Todd Bradley’s Galaxy

You may be wondering, “Hey, Todd, how’s your ear thing?”  Well, tomorrow marks 3 weeks since my surgery.  As I wrote in my last post on the topic, nearly a week ago, we’re into the stage of small, slow improvement.  But there definitely has been improvement over the past week.

With the help of my friends, I got my home  recording studio working again for the first time in several months.  I’m in the middle of a project to downsize things, selling off a lot of old audio and computer equipment, and I didn’t leave it in a working state.  But it’s working pretty well now.  One of the first things I did once I got sound coming out all the audio monitors was to listen to a few songs that my ears know well.  What I mean by that is that I know very well how the recording is supposed to sound in my studio.  They’re reference tracks.  They didn’t sound right to me, which just means my ears aren’t back to normal yet.  But I can tell they’re getting better day by day.

For example, at some point in the past week my right ear (the one that was operated on) went from being very distorted to being good enough that I can now use it for phone conversations.  At first, I couldn’t put the phone up to my right ear, because I just couldn’t understand the person on the other end of the line.  But now I can.

Also related to that, for a while I was having an echo effect where the right ear was picking up close reflections and the brain was processing it as a separate input signal.  In other words, my right ear would hear something a split second after the left ear.  Normally, the brain figures out those are really just one signal and you only consciously hear one thing.  But I was hearing it twice.  Well, now I’m only hearing it once again.

I haven’t tried driving yet, but I’m going to do that tomorrow on an uncrowded street, with supervision.  I have to prove to Beth I’m ready to drive myself before she’ll let me have the car, which is totally reasonable.

Yesterday, we went to the FlatIron Crossing shopping mall to walk around.  It was cold, windy, and snowy outside, but I wanted to do some walking, so we went to the mall.  It was really tiring on me.  I didn’t expect how much sensory overload I’d get just from the shopping mall.  But between all the shops, all the sounds, all the people moving in different directions, and looking at things on two levels (the mall has an upstairs and a downstairs) I got a little dizzy a couple times.  By the end of our excursion I was more than ready to go home.  But I think we should go back and confront the mall again until I can handle it pretty well.

As far as pain goes, I’ve found that if I use the computer too much, I get a headache and a stomach ache.  I could understand the headache, but the stomach ache wasn’t expected.  Strange.  I guess when I reach my limits, it’s triggering some sort of nausea effects that seems to me like a stomach ache.  I’m still occasionally getting headaches in the evening, and I don’t know how much of it is soreness of the muscle that the surgeon cut and how much is just from fatigue.

The past few days, I’ve been taking a one hour nap in the mid-afternoon.  There was one day a few days ago where I didn’t have a nap, and didn’t feel any ill effects.  I guess I had more energy that day, or maybe I didn’t do anything that taxed my brain too much.

I’ve noticed that my tolerance of cold is very low.  Most days out of the past week, I’ve felt cold all day long and just can’t seem to warm up, even when I wear unusually warm clothes.  A friend told me that must mean my body’s spending its energy repairing stuff in my head instead of warming my limbs.  I guess that’s as good an explanation as any.

I’ve been having an issue the past few days with weird sensations in my bladder, of all things.  I was feeling fluid emptying into it, and it really felt like it was squirting in, like urine from my kidneys was suddenly rushing in under pressure instead of just dribbling in at low speed.  There was also some minor pain going to the bathroom, but also between trips to the bathroom.  I had two guesses as to what might be going on.  First, and most obvious, is a urinary tract infection.  Since I was on a catheter for over a day while in the hospital, this wouldn’t shock me too much.  My second guess is that it’s a side effect of the Diamox I’m taking to reduce my CSF pressure.  According to the Wikipedia entry for acetazolamide (that’s what Diamox is), “Acetazolamide also increases the risk of developing calcium oxalate and calcium phosphate kidney stones.”  I think I wasn’t drinking enough water when this problem was worst, and I wonder if I generated and passed a few small kidney stones because of it.  So I had a urine test earlier this week, to see if it was a UTI.  Given that I don’t have some of the other symptoms of a UTI (blood, for instance) that the results will come back normal.  And since then I’ve been drinking a lot more water and the problem has mostly (though not completely) gone away.

