Hookup Day

 Big day today!  I have an appointment at Sunnybrook for 13:00.  I was a bit anxious about this as there has been a lot of snow and many schools and colleges have cancelled classes.  However, the TTC appeared to be running quite well except for certain buses and streetcars.

So off we went at about 1l o'clock expecting to get there with an hour to spare.  In the end, with various delays, we only had about 30 minutes to spare.  This was still enough time to eat a bit of lunch in the Sunnybrook cafeteria.  The hospital was surprisingly busy given the weather.

It turned out that my regular audiologist was unable to attend so we met with another audiologist instead. After a brief chat about how the surgery went and whether I'd had any pain or side effects, she reviewed the processor and its accessories ... and went about programming the processor ready for activation.

After attaching the processor to my left ear and the headpiece to, well, my head she began to send 'sounds' to it.  At first, I could hear nothing but after a bit I perceived some buzzing and then a sensation of sounds.  Difficult to describe but it really is rather strange at first!

Within a few minutes, she had all 16 electrodes tested and working.  She then determined what was a comfortable volume for each electrode ... or, at least, group of electrodes and I don't think we tested all 16.

Both the audiologist and Barb sound very strange - more R2D2 or Dalek than anything.  But the general shape of words are there, especially the higher-pitched consonants such as 's' and 't'.  I haven't heard those in my left ear for many years!

Half Life

For now, I can only hear from one side.  It's not really as if I can only hear half of everything but things do sound somewhat distant and one-dimensional.  

I notice that it's much harder to tell the direction of sounds so I have to be extra careful while crossing the street or even just negotiating busy places like a supermarket or subway.  Less situational awareness, you could say.

My 'hookup' date is 13th Feb 2025 which is still a little over 2 weeks from now. That will be just about 5 weeks from surgery date.  Quite a bit more than it was for the first surgery when there was only a 2 week gap.  I'm not sure what the reason is.  It may simply be scheduling as I'm sure the audiologists are in high demand.

Metallic stuff

Staples have now been removed!  Not a totally painless experience but probably less painful than ripping off the various sticky things that were applied during surgery like electrode pads and band-aids.

The wound is not fully healed yet.  It's getting there and it actually feels more comfortable and 'normal' without the staples.  The doctor recommended I keep applying the poly-sporin until it is completely healed.  He also said it's OK to do gentle skating and similar activities ... just not anything that might result in the need for an MRI as that would be a major undertaking right now!

I'm still mystified as to why anyone would want a staple through their nose/cheek/earlobe.  Much less a safety pin.

Hear today, gone tomorrow?

It's now seven days since surgery and I seem to be recovering well.

• For the first few days, my balance was off especially when I got up at night.  Now, it seems to be fairly normal with just an occasional bout of dizziness.
• I've finished taking the course of antibiotics.  I think they make me a bit drowsy.  They don't seem to have caused any stomach trouble which is a possible side-effect.  The hardest thing about them was figuring out how to work the 'child proof' top on the container!
• Very little taste disturbance or tongue numbness.  Not zero but much less than with the first ear operation.  The top of my outer ear is still quite numb.  I assume it can't feel cold either so I'll have to be careful not to let it freeze when I go outside.
• There's still a feeling of fullness in the ear.  It's something like when one's ear fills with water while swimming.  I can hear myself hum or my teeth banging together but I can't hear anything from outside the ear.

Did I just say I can hear myself?!  That is rather strange.  My understanding is that I would lose all normal hearing with the operation.  Not that there was much to lose in the first place.

  

So perhaps I will end up with a small amount of residual hearing? On Wednesday Jan 22nd, I return to Sunnybrook to have the staples removed so I will ask the surgeon about this. 

Heading In

A 9:00 appointment at Sunnybrook meant dealing with Toronto's notorious rush-hour traffic congestion.  We allowed 1hr 15m which is what Google Maps recommends if you are cycling.  We drove and so arrived a bit early.

Everything at Sunnybrook seems to be efficiently set up. E.g. the visitors' waiting room has a large monitor showing the progress of the patient.  I was taken to the Pre-operative area where I was subjected to various indignities such as a hospital gown, an intravenous and a barrage of questions about my identity and medical history.  That complete, Barb was allowed to come in and sit with me while we waited for surgery, scheduled for 11:00.  Not long before that, I said goodbye to Barb and she took my clothing and my glasses.  Everything was a bit fuzzy from here on.  I was wheeled away by a very loquacious orderly who chatted with everyone we passed. 

Outside the operating room, the surgeon and the anesthetist came by and introduced themselves and asked me the same barrage of questions.  Also, a young medical student who told me she was going to be observing the operation.

After a while, I was walked into the operating room and set up on the op table.  This time, it was a slow descent into oblivion (last time, I went out like a light!).

