CI: The Surgery Day (Nov. 29, 2007)

This is a recap of my surgery day. Now that it has been over a week since surgery, I feel up to putting together a detailed post with pictures. It has also given me time to gather more information, by questioning my surgeon at my post-op exam and doing other research. And, with my activation already done (see 12/11 post), I need to get this out of the way – now!

The weeks leading up to surgery were a lot more stressful than necessary. About 3 weeks prior, a small sebaceous cyst I’d had for years suddenly became enlarged and infected. Elective surgeries are usually postponed if there are any existing infections. It took 15 days of antibiotics and having it lanced to get the infection under control. Then with 2 days to go until surgery I started to feel like I was fighting a bug. No fever, but slightly achy with a scratchy throat. If that progressed into stronger symptoms surgery could get cancelled.

My surgery was scheduled for 10 am and was instructed to arrive at 7:15 am. The night before I made sure I had everything in order. No food or drink after 10 pm. I had picked up my prescriptions for painkiller (vicodin) and antibiotic (keflex) the previous day. I normally wear contact lenses, but those aren’t allowed for surgery so I decided to remove the left temple piece from my eyeglasses in advance. While doing that the small jeweler’s screwdriver slipped off the screw and skewered my thumb – ouch! Nice little blood sample. Later on while shaving, I sliced my lower lip and bled some more. I decided to skip trimming my fingernails. I slept better than I expected since I was jittery about waking up with the bug I seemed to be fighting starting to blossom. The next morning I woke feeling well and my wife and I arrived at the hospital on time.

The check-in process went quickly and we were up to my room by 7:30. We were introduced to my nurse. She said I should expect to be wheeled to surgery staging about 9:30. Here are a couple of photos from that time.

The geeky one-temple glasses:


Note the sliced lip:



About 8:00 blood was drawn for tests. They asked for a urine sample if possible. I shouldn’t have pissed that morning, because with no fluids in almost 12 hours there just wasn’t anything new to provide. The nurse said after I was IV’d for awhile later that might change. After that I was fitted with stockings and pump leggings that would help prevent blood clots, since the surgery could run 3 to 5 hours.


About 8:15 a different nurse tried to get me IV’d but gave up after a couple of failed attempts saying, “I only stick twice.” Around 9:00 an IV specialist got me hooked up in one shot. After a half-hour on the drip I was able to provide my sample.

At 9:30 the nurse came in and told us that there was about an hour delay in surgery, so more thumb twiddling and watching the storm clouds gathering out the window. Heavy rains were predicted for the next 2 days. We were hoping they would hold off until after we drove home later that day.

A bit after 10:00 I was wheeled down to surgery staging, where they gave me a lovely cap and placed a sticker on the left side of my head. I was happy about that – I had considered writing “not this one!” behind my right ear the night before.


A nurse went over some paperwork with me. Then the anesthesiologist came by to go over the process and asked for a baseline ECG which was taken a little later. When one of the nurses told me it shouldn’t be much longer I realized I was starting to feel like I needed to take a crap. Great – all dressed for surgery with an IV hanging out of my arm. I mentioned it to the nurse and she said if I really needed to go I should, but otherwise don’t worry about it. While I was pondering that big decision my gurney driver arrived about 10:45. He huddled with the nurse for a moment and then off we went with him saying he was going to detour by one of the restrooms for me. In hindsight I am very glad we did that. During the first few hours after waking from surgery, taking care of that business is the last thing one wants to deal with.

As we rolled into the operating room I recall seeing about 4 people: my surgeon, the anesthesiologist, and a couple of others. I’m glad they let me wear my hearing aids and eyeglasses into surgery so I could communicate. One person brought a box labeled “left cochlear implant” up to me for my confirmation. I gave them a thumbs up and pointed at my left ear. Next I was slid over to the firm, narrow operating table. I laid there for a few minutes, glancing around at the variety of equipment in view. My surgeon leaned over me to say hi and gave me a friendly smile. That was probably around 11:15 am. The next thing I knew I was waking up in recovery, which I’ll get to later.

The surgical technique my surgeon uses was developed at Nottingham University Hospital Cochlear Implant Program in England about 4 years ago. My surgeon has been using it for over 2 years. The 2 main differences from other techniques are the location and size of the incision, and that no sutures hold the implant processor in place. The incision is only about 1.5 inches long, set about a half inch back from the crease of the upper portion of the ear. As with all CI surgeries a shallow divot is made in the skull to hold the processor. I was instructed not to rub that area for 30 days because it would be possible to dislodge it until scar tissue developed which would firmly hold it in place thereafter.