I really hope I don’t jinx things, but I was expecting to have a few “setbacks” during recovery – days where I was seriously worse than the day before.  I’ve had some days that were slightly worse than the day before, but most days have been better.  And no really crappy days.  Like I said, I hope I didn’t just jinx myself!

My surgeon wants me to go have an opthamalagist exam, which is now scheduled for Monday morning.  Apparently, in some small percent of cases, changes in CSF pressure can have an impact on field of vision and other eye related stuff.  So he wants me to have an exam as a baseline, now that my CSF pressure is (at least for the moment) in the right range.

Speaking of which, I brought up the question of whether we should be trying to find the root cause of my CSF pressure problems.  Sure, I had some fluid drained and so the pressure is fine now, or at least it was when I had the spinal tap a couple weeks ago.  But what caused it to be so high in the first place?  And what’s to prevent it from getting high again?  The surgeon gave me a long list of possible things that can cause a high CSF pressure, but they didn’t seem applicable.  The only one that might be pertinent is sleep apnea.  I do snore some when I sleep, but since I’m such a light sleeper, I almost always wake myself up immediately.  So I don’t think I have sleep apnea, but the surgeon wants me to have a sleep test done now, just to be sure.

And that’s the latest in the “leave no stone unturned” story of Todd’s ears.  It’s probably a lot of TMI (too much information), but I’ve already had two people contact me out of the blue because they found my blog and think they might have ear problems like mine.  So apparently, putting all this info online is already helping other people, and that’s a good thing.

I just read that Monster.com had a major security breach, and crackers stole not only basic personal info of users but their passwords as well. So, if you’re like me, and used the same password on Monster.com as on other websites, your login on those other sites is now at risk.

I just canceled my Monster.com membership over this, but the damage has already been done.

For  a while there, I was trying to write a blog entry every day describing how my recovery’s going. But it’s been a few days, so I’ll just try to bring readers up to date.

On Tuesday, I did lots of resting.  Beth’s nature hike Monday wore me out, and I wanted to build up my strength to travel home.  That’s because Wednesday was our planned flight back to Colorado from Louisiana.  So Tuesday was just hanging around in the hotel and packing.

Wednesday morning we got up early, had breakfast, and checked out.  Then we headed across the causeway (the bridge across Lake Pontchartrain to New Orleans) to the airport.  After some challenges finding the rental car return, we eventually got our bags checked in (including one that, at 69 pounds, was significantly overweight so we had to pay extra).  I asked for one of the little blue cards saying I’m disabled and allowing us to get on the plane first.  So we got two seats in the very first row, which was nice.  First ones on the plane, and first ones off.

The flight was uneventful, and due to a lack of winds at altitude we arrived ahead of schedule.  After landing, we got our bags and then had a town car drive us straight from the airport home.  I didn’t want to have to deal with the Super Shuttle driving us who-knows-where and knew I’d just want to get home ASAP, so we paid a few extra bucks and got door-to-door service, which was nice.  Since the driver took the toll road, we were actually home at just after 1 PM Mountain time.  A great journey!

The airplane didn’t bother my ears too much.  No pain or anything, but my right ear did pop a LOT as we were going up and down.  Some of the popping was coming from the usual method, through the Eustachian tube.  But some of it was coming through the little hole my doctor cut in the ear drum just to make sure.  (That hole will heal over in a few weeks, but until then I have to take ear drops 3 times a day to make sure it doesn’t get infected.)  My ear was definitely “tired” by the end of the day, and I started heading for bed by 8:50 PM.

Today marks 2 weeks since my surgery.  I’m catching up on a bunch of stuff from being gone for over 2 weeks – household finances, unpacking, etc.  Basically, it’s another day of low activity and healing.

The time of rapid improvements has passed, I think.  For the first week or so I was hitting some personal milestone in my recovery every day – first day with no dizziness, first time walking outdoors, first time peeing like a boy again, etc.  I think for the next few weeks it’s going to be slow, almost imperceptible progress while the swelling in my ear continues to go down, the jaw muscle that got cut continues to heal, and my hearing continues to get a little better each day.

I don’t feel ready to go back to work yet (can’t concentrate well enough, and need lots of naps) but I can imagine going back part time in another couple weeks.  So for now I need to do lots of resting and let my body continue to heal up and get normal again.

