting quite a lot around the incision, so the nurse gave me Vicodin (and some graham crackers), which eventually eased the discomfort.

Then Steve and my mom were there, smiling and obviously relieved. We got instructions and a prescription. I dressed, the nurse wheeled me to the car, and home we went.

I spent the afternoon playing Settlers of Catan with Steve and my parents. They didn't let me win, so I must be OK.

Despite some intermittent dizziness, the incision-area pain that is reminding me now to take another pain pill, and my still-raw throat, I feel good. So far, I'm not having any problems moving around or communicating. It's harder for me to hear with just the left ear in business, but not so much harder that I can't interact with people.

Tomorrow, I can remove the giant bandage from around my head and take a shower, which should go a long way towards helping me heal. For now, I'm rocking the Cindi Lauper Circa 1984 Look:

Into the void.

In less than 12 hours, at the ungodly hour of 5:45 a.m., I will check in at the hospital. The hospital is located far, far away from home, making for a ridiculously early wake-up time that will be much harder on my husband and chauffeur than it will be on me. After all, I get to sleep through the whole thing, while he has to sit around for hours and hours waiting for me. Nevertheless, by mid-day tomorrow, we should be heading back home.

I'm ready for the procedure itself. But as for what comes next, it still feels like the Great Unknown. I simply have no idea how I'm going to feel, and how I'm going to hear and function, starting in less than a day.

People keep asking me how quickly I will be able to hear with the implant. This is a simple question with a more complicated answer than you might realize. I won't hear anything with the implant until May 31, when it is activated. That's two whole weeks with only one functioning ear, and those two weeks scare me the most right now. I know, logically, that I'll be fine, and I've warned friends, family, and co-workers that I may not be feeling up to a great deal of interaction during that stretch, but it's unnerving to anticipate.

Once I receive my external processor and have the device switched on, I will almost certainly be able to "hear" with it immediately. What will take time is to understand what I'm hearing - to separate and distinguish and comprehend the sounds as speech, music, traffic, computer keyboard, cell-phone ring, doorbell, and kitty cat. I can't predict how long that process will take, and neither my doctor nor my audiologist has hazarded a projection. They say "quickly," because I hear most of those sounds to some degree now, and I already understand what speech sounds like, but attaching a specific duration to "quickly" would likely cause me impatience, frustration, and self-doubt.

And so, I don't know. But I'll keep you posted.

All systems go.

The surgeon has informed me that my inner-ear structures are "normal." I am pretty sure he meant "normal enough for me to stick a computer chip in your head," rather than "normal-normal," but I didn't quibble with his pronouncement.

So: CT Scan, check. Insurance approval, check. Work arrangements, check. Season One of Veronica Mars on DVD, en route (thanks, J.). Looks like I'm good to go, two weeks from today.

In the week since my last appointment, my residual uncertainty seems to have dissolved to almost nothing. I'm getting more and more excited about the potential the CI offers to improve my hearing, and less and less worried about the initial adjustment period. I've been following eagerly the experiences of two of my imaginary internet friends who recently had the surgery, and have been talking a lot with Dawn about her own progress and that of others she knows. Having these inside views of the recovery and adaptation process makes it much less nerve-wracking for me.

In the meantime, I'm arguing three cases next week before the Tenth Circuit, here in Denver (two of them are consolidated). The Circuit staff has been wonderful about ensuring that the amplification system will be functioning effectively. The infrared in Courtroom III still doesn't work, so they've brought in an FM system. I have tested it, and it's good - the tech guy is tweaking it to try to make it great. The IR in Courtroom II is working perfectly. So, I expect my arguments to be free of technical difficulties. I'll let you know how they go.

The couple that, um, bleeds together....?

Friday's CAT scan was a piece of cake. I was in and out in 15 minutes, with no need for that nasty contrast goop or even a hospital gown. My doctor will receive the results tomorrow, and then will (hopefully) give me the green light for surgery on the 16th.

On unrelated fronts, Steve and I had an awesome day of climbing in Eldo yesterday. We haven't had an entire weekend day to hang out justthetwoofus since FEBRUARY, if you can believe that. We were slated to attend a wedding in Albuquerque this weekend, but Steve had a major deadline that precluded us from driving, and the airfares turned out to be astronomical. $300+ to fly to ALBUQUERQUE? It's barely an hour in the air from here! So we incurred bad wedding karma that will someday come back to haunt us, and stayed home.

Here's a lovely photo from the end of our day on the rocks. Isn't it romantic?

May 16th.

That’s when I’ll be having the cochlear implant surgery, barring any wacky results from the CT scan I’m having on Friday, or any unexpected insurance glitches.

When Steve and I met with the audiologist and surgeon yesterday, we really weren’t sure what to expect, or even what we wanted to happen. The appointment had been rescheduled so many times, the insurance stuff had been SUCH a hassle, and we were less than optimistic that the surgery could happen without interfering with a great many existing schedule constraints.

But the appointment itself went beautifully. The audiologist was as wonderful as we remembered, and patiently answered all of our questions. We finished the required testing, confirmed my candidacy for the operation (and that digital hearing aids simply do NOT work for me), then turned to the thorny issue of scheduling. Amazingly enough, the surgeon had an opening on May 16, during the only week before late 2006 that Steve and I had agreed would work comfortably for our schedules. I took a deep breath, and let them pencil me in on the calendar.

After we picked a date for me to go under the knife, the audiologist talked us through the pros and cons of the different CI devices.  This was fun - there are only three options, and I was only considering two of those, but we got to look at and handle all the different devices and their many components and accessories. Steve and I make a great team for this aspect of the process, as I know what I want from a hearing/functionality standpoint, and he understands all the technical jargon. Ultimately, I opted to go with Cochlear’s Nucleus Freedom system, mostly because it uses high-powered hearing-aid-style batteries and thus has more flexible portability, whereas the Advanced Bionics system uses rechargeable batteries that require access to an electricity source - problematic for any kind of backpacking or backcountry ski trip of more than two days. I have tentatively ordered one external processor in dark brown and another in a flesh color almost identical to my hearing aid, mostly so that I can tell the primary and back-up devices apart.

While we waited to meet with the surgeon, Dr. Cass, my anxiety returned. I asked Steve why he thought I should have the surgery, given that I do quite well with my current hearing-aid system. He reassured me that the decision was all mine, and that he thinks I am just fine as I am. But he reminded me of how much potential benefit I stand to gain - the doctor and audiologist believe my right ear will eventually surpass my left as my "good ear," which would be a dramatic improvement - and how important better hearing will be as my eyesight continues to dwindle. And, he added, from a gear-geek perspective, the technology is incredibly cool, and it opens up all kinds of new doors for me to better enjoy music, movies, and other media in addition to functioning better in quotidian sound environments.

Dr. Cass put us both immediately at ease with his patient and low-key manner. He didn’t seem to be hard-selling me on the surgery, and he talked us through the risks in plain English and appropriate detail (and he assured us that he has NEVER had an occurrence of the scariest one, partial facial paralysis). Meeting with him, more than anything else in the process, made me feel comfortable about going forward with the surgery.

Of course, I woke up this morning once again wracked with anxiety about the decision, wondering why I am setting myself up for a long process of re-learning how to hear (and all the accompanying audiology visits, out in the BFE of the Fitzsimmons campus) when I’m getting by pretty well with the status quo. But after having a long and positive talk with my boss, exchanging a few confirmatory e-mails with the clinic, and scheduling the CT scan for Friday morning, I’m feeling excited, confident, and emotionally ready to proceed.