Saturday, February 19, 2005

Diamond bracelets and Rodeo Clowns

I'm sorry for not updating you all sooner - it's partly due to the travel, partly due to the damned computer being in for repairs (fortunately Husband is kind about sharing his laptop which is what I am typing on now) and partly due to everything being so, kind of, overwhelming that I haven't been able to process it all until now.

My appointment was at Halifax's Victoria Health Center ENT unit at 10:00 a.m. on Thursday. I was to be there ten minutes early. To make sure we had no problems, Husband and I drove to HFX on Wednesday afternoon and were at the hospital at 9:30 Thursday morning.

In spite of us being twenty - or, more accurately, 30 minutes early for the appointment, they saw us right away. "Stacy", the Speech Pathologist from the CI evaluation in November, was there. So was a surgeon, Dr. H., and the director of the CI Implant Program, Mrs. W. I liked the look of Dr. H. immediately; he had a very kind face and gentle manner. He appears to be from the Middle East (Husband says he has an accent) and I felt very comfortable with him immediately. He did a number of balance tests and eye-tracking tests with me. Apparently my trained seal act is road-ready because I passed phase I and now was told that THE surgeon, Dr. B., would see me. Heavens. All right.

I liked Dr. B., too. He, for his part, seems to be from the subcontinent (India, probably). (Atlantic Canada has a constant shortage of doctors; they tend to migrate to more glamourous climes, so a higher-than-average number of our doctors are foreign-trained and are recruited to work here. Interestingly my "day job" means that I know the hoops these people must jump through to be allowed to practice in Canada and that I am aware that it is usually the very best and brightest foreign-trained doctors with the highest marks who leave for the west - and are then trained and tested all over again. Sorry for their home countries but it certainly didn't hurt my confidence any.)

Dr. B. ran me through all the balance and eye tracking tests again (these involve, for example, telling me to concentrate on the tip of his nose, then jerking my head to the left or right while I must keep my eyes focused on the nose; standing in place with my eyes closed; marching in place with my eyes closed and my arms out, etc. "Oh dear," I said. "If I'd known I wouldn't have worn heels!"). There were many, many questions, most of which Husband was able to field. Most of the questions involved trying to figure out the source of the deafness. They asked about deafness in the family, about what drugs I'd been taking when it happened, whether my ulcer problem back in the 90s had ever been diagnosed as a disease or a syndrome, whether there was MS in the family...

In the end, Dr. B. said "It is a mystery."

"I don't like mysteries."

Both Dr. H. in his initial consult and Dr. B. in the second talked to me about risks. I made sure that they understood that I understood the very real risks. I told them "Christine", the audiologist at the Nova Scotia Hearing and Speech Centre, had explained them most clearly to me when I'd seen her in November and that I'd done independent research on the internet since then.

I told them I understood about the risk involved in general anaesthesia to start with. That I understood I might lose or irrevocably alter my sense of taste. I could suffer facial paralysis on the implant side. And that in a worst-case scenario, I could suffer a leakage of brain fluid that could require a shunt to be permanently placed in my skull.

We talked about which model I had chosen, what colour I wanted (black, I decided - I hated the medicinal beige and grey and rather than hide the thing decided to embrace a kind of high-tech look) and about which side I wanted implanted. The degree of consultation and choice was phenomenal.

And so, while Dr. B. may not like mysteries, this one wasn't deep enough to put him off the surgery for which I am an ideal medical candidate. And all of a sudden, Husband (who had been jotting things to me on a notebook to facilitate all this discussion), signed the word "paperwork" and everyone was gathering up coats and files and we were going off to Dr. B.'s office.

And then he wrote out a consent form, listing those risks, one, two, three, four. And giving permission for him to do any necessary but unforeseen procedure that might come up while I was under anaesthesia. And while he wrote all that down, it hit me - what I was literally signing up for. For the first time, I was scared of the surgery. I flashed back to other times I'd had surgery - all the other times. How sick and miserable I'd felt. How much pain is involved. "God," I thought. "I'm volunteering to do this again. I'm volunteering - I'm begging - to have them open up my skull. SO MUCH could go wrong..."

All around me everyone was so jovial - Dr. B., Dr. B.'s lovely secretary, Husband, everyone laughing and joking. It was a time for happiness, a quiet sort of elation. I was a good candidate, things were good, Dr. B. was going to help me hear again, Husband was going to get his wife back. And I was half-elated, half-paralyzed with fear.

Of course, when the doctor's outstretched fingers slowly - or maybe it just seemed that way - turned that paper 180 degrees to face me, I didn't hesitate. I'd been waiting a long time to sign on that dotted line. Now, I would just wait for Dr. B.'s secretary to call with a surgery date. They are thinking perhaps May, which is breathtakingly close after all this waiting.

In the hallway outside Dr. B.'s office is a striking photograph of the internal part of the CI I am getting - the Advanced Bionics HiRes Cochlear Implant. This was a close-up photograph of the very end of the implant's "tail", the bit that curls into the cochlea, showing each of the tiny, shiny electrodes strung along their minute, transparent silicone string.

"It looks like a diamond bracelet," I commented.

We embraced on the way to the elevator and that night celebrated in true Maritime style, over Keith's Draught in a Halifax pub. It was a time to debrief, just the two of us, about everything that had happened.

"Whenever I'd get anxious or nervous," Husband commented (during the balance and tracking tests), "'Stacy' would distract me with small talk."

"Huh," I replied. "I was wondering why we needed a Speech Pathologist there. So maybe she was sort of a... a..."

"Rodeo Clown," he finished.

It all seems to have taken so long and yet happened so fast. But with the signature of that consent form, it became real to me. No more hoops. The internal component, they say, has already been ordered and now they will order the external based on my choices.

It is, it would seem, really going to happen.



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