And that’s how I’m feeling at 2 weeks post-op.  I’ll end this post with a photo I just scanned today.  It’s a picture of the inside of my head as my surgeon works on me.  Unfortunately, I can’t make out the details well enough to understand everything we see here.  To me, it looks like it could be a scene from the butcher shop. 

(let me know if you want to see the full size high resolution version of this)

Yesterday Beth and I traveled home by flying Southwest Airlines from New Orleans to Denver. As I was getting dressed, I had this little fantasy:

Wouldn’t it be cool if when we arrived they told us, “By order of the Obama Administration, the TSA has eliminated all elements of Security Theater and replaced them with only security screening practices that actually have an impact on passenger safety. So leave your shoes on, and bring your water bottle. Oh, and your Chap Stick – just keep it in your pocket.”

It turned out to be the most low-key security screening I’ve seen in the USA post-9/11.  There was only one line, and most of the time the screeners were just standing around waiting for passengers to arrive.  When we got to the front of the line, we had as much time to do the undress-pass-through-redress ritual as we needed, which is a good thing due to my current physical limitations.

Here’s a note about the progress of my recovery from ear/brain/skull surgery.  Today is Monday January 19, 2009, which is 11 days post-op.

Yesterday afternoon, while I was resting from our visit to Hammond, Beth went birding and discovered the Northlake Nature Center.  So we decided to visit today.  It was supposed to be an easy walk around a forested pond area, but turned out to be a lot longer than either of us expected, thanks to a small pocket map that neither corresponded to reality nor to the official trail map of the place.

We started with a trip to the supermarket where we got a few things we need before leaving town.  Beth also was trying to get rid of some recyclables.  She thought they might take recyclables at the Customer Service Counter there, like they used to at King Soopers in Boulder before they had a more complete recycling system.  No such luck.  She even asked the checkout clerk if she knew of any recycling centers in the area.  The young woman made a face and a noise that made it clear she’d never given recycling a single moment’s thought.  As we were walking out, Beth pointed out to me that even though she’s only been here 2 weeks, she knows more about the recycling infrastructure in this community than the people who have lived here their whole lives (since we’ve actually visited two such places).

After the supermarket, we drove to the trailhead and set out.  The first mile or so was a nice (though chilly) walk around some beaver ponds.  Not much in the way of birds or any other animals to see, though.  But we continued on what our map said was a loop trail.  I don’t know if the loop trail is wishful thinking, something they hope to install someday, or something that existed before a hurricane at some point in the past.  But we found ourselves the only hikers on some pretty sketchy trails that hadn’t been maintained in a while.

I guess we only walked about 2 miles, but that was about twice what I wanted.  A lot of it was a challenge for me since we were climbing over and under logs across the trail, over bridges that were falling apart, and so on.  But we finally spotted a road, and once I saw that road I was able to compare the road I could see to Beth’s crappy map and figure out where we really were, realizing it was only about a half mile back to the car now.

I was glad to get back to the car, since we it meant food and drink.  Thinking we’d only be gone for 30 or 45 minutes, we didn’t take water with us.  But after two hours, I’d had enough.  So we went to a local restaurant where they wouldn’t care that we smelled bad, and gorged ourselves.  Then we went to another place across the parking lot for beignets for dessert.  And eventually back to the hotel room, where I got a much needed nap.

So once again, it was walking in a nature trail environment, but this time it included lots of balance tests – balancing on wobbly 2×4 bridges, stepping over logs, rolling over logs, etc.

Symptoms at 11 days post-op:

• dizziness: none
• nausea: none
• hearing: heard my pulse in my right ear; heard my footsteps in my right ear; sense of fullness in right ear
• endurance: low
• pain: mild headache much of the day (no painkillers)
• digestive system: getting better, but not great
• emotions: tired; grumpy about trail maintenance; impatience with autophony

Here’s a quick note about the progress of my recovery from ear/brain/skull surgery.  Today is Sunday January 18, 2009, which is 10 days post-op.

Beth and I spent the morning on a country drive from Covington to Hammond, Louisiana, taking what’s essentially “the back way” on an older highway north of both towns.  There’s lots of farmland and pine forests up there.  Once we got to Hammond, we had lunch (I had an individual pizza that was really good, and Beth had a muffaletta which is a huge New Orleans style sandwich) and then walked around downtown some.  Because it was Sunday, most shops were closed and traffic was very light.  Things in Louisiana come to a standstill for Sunday almost as much as the state of Israel shuts down for Shabbat at sundown Friday.

