There were some nail-biting moments, but the CI has been activated!
Brandt was able to get his magnet to stick to the new implant on Monday night, so we thought there wouldn't be any problem with activation on Wednesday. But even though Beth was able to get it to "lock" fairly easily, the computer couldn't measure impedances of the electrodes, which is the first step in activation. There was a collective "ummmm....." in the room. When Brandt pushed down on the magnet, it finally connected but if he moved even slightly it was lost. Beth called Ariel over to bring a strap or something to keep the magnet pushed tight on his head. She brought a t-shirt and ripped it up, tying it around his head like The Karate Kid. It worked! Impedances were measured. "Now let's see if we can actually activate..."
Thankfully it worked, and after only a few minutes, Brandt was already understanding speech! Last time, Beth had to type everything she was saying but this time it wasn't necessary. She explained that patients often progress much faster with the second implant, because the brain already knows how to process the sound--there is "crossover in the pathway" that allows for much quicker and easier understanding. But of course it still takes some effort to teach the other ear how to hear with the new technology.
When we got home, Brandt wanted me to test him with some sentences. I decided to make up some really weird sentences where he couldn't easily guess troublesome words. I said "The purple goat quacks at lunchtime," "My cat just gave birth to 17 puppies," and "The waterfall is full of Orange Crush soda." Shouldn't really be surprising at this point, he got them all right.
Today, 48 hours post-activation, Beth decided to put Brandt in the sound booth and run some tests that are usually NEVER done this early. At 50 dB, he scored 42% on the AZ Bios sentences test. Apparently this is incredible--there are many patients who don't score that well after several weeks.
Friday, June 19, 2015
Monday, June 8, 2015
CI Activation Postponed
Well, the swelling did subside somewhat, but I was only 50/50 hopeful that activation would be possible today.
Dr. Awesome said that the 'golf ball' lump is a hematoma--a mass of blood and fluid built up under the skin. The only thing that can be done for it is to wait; he said it would take a good MONTH for it to subside and that activation probably wasn't possible today. But he thinks that in another week it should be fine. He still wanted us to go over to the clinic to see if Beth could possibly get him activated.
Beth was able to get the processor to find the implant, but couldn't get the "lock" necessary for activation. Remember from last time that Brandt has a "thick scalp and skull," and coupled with all the excess swelling, today just wasn't happening. Sigh. She said this was the first time she'd ever had a patient who couldn't be activated on the scheduled date, for anything other than infection.
At least he's maintaining his reputation for being a weird patient!
Dr. Awesome said that the 'golf ball' lump is a hematoma--a mass of blood and fluid built up under the skin. The only thing that can be done for it is to wait; he said it would take a good MONTH for it to subside and that activation probably wasn't possible today. But he thinks that in another week it should be fine. He still wanted us to go over to the clinic to see if Beth could possibly get him activated.
Beth was able to get the processor to find the implant, but couldn't get the "lock" necessary for activation. Remember from last time that Brandt has a "thick scalp and skull," and coupled with all the excess swelling, today just wasn't happening. Sigh. She said this was the first time she'd ever had a patient who couldn't be activated on the scheduled date, for anything other than infection.
At least he's maintaining his reputation for being a weird patient!
Monday, June 1, 2015
Going Bilateral: CI SURGERY II
In only 8 months, Brandt has gone from Nearly Earless to Bilateral Cyborg.
Preparation for the second surgery was minimal. No 6-hour drive to Dallas for a second opinion, no long discussions about whether he should go for it or not, and I haven't spent hour upon conflicted hour crying and binge-watching 30 Rock to keep my mind off my fears. We've been here before, it's old news, and instead of being terrified I was surprisingly calm about it. Brandt always seems calm, so it was hard to tell his exact feelings. The only difference in prep this time was a VNG Balance Test, which is required for all patients getting a second CI. Brandt spent several hours wearing special goggles that tracked his eye movements as he looked at dots, and had air puffed in his ear to see how he responded. The ear about to be implanted didn't do as well as the already-implanted ear, and his results were near the cutoff of failing, but he passed and Dr. Awesome wasn't concerned.
On the morning of May 28 we checked in to Outpatient Surgery at 9:00 AM. The waiting room was PACKED, which was odd because last time we were the only ones there. We saw Dr. Awesome power-walk back and forth through the waiting room several times, as the hours dragged on. Brandt was finally called back at 11:00 for surgery prep, and I followed half an hour later. Dr. Awesome talked to us about Brandt's progress being dragged down by the nonimplanted ear. He said that this happens sometimes, it's "an issue with the integration of being bimodal." He explained that it's like trying to see with one contact and one glasses lens, and the brain can't integrate the two. Then he said "It's time for the left ear then. Let's get this done." I said "Good thing we're already here!" After another 20-plus minutes Brandt was wheeled off to surgery.
Surgery began at 1:12 PM and I expected him to be done by 2:30, since last time he was done in exactly one hour. I gave a little more time in my estimate since Dr. Awesome says it takes "exactly 90 minutes." By 2:45 I was starting to get antsy, and when Dr. Awesome finally came through the door at 3:00 I was getting worried. I couldn't tell if he looked upset or exhausted (Brandt was the fourth surgery of the day instead of the second like last time). He said everything went fine so I breathed a sigh of relief. He said that Brandt should do much better with two CIs, reiterating that "once they adjust to the implant, that natural hearing is just blah."
