Fixing my Ear, Nose and Throat in 5 Surgeries

 

I have undergone five surgeries since 2002. All five were ear, nose and throat (ENT) related. I removed my over-sized tonsils, which were causing very frequent sore throat. I was unable to breathe normally through my nose because of a deviated septum (the cartilage between nostrils) and excess cartilage in my nose. In addition, I was born without 1.5 out of 3 middle ear bones in my right ear which meant I was almost completely deaf on my right. I thought it would be interesting to share what the experience was like.

General anesthesia

All five were classified as day surgeries. This meant I was admitted and operated on the same day. As all five surgeries were done under general anesthesia (GA), I had to stay a night for observation each time. GA is an interesting experience. What it does is to paralyse you. Most folks call it being put into sleep but it is not. Your body knows that it is being sent into a coma and fights the GA though you would be unconscious by then. GA is administered via intravenous therapy. The oxygen mask that is placed over your mouth simply helps to ease breathing. It is rarely used to administer GA. As GA is being pumped into your body via IV, your limbs are first to go numb. You are still awake. (I fought to the very last to remember the experience. I had five tries anyways.) Then the feeling of being paralysed rises to your chest before it hits your head and you finally “fall asleep”. Your body then goes into shock but it is short-lived and patients are usually not aware. The general anesthetist’s job is to stabilise your body quickly so that it exits the shock phase and enters induced rest. Then, a breathing tube is inserted into the throat to aid breathing, and the surgery begins. One tip for those going into GA is to try to position your body in the most comfortable position as far as possible. Make sure your palms and feet are resting normally, and that no muscle is being exerted. Tell the nurses if you are not resting comfortably and they will help adjust. If not, you are going to suffer from muscle ache when you wake up. I learnt that from my third surgery. Waking up from GA feels roughly the same as waking from a bad hangover. Your head is heavy, you feel drowsy and you just want more sleep. I was fortunate to react well to GA four out of five times. The one time I did not, I spent six hours vomiting occasionally. That is par for the course.

Tonsillectomy (Throat)

My favourite surgery. There is not much to say about this. It is straightforward and simple. The surgeon removes the tonsils via laser and it is easy to get a clean cut. Healing is quick and recovery is easy. The best part is being on soft and cold diet for two weeks. I had so much ice cream. Post surgery improvement was very observable. The number of times I had sore throat fell drastically from every two weeks to at worst thrice a year.

Septoplasty (Nose)

But I was still getting flu quite often (once every two months) because I had difficulty breathing through my nose. This meant that I only breathed through my mouth, leaving my throat dry and exposed – a perfect breeding ground for viruses and bacteria. My septum was deviated quite badly though it was fortunately not observable from the outside. The first surgery helped to straighten it and also remove excess cartilage. But the surgeon was too conservative and I was still not fully comfortable with breathing through my nose. I went for another round roughly ten years later and the surgeon took more aggressive measures. Recovery was quick and easy. For the first time in my life, I felt that I could take in all the air my lungs needed via my nose. It was life changing. But I was still subconsciously breathing through my mouth when I slept because my brain was hardwired to do so for thirty years. I actually had to tape my mouth shut when sleeping to redefine my habits. After two weeks of doing so, I defaulted to breathing through my nose when asleep automatically. It was no surprise that I was getting flu a lot less. In fact, I am now falling sick significantly less often than my family and friends.

Ossiculoplasty (Ear)

I was unaware that I was almost deaf in my right ear until I was six. My aunt had then gifted me a PC and I told my parents that the right speaker was not working. It was working. But they did not take note because I was able to judge sound direction perfectly well. What had happened was that my brain had compensated by leveraging my left ear. I was put through a regular hearing test when I was eight, and test results indicated that I was almost deaf on my right. Conversely, my left ear was incredibly sensitive, picking up sounds beyond the average human range. I decided to deal with the issue in my thirties because it was affecting my work. Scans showed that I was missing 1.5 middle ear bones which resulted in a disconnect. The solution was to insert a titanium implant (see image below) to bridge the gap.

The first surgery was not a success largely because the implant that was inserted was too short (4mm, as shown in the image above). In the second surgery, the surgeon replaced it with a 6.5mm implant. When I woke up from surgery, I could immediately hear the difference. Even though my right ear channel was clogged with blood, I was picking up sounds. This was my one time waking up from GA with a huge smile across my face. Over time, the sounds got clearer and louder mostly because excess blood had cleared. When my surgeon removed some dressing after a week, I was unable to believe what I was hearing. In fact, I got confused. My brain needed time to adjust to being able to hear from the right. Walking along the roads was disconcerting. I was jumping at sounds buffeting my right ear, and I actually had to hold onto a lamp post to steady myself before walking slowly.  But you can probably guess how magical the experience felt. It was pure joy. The graph below shows how drastic the improvement was. The dark red portion indicates the improvement in my right ear. Improvement varies case by case and this was the best result I could hope for.

I am now able to hold conversations with folks sitting on my right. I am enjoying music like never before. The world has become a much livelier (and also noisier) place. That said, recovery was tricky. I had to completely minimise movement for three full weeks. I was also feeling very listless in my first week because my ear was clogged up which made me feel like half my head was underwater. Nonetheless, the difficult recovery made the surgery’s success all the sweeter.

Now that my ear, nose and throat are all fixed, I hope never to enter the operating theatre again. This has been a life changing journey and I am very grateful to those involved.