I didn’t walk nearly as much as we did yesterday at the state park, but this one was in an urban setting and had its own challenge: street noise.  Even though traffic was light, we were downtown and so traffic would get backed up at a stoplight and then come thundering down all at once.  But I did well, and we had a nice afternoon.  Beth took a lot of photos and then we drove back to our hotel and I had a nap, which I do pretty much every day.

Symptoms at 10 days post-op:

• dizziness: none
• nausea: none
• hearing: had some problems with traffic noise
• endurance: didn’t push it today
• pain: mild headache much of the day
• digestive system: getting better, some stomach ache at night
• emotions: positive, tired

It’s Saturday.  Beth and I spent the afternoon at Fontainebleau State Park walking around a big loop Nature Trail they have there.  We’d visited this park a few days ago, and I walked out the pier onto Lake Pontchartrain, and relaxed some on the park bench.  This time, I was ready for a much longer walk.  My surgeon said the number one best thing I can be doing right now is walking, so we did plenty of it today.

After spending the morning doing laundry and then going out for pho at a local Vietnamese restaurant for lunch, we set out for the park.  The trail was pretty level and gravel, so it was easy walking.  It leads through a bunch of woodlands, and we stopped here and there to watch birds.  I saw a bunch of tiny birds and some big birds in the distance and a woodpecker or two.  Most important, though, I just walked.  It was a chilly day, so I’m glad I wore three layers and my knit wool cap.  Near the end of the loop trail, the trail goes out onto a boardwalk over some wetlands, and we went out there and watched some coots.  Eventually, the loop dumped us off in the big park near the pier, and we walked back to our car at the visitor center.

I was pooped afterward!  I felt like we must have walked for hours and several miles, but I looked at the clock and the map and realized we were only gone for probably 2 hours and 2 miles.  But the way I felt, it sure felt like more than that!  Nonetheless, it taught me some important stuff.  First, that I’ve got lots of room for improvement still in my walking speed and endurance (but hey, I just had brain surgery last week, so whaddaya expect!).  Second, walking through the forest sure beats anything I could’ve possibly done inside a hospital!

After the walk, we stopped off at Starbucks for some hot chocolate, and then came home (to our hotel room) for a much needed nap, before going out for dinner at a totally unremarkable sandwich shop called McAlister’s Deli.

Symptoms at 9 days post-op:

• dizziness: none
• nausea: none
• hearing: I’m not hearing footsteps through my body as loud as I used to, maybe not at all.  The sound of my voice isn’t as loud in my right ear, but my right ear is in flux still. Constant medium level ringing in right ear.
• endurance: low
• pain: nearly zero – I didn’t take any pain medication at all today, for the first time since before surgery
• digestive system: constipated 24 hours
• emotions: positive, encouraged by continued visible progress

Todd’s big event for Friday January 16: spinal tap.  And I mean that with lowercase “s” and “t”.  Though I’m a huge fan of the band and the film, this was my first opportunity to get my very own spinal tap.  Well, in all fairness, I did have one before (last Thursday in fact), but I was unconscious for it.  So here was my chance to experience one live!

Preparation was simple but unpleasant.  Nothing to eat or drink after midnight.  I was supposed to show up at 11 AM at the outpatient surgery center, and so this only meant skipping breakfast.  Once I got there, I did the usual routine of slipping out of my regular clothes into a hospital gown.  This time they had little booties to help keep my feet warm, which was a nice touch.  And I think I had 2 or 3 blankets on top of me because the place was so damn cold.  I told the nurses how I was looking forward to going back to the Rocky Mountains where the weather’s warm.

They asked me a bunch of questions, took my vitals, put me on an IV, and then we sat in a holding pattern for a while.  Once the anesthesiologist was ready with his previous case, they gave me some happy juice, cleaned up my back with antiseptic goop, and stuck me in the back with a needle.

The first needle was to numb the area so they could then put in the mother of all needles.  Once that went in, they were able to take a sample of my spinal fluid (it looks like gin) and measure its pressure.  Yesterday’s pressure was 22 mmHg, which is up 1 mmHg from the surgery.  The goal is to have the pressure be in the mid-teens.  So he drained off some fluid until my pressure was at 18 mmHg, pulled the needle out, gave me a band-aid, and sent me off to recover.

