MVD #1 Diary - Jack O'Donnell
The hardest part of the MVD was waiting out the period of time from when I was first approved for surgery in late August 2000, until the date of the actual surgery, October 18, 2000.
During the three weeks prior to surgery, I was getting most of my pre-surgical testing done locally and compiling copies of all relevant medical records. Some of the pre-surgery testing included an EKG, Blood tests, Urineanalysis, Chest Xray and a brief physical by my Primary Care Physicians. In addition to all of these test results and a prior MRI, I also had my Pulmonary Doctor, Neurologist and Primary Care Physicians forward all relevant medical records to Dr. Jannetta's office. I also carried copies with me to Pittsburgh to be sure there were no slipups at the last minute.
Monday, October 16, 2000 - Date of Departure:
At 9:30 AM Karen, my friend of over 24 years, and I depart from Warminster, PA and begin the 300+ mile trip to Pittsburgh. Upon arrival in Pittsburgh we check into the Marriott Residence Inn – Oakland at 3896 Bigelow Boulevard, Pittsburgh, PA 15213 (Phone: 412-621-2200, Fax: 412-621-0955). We have rented a one-bedroom suite, with a kitchen, separate bedroom with queen size bed and TV, along with an adjoining living room with a sofa bed and TV. It is only about 4 miles away from the hospital. The normal daily rate is around $109.00, but due to Karen's Platinum Club card; the rate is reduced to $69.00, $77.00 including parking. The room rate at the Visitors Center is around $72.00, so this seemed like a real deal. After unpacking and taking a test drive to the hospital, we take a brief tour of Pittsburgh, have a few drinks at Houlihan's at Station Square and then head out to find a restaurant for dinner. We find Gulliftys at 1922 Murray Street. Everything was excellent and reasonably priced. Following our early dinner we arrive back at the Residence Inn shortly after 8:00 PM and after a few hours of watching television, it's off to sleep. Although I fall asleep immediately, I'm wide awake and typing this Diary at 3:45 AM. Good thing we have two rooms, Karen is sleeping away in the bedroom while I'm sitting here typing on the sofa bed. After being awake for close to forty minutes it's back to bed and hopefully back to sleep. We'll see…….
Tuesday, October 17, 2000 - Pre-surgery Testing:
Well sleep didn’t come until close to 6:30 AM, and then up again at 8:30 AM. Where’s the anesthesia to bring sleep when you need it. The Residence Inn has a complimentary breakfast in the lounge, which consisted of scrambled eggs, sausage, hot oatmeal, waffles, and a variety of muffins, bagels, breads and fresh fruits. Next on the agenda is hearing tests at 11:00 AM, with registration scheduled for 10:45 AM, at Pittsburgh Ear Associates at AGH. It’s located in Suite 402, in the East Wing of the hospital. We were told to park in the James Street garage, so that’s what we did. The hearing tests are an ABR (CPT Code # 92585) and Audiogram (CPT Code # 92557). The first test is the Audiogram, which involves sitting in a small soundproof room with headphones on. Initially you are asked to repeat a series of words that are whispered in your ear at various volume levels. Next they play various sounds in your ear and you signal that you hear each sound by raising your hand each time you hear something. This test takes about fifteen minutes. Next we go to another room for the ABR (Auditory Brainstem Response) test. These results provide the baseline hearing data for the hearing monitoring that will be done during surgery. First they place about four electrodes on your forehead and cheek and place tubes in both ears. You are then asked to lie down, relax, and sleep if you wish. They then begin to play sounds in your ears, alternating from ear to ear. These sounds are similar to low and loud clicking, bees buzzing and a loud jackhammer. I’m now sure the person who suggested sleeping just had an unusual sense of humor. Anyway, the test was simple and also took about fifteen minutes. We then head down to the Cafeteria, located on the second floor of the Snyder Pavilion, at about 11:30 AM to eat lunch and kill some time before my 1:00 PM meeting with Dr. Peter Jannetta. The Cafeteria proves to have an excellent variety of food choices, all of which were reasonably priced. At 1:00 PM, we head to Suite 302 in the East Wing for our first ever meeting with Dr. Jannetta. I had hoped to meet Ruth Divosevic, who I had been corresponding with throughout this process, but she was off work today. Ruth was extremely helpful in providing the necessary paperwork and information to enable me to get almost all of my pre-admission testing done in my hometown. Finally, the long awaited meeting with the world famous Dr. Peter Jannetta who walks into the examining room and introduces himself as Peter Jannetta. After some small talk about friends he knows who live near me, he asks the necessary background info on my HFS, prior Botox® history, current medications and my overall health situation. He then walks me through the surgery and possible complications. Some of the possible complications obviously involve hearing loss, which I already knew. He explains that the surgery will probably