Once More With Feeling

When last we left my ear, the left one that is, the lining of its outer canal and the ear drum had, after a tympanomastoidectomy and against all of the known laws of medicine and biology, turned themselves into mucosa. Odder still, all of the difficulties typical of this sort of surgery were averted. The cholesteotoma was successfully removed, all of the grafts took, and the hearing was returning as expected. But with the tissue stubbornly remaining mucosa, my hearing can’t get much better (at least not very quickly), I have to keep my ear dry at all times, and even then, it’s ridiculously susceptible to infection, meaning I get a regular diet of antibiotics that’s probably not a great idea in the long run.

Last week, I visited my doctor’s mentor, which put me three or four rungs up the specialist ladder, and I don’t think there are any rungs above this one. He looked into my ear, asked a few questions, and said there were really only two options available to me: leaving things as they are or doing the surgery again. He recommended doing the surgery again, with the slight change that a single large graft be taken from my hip (rather than the several small grafts taken from behind my ear). He also said, without my even having asked, that the hearing would never really recover in that ear, though he quickly qualified that by saying that he hadn’t seen the full history of my hearing tests (he’d only seen the most recent one). He then went on to assure me that my doctor is an excellent technical surgeon and, for good measure, he cauterized my ear.

I had a little over a week to think this over before going back to my doctor, during which Jeannie stopped by to share the story of how badly her cholesteotoma surgeries had gone. I admit to feeling lucky in comparison. Though my hearing hasn’t fully returned and there is some ringing in my ear, the situation is one I could live with without complaint if it were permanent. As annoying as some of this has been, I haven’t suffered in any meaningful way, and unlike any sane person, I actually don’t mind going through surgery. I find the whole process fascinating, especially when I trust everyone involved, and I love the idea that I don’t really have to do anything but be attended to for a few days. And it’s the only time I ever indulge in anything even remotely like recreational drug use.

I went back to my doctor this morning, and we discussed everything. I’m actually developing more of a rapport with him than is usual with a surgeon, and I find his prototypically geeky combination of expertise and childishness charming. He was so proud of his mentor, and he wanted me to be, too. After reviewing all of the background, options, and implications, I asked him what he would do if it was his ear. He said given my youth, he would have the surgery. He said I would have to live with this ear for a long time, and that being otherwise very healthy, I should heal quickly. (It’s nice, now that I’m forty and it feels a bit like I’m falling apart, to be told I’m young, hale, and hearty.) He couldn’t imagine that I’d end up any worse off than I am now, and I might very well end up better off. He admitted that he couldn’t tell me how likely this was to work, since what he’d already done should have worked. And then he let me think about it. I decided to go ahead, and now I’ll spend Memorial Day weekend recovering from surgery. I kind of wish I could get it done sooner.

There was an interesting aside in this discussion. I mentioned that the hearing isn’t bothering me, and if that were the only problem, I’d be relatively happy. It’s just the other implications of the mucosa that are bothering me. I told him that in reflecting on this over the last week, I wondered if there was a way they could just replace the tissue in question with vinyl or some other inorganic substance. I wouldn’t have any hearing, but I wouldn’t have the issues of moistness and infection. He said that there actually is such a procedure where they block the ear canal. He said that hearing is reduced, but not destroyed. Yet he wouldn’t recommend this for me except as a last resort because it’s destructive and he still has hopes that my ear can be fixed. I found this comforting first because such a thing would be possible and second because it’s not yet necessary. It’s nice to have options.