My only participation was to just breathe deeply when requested, so I had the easy part. The happy juice he gave me wore off fast, and when I was dressed in another 20 minutes I probably could have walked out under my own power, but they wheeled me out on a wheelchair per tradition.  (The drive back to the hotel was less than 5 minutes and I walked from the parking lot to our room)

Beth made me a big lunch which I enjoyed in bed with a Coke and a smile.  Later that afternoon, I had a nap for an hour or so.  That evening, we went out for po boys!  Yum!

It was another typical day in Todd’s journey: sleep, experience some new drugs, get a needle stuck in my spine, eat, sleep, eat some more.

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Hi, everyone.  Today’s big milestone with respect to my SCDS surgery recovery was my one week checkup with the surgeon.  Hurray, I survived the first week! 

Dr. Gianoli said immediately that he thought I was looking good, as if perhaps some of his patients make their one week checkup appointments on hands and knees or something (geez, I hope not!).  He asked a bunch of questions, looked at a bunch of things, and did a few things.  Here’s how it all came out.

• He removed all the staples and sutures, and said the swelling is very minor which makes it easy to remove these things.
• He seemed a little surprised to hear that I couldn’t hear out of my right ear at all until he looked at it and saw that it’s filled with blood.  He didn’t like the idea of me flying home with all that blood in the middle ear, and recommended that I either (a) drive home or (b) have him do a myringotomy.  The myringotomy is just a hole cut in the eardrum to allow drainage and equalization of pressure.  We talked about the options a bit and I decided to go with the hole.  The impact of this is that I need to make an extra effort over the next few weeks to avoid infection.  I’ll be extra careful not to get water in my ear and Beth will also irrigate it with a sterile antibiotic solution daily.
• After I filled out the form authorizing him to do the procedure, he numbed the eardrum with a topical, and then cut the hole.  Then he suctioned out some gunk.  I never saw it, but I assume it was blood and stuff.  After he did that, I started to hear sounds in my right ear, though they don’t sound “right” since there’s still other gunk in that middle ear.
• He wants me to go have my CSF pressure checked again, so I made an appointment for tomorrow to have that done.***  I’m not allowed to eat after midnight, and they’ll give me lots of happy juice so I won’t care that I’m getting a needle stuck in my spine.  I’m supposed to be there at 11 AM.  Yes, it looks like yet another day of wearing a hospital gown, getting probed, and then sleeping it off all afternoon.  If the pressure level looks good, then I think we’ll stay with the current dose of my CSF pressure med.  If it’s too high or too low, then Dr. G will have to figure out something else.  But we do want to get my CSF pressure dialed into the normal range as part of all this since that may make some of my other symptoms go away.
• I also scheduled my next follow-up visit, which is for 5 weeks out.  I hope things are in such great shape in 5 weeks that the follow-up just amounts to this: “How’s the ear?” “Awesome, how are you?”  “Good, did you know Mardi Gras is this weekend?”  “Sure did.” “Examination complete!”  But we’ll see.  I don’t want to push things.  I think I pushed my recovery from my 2nd knee surgery too fast and that’s one reason I still have knee problems to this day.
• And finally I dealt with some administrative stuff.  It sounds like the various bureacracies still don’t have things lined up for my short term disability benefit.  Hopefully, one form I signed today will help with that.  Today was pay day at Polycom, and that reminds me that since I’m on unpaid medical leave someone else (my short term disability insurance provider, specifically) needs to be paying the bills.

I talked to the admissions clerk for the place where I’m getting the “lumbar puncture” done tomorrow.  She went through the usual medical history questions while Beth was driving.

And it was then that I finally got to whip out the zinger I’ve been waiting all week to use.  The conversation went something like this:

Clerk: Have you had any major surgeries?

Me: Well, as a matter of fact, yes.  I just had brain surgery last week.

Clerk: Oh.  Wow.  OK.  Other that that have you had any major surgeries?

Me: Nothing more major than that one.

Clerk: No, I imagine not.

Me: Just a couple of knee surgeries here and there in the past.

Clerk: OK, thank you Mr. Bradley.