I knew from the previous surgery that Brandt was going to be pretty out of it when I was called back to get him ready to leave. I thought he seemed more lucid than last time but he mumbled "Why do I feel so much worse this time?" He had a male nurse who I asked for assistance in getting Brandt up and dressed (he couldn't use the "need for privacy" as an excuse like the female nurse had used last time). He was very helpful and Brandt tapped him on the arm to slur "You are a much better nurse than who I had last time." Brandt kept saying that he felt worse than before and was in more pain. I was confused because he actually seemed to be doing better. We got him loaded in the car and of course it started raining, just as it had last time. It took almost two hours to get home in the rush hour traffic, a drive that takes 45 minutes at less congested times of the day.
Brandt continued to say that he didn't know why he felt so awful, and took a lot more pain medicine than the first time. The next day he casually mentioned that his calf was sore, and I immediately called the hospital to see if we needed to rush to the emergency room, as this could be a sign of a blood clot. He also e-mailed Dr. Awesome's assistant and she echoed what I was told on the phone, that unless he developed other symptoms we shouldn't worry. Then the day after that, I got another shock when the bandage was removed. It had basically fallen off since it wasn't wrapped onto his head very tightly, and when it came off there was a golf ball sized lump behind his ear. Googling "swelling after CI surgery" resulted in conflicting advice that swelling is both 'completely normal' and 'cause for alarm.' I waited until first-thing this morning to e-mail Dr. Awesome's assistant (again) to ask if we needed to come in to the office. She asked me to send her a picture of the swelling--can you believe the Age of Technology we're living in?!--and said that yes it was swollen but there was nothing they could do about it in the office, so just make sure he continued to sleep upright and the swelling should subside.
I honestly don't see how this massive Ball-of-Swelling is going to go down enough in one week for activation to be possible...
Preparation for the second surgery was minimal. No 6-hour drive to Dallas for a second opinion, no long discussions about whether he should go for it or not, and I haven't spent hour upon conflicted hour crying and binge-watching 30 Rock to keep my mind off my fears. We've been here before, it's old news, and instead of being terrified I was surprisingly calm about it. Brandt always seems calm, so it was hard to tell his exact feelings. The only difference in prep this time was a VNG Balance Test, which is required for all patients getting a second CI. Brandt spent several hours wearing special goggles that tracked his eye movements as he looked at dots, and had air puffed in his ear to see how he responded. The ear about to be implanted didn't do as well as the already-implanted ear, and his results were near the cutoff of failing, but he passed and Dr. Awesome wasn't concerned.
On the morning of May 28 we checked in to Outpatient Surgery at 9:00 AM. The waiting room was PACKED, which was odd because last time we were the only ones there. We saw Dr. Awesome power-walk back and forth through the waiting room several times, as the hours dragged on. Brandt was finally called back at 11:00 for surgery prep, and I followed half an hour later. Dr. Awesome talked to us about Brandt's progress being dragged down by the nonimplanted ear. He said that this happens sometimes, it's "an issue with the integration of being bimodal." He explained that it's like trying to see with one contact and one glasses lens, and the brain can't integrate the two. Then he said "It's time for the left ear then. Let's get this done." I said "Good thing we're already here!" After another 20-plus minutes Brandt was wheeled off to surgery.
Surgery began at 1:12 PM and I expected him to be done by 2:30, since last time he was done in exactly one hour. I gave a little more time in my estimate since Dr. Awesome says it takes "exactly 90 minutes." By 2:45 I was starting to get antsy, and when Dr. Awesome finally came through the door at 3:00 I was getting worried. I couldn't tell if he looked upset or exhausted (Brandt was the fourth surgery of the day instead of the second like last time). He said everything went fine so I breathed a sigh of relief. He said that Brandt should do much better with two CIs, reiterating that "once they adjust to the implant, that natural hearing is just blah."
I knew from the previous surgery that Brandt was going to be pretty out of it when I was called back to get him ready to leave. I thought he seemed more lucid than last time but he mumbled "Why do I feel so much worse this time?" He had a male nurse who I asked for assistance in getting Brandt up and dressed (he couldn't use the "need for privacy" as an excuse like the female nurse had used last time). He was very helpful and Brandt tapped him on the arm to slur "You are a much better nurse than who I had last time." Brandt kept saying that he felt worse than before and was in more pain. I was confused because he actually seemed to be doing better. We got him loaded in the car and of course it started raining, just as it had last time. It took almost two hours to get home in the rush hour traffic, a drive that takes 45 minutes at less congested times of the day.
Brandt continued to say that he didn't know why he felt so awful, and took a lot more pain medicine than the first time. The next day he casually mentioned that his calf was sore, and I immediately called the hospital to see if we needed to rush to the emergency room, as this could be a sign of a blood clot. He also e-mailed Dr. Awesome's assistant and she echoed what I was told on the phone, that unless he developed other symptoms we shouldn't worry. Then the day after that, I got another shock when the bandage was removed. It had basically fallen off since it wasn't wrapped onto his head very tightly, and when it came off there was a golf ball sized lump behind his ear. Googling "swelling after CI surgery" resulted in conflicting advice that swelling is both 'completely normal' and 'cause for alarm.' I waited until first-thing this morning to e-mail Dr. Awesome's assistant (again) to ask if we needed to come in to the office. She asked me to send her a picture of the swelling--can you believe the Age of Technology we're living in?!--and said that yes it was swollen but there was nothing they could do about it in the office, so just make sure he continued to sleep upright and the swelling should subside.
I honestly don't see how this massive Ball-of-Swelling is going to go down enough in one week for activation to be possible...
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