Surgery Day

First off, I should say this blog post is not for everyone. If you are casually curious about how I’ve been doing, this blog post is not for you. But if you are interested in the actual experience of how SCDS is “treated” through surgery, or if you are an SCDS sufferer and want to know what will happen in surgery,  climb aboard.

I should warn the reader that this may not be the prettiest of blog posts.  My purpose in writing out the experience is not to be literary or clever with words.  It’s to be straight forward. In the several months prior to surgery when I was trying to decide which surgery to commit to, I read many other people’s surgery stories. It helped me to prepare myself for what was to come and I am hoping that my story might be able to help someone too.

My Understanding and Choice of Surgery
There are a few different approaches to surgery for SCDS. Because I am bilateral (got holes on both sides) and know I am a candidate for having surgeries on both sides, I chose to have a surgery in which the superior canal with the dehiscense would be capped off, rather than plugged.  This is also known as resurfacing. In the research I conducted, I found that people needed to have at least one side of their semicircular canal functioning for the well being of the vestibular system. (Note: this is just my experience in learning about SCDS. I am not a medical professional and anything I write here should by no way be taken as medical facts.)

I chose Dr, Gianoli in Covington Louisiana to perform the surgery based on his skill and experience in this approach.  In addition to the resurfacing procedure, Dr. Gianoli also has found success with reinforcing the oval and round windows of the inner ears. His reasoning is that the process of resurfacing can cause additional pressure on these other windows in the inner ear. The pressure could cause fistulas, which would then compromise the vestibular function.  So the resulting description for the surgery that I had is called a “mid-fossa approach with a mini-craniotomy”.  The “mini” just means he cuts into as little space as possible in the skull and approaches the inner ear and does minimizes interaction with the brain. So it is a two-part surgery: going through the skull to resurface the canal and going through the ear drum to reinforce the oval and round windows.  If this sounds confusing and overwhelming then I am probably explaining it correctly. It really is.

So here is how this took place for me.
On the day of my surgery (Thursday, January 30th) I checked into North Oaks Medical Center at 5 am. I had already answered many pre-admission questions over the phone the day prior, so the initial steps for checking in were to check my vitals, get me into a gown and have me put on those lovely tight leg stockings that feel ridiculous but are supposed to decrease the chances of blot clotting. They also started an IV at that time.  I also met briefly with Dr. Gianoli to discuss any questions and then spoke with the anesthesiologist. My family was able to stay with me during this process which helped me feel less nervous.

When it was time to go back to the operating room the kind nurses gave me what they referred to as some “Happy Juice” (which I didn’t question at the least, because when you are going into a surgery on your skull, you will accept anything labeled “happy”) and wheeled me into surgery room.  The last thing I remember was telling the nurses my opinion of the Seahawks winning the Superbowl (a clear indication that the Happy Juice was working, since I know next to nothing about football) as they gave me the epidural in my back.

Apparently while I was in surgery my family was kept updated on my progress in the waiting room by way of a nurse telephoning out to the waiting room every hour, but the reports were brief. After the surgery Dr Gianoli met my family in person and gave more details answered their questions. Basically there were no surprises and everything went as expected. The dehiscence was about 3-4 mm in length, which he had known from the CT scans, and the procedure went smoothly.

When the surgery was over I woke up in recovery room. I think they asked me questions to check my awareness levels as I drifted in and out of sleep. Then they wheeled me to my ICU room and my family met me there. I was very, very dizzy and my head hurt and felt nauseous —  all very common reactions. I was able to walk to the bath room (which was 100% inspired by the male nurse offering to fetch me a bed pan). My legs were very wobbly and it took two strong adults to walk me there. The rest of the day I floated in and out of sleep with a cocktail of pain IV “goodies” (their word, not mine. I love people in the south. I swear I heard also enough colloquial phrases to last me a life time.) The “goodies” included morphing for pain, steroids to minimize swelling, anti nausea meds, and x. I was sleepy most of the time and I know that I wasn’t always thinking clearly because I kept asking the nurses the drug to stop the dizziness. In my right mind I know there isn’t a drug to stop that. The first day I was also allowed two liquid meals (lunch and dinner including a coffee from the coffee bar down stairs. (Hey, it’s a liquid and I’m from Seattle.)

In terms of sounds in my left (surgical) ear, I was not able to hear much, but I know the sound in that ear will come and go for the next couple of months. Dr Gianoi put in a packing filler when he did the round window and oval window reinforcements to keep pressure in that area and protect the new extra layers there. Apparently some of my hearing ability will be determined by how fast the packing disintegrates. It could be anywhere between 2 to 8 months with average being 3 or 4.

The next day I was released at 10 am. I will write again soon with a summary of the following week post-surgery for those of you still curious.

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