The next thing I knew, I was back in the same spot in the Pre-operative area.  As before, there was a sense of a time 'drop-out': I had no idea what time it was or what had happened since blacking out.  It's not the same as waking up from a good sleep.  I could not have said if I had been out of it for an hour or a week!  After a while, I made out a clock across the room and things started to make sense.

So far, so good.  Just a little jaw pain, a slight queasy feeling and only minimal tongue numbness and taste disturbance.  Not even much tinnitus, unlike last time when I had major tinnitus.

Tweet, tweet!

 In recent years, Barb and I have become interested in birding.  Not so keen that we will jump into the car and drive 500km for a reported sighting of a Lesser Spotted Killjoy but it's something we enjoy both at home in Toronto and around the cottage.

Much birding is done by ear as well as by eye.  Experienced birders seem to be able to locate a bird at some distance just by listening.  Mystifying: I might hear a bird without really knowing where it is, not even if it's ahead or behind me.  So I'm hoping that having two cochlear implants will improve my birding abilities!

That alone is not sufficient reason to be bilateral.  Perhaps a more important reason is not being able to locate the direction of things like emergency vehicles.  I have no trouble hearing police or ambulance sirens but haven't a clue which direction they are coming from. 

Moving Along

 Decision made, things started to move along quite quickly.  

I was scheduled for a CAT scan of my head.  I had a CAT scan done in 2009 but things can change, I guess.  The CAT scan was done at a private facility in Mississauga, not at a public hospital.  They do CAT scans but also MRIs, ultrasounds, etc.  My appointment was at 9:00.  No, not 9am as I thought but 9pm.  The place seems to run 24/7! They were running on-time so no long waits.  

Those horror stories one reads about where people in Ontario have to wait months or years to get medical imaging don't seem to be our experience.  OK, it wasn't quite next day but in this case there's no rush and I only had to wait about a week from the initial requisition date.

CAT scans are the best thing since sliced bread!

I also had to get a couple of vaccinations against pneumococcus infections.  This, apparently, is a bit of a risk for surgery generally and for older people especially.  Well, I'm over 65 now so I guess I'm 'older' even if I don't feel it.

The vaccinations took a bit of time, mostly because of some confusion over which vaccines the local public health unit (Toronto) provides and pays for.  This seems to have changed recently thus the confusion.

One change from my first operation is that it's now done on an outpatient basis.  So no overnight stay in hospital.  It will be in at 7:30 am, the operation will be 9:30 to 10:30 and I should be out sometime in the afternoon.  We won't be taking the TTC for this one!

**Update: it's now scheduled for 9:00 am and the operation will be at about 11:00.  I should be out around 15:00 if all goes well.

Time for two?

The companion hearing aid for the Marvel processor is small, sleek and uses a smaller size of battery compared to the old models.  However, the audiologist at Sunnybrook told me that it might not be sufficiently powerful for my hearing loss.  She suggested I consider having a second cochlear implant instead as there is little hearing to be lost in my left ear.

In Ontario, children often have both ears implanted.  Until recently, however, adults could only receive one cochlear implant   In 2020, the Ontario government approved funding for second implants for eligible adults. I was informed of this at the time but, it being mid-pandemic, the timing wasn't great so I didn't pursue it further.

By June 2024, with the pandemic over, it was time for a fresh look. I was given an appointment for an evaluation in September 2024.  That gave me a month or two to get used to my new Marvel processor and to give some thought to a second implant.

The appointment was actually three appointments in one morning: first, an evaluation by an audiologist, then a balance test and finally an interview with the surgeon.  The outcome of all this was that I was approved for a second implant. The surgeon thought I would do well provided I was willing to put lots of work into the rehabilitation process.

Possible benefits:

• better hearing generally.  Not a certainty but it's quite possible that 1 +1 = 3, so to speak.
• better hearing in noise.  Noise is always challenging. For reasons that are not totally clear to me, having the ability to hear on both sides helps the brain to filter out noise and pick out the sounds it wants to hear.
• better directional hearing.  To me, most sounds seem to be coming from about 45 degrees to my right.  The exception, perhaps, are low-frequency sounds that I can pick up with both ears, e.g. cars and trucks.
• redundancy.  If my first implant fails or I have some health problem that precludes using the right side cochlear implant then I would still have a backup.

There are some potential drawbacks:

• cochlear implant processors and their parts are expensive. Upgrades and maintenance would be more costly.
• total deafness when I remove the processors, e.g. at night.  Well, I'm totally deaf at night anyway so this is not much of a drawback.
• surgery has some risks.  The risks are not large and the medical community now has quite a bit of experience with this.  In 2022, worldwide, the millionth patient received their implant!  Sunnybrook alone does about 260 implants a year.

This time around, I had no hesitation in accepting the recommendation.