The surgery itself took a little longer than normal due to some boney growths in the mastoid region that slowed the process of making an access tunnel into the middle ear. However once that was achieved the insertion of the electrode array into the cochlea went smoothly. After the implant was in place it was hooked up and a series of tests run to ensure it was functioning correctly. I believe they monitor brainwaves and a middle ear muscle to obtain responses to the tests. Closure of the incision was done with sub-dermal sutures, but no surface stitches. Dermabond was used over the top of the incision. It’s a fancy Krazy Glue that both holds the wound together and forms a water and germ proof barrier.

Surgery was completed between 3:30 and 4:00 pm. My surgeon visited my wife in the waiting area around 4:30 to let her know everything went very well and that I was awake and smiling in recovery. I certainly don’t remember that! The first thing I remember was becoming aware that I was lying inclined on a gurney in the brightly lit recovery room around 5:00, that my left ear had some pretty loud roaring tinnitus, and that I was woozy as all hell. I think there were a lot of other patients recovering in there but I had no desire to focus on anything at all. A nurse came by to check on me and I told her I would probably need to vomit soon. She put a towel on my chest and I had a couple of token pukes. Unbelievably, even though I was nauseous the next day or so, that was the only time I barfed. I think I dozed on and off for a little while longer before they wheeled me up to my room around 6:00.

I was very happy to see my wife when she walked in the room. She had a big smile for me and told me everything went well. I’m sure I was informed of that earlier, but that’s the first time it registered. What a relief. At that point I took a little inventory of my state: No specific pain, just a slight throb; intermittent roaring tinnitus in my left ear, loud but not painfully so; my right ear seemed stuffy and I wasn’t hearing well out of it; still woozy and nauseous; the outside edge of my right arm from elbow to pinky finger was very numb; the left edge of my tongue felt tingly, half-numb. So not feeling all that great, but happy all the same.

Around 6:30 my surgeon dropped in to check on me. He reiterated what my wife said regarding the surgery going well, adding that he felt it would be better to leave the dressing on overnight due to the later end of surgery then planned, and that I should be able to go home in a couple of hours as long as I was steady enough. I mentioned the numbness in my arm and he said that was from lying on my arm for so long during surgery, and that it would clear up over the next couple of days. After the good doctor left a nurse brought a food tray. I sucked on some ice chips and nibbled on red jello, which tasted intense. There was a bowl of broth, but just bringing a spoonful within range of my nose I knew I wasn’t ready for that! So I just stuck to ice, jello and warm tea for the next couple of hours. At some point the leg pump device started to get on my nerves. It would pump up and squeeze my legs every 30 seconds or so and the regularity of it became annoying. I was really glad when they removed it.

About 8:30 my nurse gave me a final dose of anti-nausea medicine through the IV in preparation for my departure. A few minutes later she helped me to my feet and guided me to the bathroom. I felt wobbly but was able to stand by myself and pee. Apparently I passed the test so they unhooked me from the IV, set me in a wheelchair and wheeled me out to our car just after 9:00.

Fortunately the rain storm hadn’t hit yet, so we had a quick 10 minute drive home. The first thing I did when I got home was put my contact lenses in. Wearing eyeglasses always makes me feel slightly “off” because I wear them so infrequently. I was also bothered that the hearing in my right ear was so bad, but at that point just hoped it would recover overnight. For the next couple of hours I was still fairly nauseous, but was able to start nibbling on a banana and had some chicken broth later on. I took a vicodin at 11:30 and when it started kicking in I felt better. I slept in 2-3 hour stints, taking a vicodin every 3-4 hours.

The next morning it was raining cats and dogs. I got up around 8:00 feeling better, though still a bit wobbly. Not spinning vertigo, but an unsteady feeling especially if I tilted my head. The hearing in my right ear had recovered a lot, which was a big relief, and the tinnitus on the left had abated somewhat as well. My stomach had settled down enough to have a light breakfast. About mid-day we headed out to see my surgeon at his office. He removed the dressing. The top of my ear was sticking way out – it made me laugh! He said that was normal and it would go back to its usual position over the next month.

I think I covered most of the subsequent recovery in my other posts. Following are photos from the recovery period.

These were taken within a couple of hours of removing the dressing the day after surgery, before the swelling started:




The following are from 2 days after surgery, about when the swelling peaked: