Sunday, December 15, 2013

Confessions of a Stapedotomee*

A car door slams beside me and I blanch as if a grenade has exploded. A bus roars past with an engine designed to power a jumbo jet at take off. A wall clock whispers tick, tick, tick in the silence of the mid-winter afternoon. My world has suddenly become louder, a torrent of sounds, the nuances of which I’d forgotten... I’ve had a stapedotomy.   
Two and a half years ago a hospital doctor informed me that I would gradually lose my hearing because I had a condition known as otosclerosis. His tone was deadpan and he did not look up from the report he was completing when he gave the diagnosis. There was nobody else in the consulting room, just me and the “bearer of bad news”. Something about a hearing aid was mentioned on that morning but I wasn’t listening, I was numb. 
At home I undertook a swift search of the Internet to educate myself about this “otosclerosis” thing. In layperson’s language the said sclerosis refers to the ossification (thickening) of the stapes bone (often called the stirrup in school biology lessons) in my middle ear. The thicker the stapes, the less it is able to transmit sound. And from what I could gather Time would see to it that my stapes duly thickened.
Measuring between 0.25 and 0.33cm, the stapes is the smallest bone in the body. It is miniscule and yet it was going to assume a lead role in screwing up my life. Signs of the sabotage were already apparent. Friends confessed secrets and sins to me in whispers and I could only nod wisely and reply “Hmmmmm” because I’d heard nothing. Timid students gathered up the courage to make a once-in-a-lifetime contribution in seminars. Wary of asking them to turn up the volume and repeat their ordeal, I resorted to a range of neutral expressions I’d crammed into an arsenal stocked for such occasions, “Valid point. Would anyone like to expand on that?” In truth, it was a strategy designed to allay suspicion that I was losing my hearing.
Being diagnosed with otosclerosis undermined the illusion of “it can’t happen to me”, making me feel generally more vulnerable. In coming to terms with what had happened, I indulged in tragicomic fantasies. Spring mornings were doomed to become silent as birdsong gradually faded from my life. I would be squashed by a juggernaut that everyone except me, the unfortunate heroine, had heard coming. How I rued the times I’d grumbled about noise. Well, now I was on a one-way journey to permanent silence, or so it seemed.
That was when otosclerosis’ best friend came ringing at my door. Tinnitus arrived and it had no intention of leaving. On that first evening, unaware of the new guest’s arrival, I fumed at the neighbours’ lack of consideration. Why had they (people in their forties) suddenly decided to have a rave party? On the following evening someone’s central heating gurgled and bubbled through the night. With the realisation that the sounds were inside my own head, gloom descended on my house. Tinnitus, often described as “white noise” was my lot and it was even going to deny me the silence that I’d presumed was my destiny. If it is true that hearing is the last of the senses to be lost to a dying person, it was highly possible that the last few moments of my life could be “coloured” by rave music...
On a routine visit to my GP the following year, he enquired whether I was aware that surgery could restore the damage caused by otosclerosis. This was the first time I heard the blessed word “stapedectomy”; a procedure in which the stapes is removed and a prosthesis is put in its place. An appointment with an ENT consultant confirmed that my left ear (the worst) was a good candidate for surgery whereas the right which, so far, was minimally affected by the condition, would be monitored. Leap frog the nail-biting months on the waiting list, the pre-op assessment and one year later I walked into the ENT ward with my backpack, hoping that I’d walk out with much-improved hearing.
Those hopes tangoed with fear as the time of surgery approached. I sat on my bed fretting over the terrifying words of warning I’d read in the ENT-UK leaflet which the hospital had given me. In its description of the complications that could arise from a stapedectomy the words “total hearing loss” and “serious implications to certain employments” jumped out at me. They reverberated around my head and were competing with the tinnitus for attention when the surgeon walked in, distracting me from the doomsday scenario. He patiently explained all the risks in a kindly tone that I suspect priests adopt when talking to a condemned prisoner. He told me I was going to have a stapedotomy (only part of the stapes is removed) and that a tiny prosthesis would be inserted in its place. “What’s it made of?” "Teflon", he smiled. Teflon? It was perhaps not a good time to mention rumours I’d heard about Teflon being carcinogenic. When asked if I still wanted to go ahead, I sighed, “Well, I’ve come this far...”
Thanks to the miracle of general anaesthesia I have no memory of the surgery and there was little subsequent pain. As I settled into sleep that night I noticed that for the first time in a couple of years I had no tinnitus. The following morning the surgeon arrived early, tapped me on the head with his tuning fork, asked where I heard the sound, and I presumed I’d given the right answer because he looked satisfied, as did the half dozen or so student-doctors who shuffled along behind him. After a few words of caution about how to care for my otosclerosis-free ear, he departed my cubicle. Shortly afterwards, I returned home, eager to test out my newly acquired hearing.
That first test took place a week later. The packing had to be removed from the ear canal for me to enjoy the benefits of stereo sound.  But there was an imbalance. My brain had not yet grasped the miracle of the stapedotomy and, until it lowered the volume, I was obliged to use cotton wool to moderate sound.
For the first few weeks the rules are no flying, no scuba diving, no straining, no water in the ear, no sneezing ... and then I sneezed. Immediately, an electric saw whined and screeched into action and there was no “Off” switch. Tinnitus had returned with a vengeance. When I complained, the ever-confident surgeon assured me that the tinnitus would eventually fade. Try not to sneeze again, he counselled, “And if you do, keep your mouth open.” As usual, he was right. Three weeks later the tinnitus has abated somewhat and my nerves have settled.
But the recovery is going to take longer than I'd anticipated. Five weeks after surgery there is still some inflammation and sensitivity, and the rules remain in force. Is it worth it? Undoubtedly, yes. The clearest indication of progress so far is the volume on my radio. I have turned it down from 24 to 19. Had it not been for the stapedotomy and the extraordinary skills of the surgeon, eventually I would have lost my hearing, and every time words I could not hear were directed at me I was reminded of that, of how isolating deafness could be.

*Stapedotomee: one who has undergone a surgical procedure known as a stapedotomy. TRUE/FALSE?