last between one to three hours. He indicated that someone would be sent out after about one hour of surgery to update Karen on the progress and that he would speak with her immediately following surgery. I am expected to be in recovery for about two hours before going to my room. I should be out of bed during the next day, Thursday, at least for visits to the rest room. The most common side effect is a slight headache and discomfort around the incision. This generally goes away quickly. I asked about the risk of Bells Palsy and he indicates that if it does occur, it is almost always only temporary. He states that I could be released from the hospital as soon as Friday, but need to remain in Pittsburgh until my post surgery appointment the following Tuesday. He also indicated that during surgery a portion of bone, behind the ear, is removed to allow access to the cranial nerve. Titanium Mesh is later screwed in as a replacement for the bone, before the disposable sutures are added. The addition of the Titanium Mesh has been found to significantly reduce the headaches post-op. Dr. Jannetta was extremely down to earth, personable and took time to thoroughly answer all questions. I was quite impressed. Following this meeting I next see Rick, a physicians assistant, who first marks behind my left ear with a pen that resembles a laundry marker to make sure they don’t operate on the wrong side. We then walk through a background on my current and prior health, surgeries, and my lungs are listened to. We follow with the standard follow the flashlight up and down and side to side, the obligatory tongue depressor in mouth and repeating ahhh. Next my reflexes and arm, hand, leg and feet strength are tested by pushing or pulling against Rick’s hands and I’m finished after being reminded to call the Ambulatory Care Center at 412-359-8294, between 3:00 – 5:00 PM for pre surgery instruction and my arrival time for Wednesday. So, next the call is placed. I’m asked about the medications I take, am reminded no food or liquids after midnight and that I am to report to the Ambulatory Care Center on the 11 th floor of the Snyder Building at 6:30 AM on Wednesday, two hours prior to my scheduled 8:30 AM surgery. We leave the hospital at around 3:45 PM and return to the Residence Inn where I update the diary. Next we walk across the street for an Italian dinner at Zarra’s, 3887 Bigelow Boulevard (412) 682-8296 – recommended to us by someone at the front desk of the hotel. The selections listed on the menu and the prices seemed too good to be true, but the food, portions and price turned out to be excellent. I would highly recommend this restaurant.
Wednesday, October 18, 2000 "MVD-Day":
I was a little surprised that I actually slept from 11:30 PM until 4:00 AM. The official wake up call comes in at 5:00 AM, and I'm already up to answer the call. We head for the hospital at 5:45 AM, arriving at 6:15 AM. I wear sweats and boat shoes to make things simple for any additional pre surgery testing. Upon arriving at the hospital we proceed to the 11th floor and stop at the Admission’s Desk, in the hallway just outside the elevator. After checking to make sure I’m in the computer, Karen is asked to wait in the waiting room for ten minutes as I’m taken to a hospital room where I truly become a patient. I’m told to remove my clothes and put on this truly stunning gown with straps in the rear, along with these, I'm given way, way too tight slippers with little speed bumps on the bottom. Next, a nurse comes in with lovely tight white full leg hose (T.E.D. Anti-Embolism Stockings, to reduce the threat of blood clots from forming in the legs) for me to put on. Now I’m really set, open backed gown and hose. At about 6:45 AM, Dr. Jannetta’s Physicians Assistant stops by to tell me that shortly I will be taken to the OR holding area to meet with the Anesthesiologist where I will probably stay for about an hour waiting for my surgery. This seems ok since I’m not scheduled for surgery until 8:30 AM. It is a good thing I had to fight to get my HMO to approve the surgery since that made me totally committed to the surgery and not the least bit nervous. The reason I mention this is because at 8:45 AM, I still sitting in the same room waiting. Finally, at 8:45, a nurse comes in to take me out in the hallway and asks me to get on a gurney for the trip to the Operating Room. As we get to the elevators, she picks up a telephone and calls for an elevator "STAT". I explain to her that I would have been content to spend my entire life without hearing the word "stat" used in connection with me. She chuckles and apologizes and we enter the elevator for the ride down to the OR. Once there I’m introduced to the nurse anesthetist, who asks me a long list of questions about my medical history, medications I’m taking, checks my pulse, bloodpressure and temperature and explains how the anesthesia will work. Next I’m introduced to the Anesthesiologist. After assuring that I have no allergies, we start the morphine. Next, Dr. Jannetta stops by and asks if I have any last questions? I explain to Dr. Jannetta that I’m not fond of hearing "any last questions" prior to brain surgery. He also laughs and I’m wheeled into the OR. We’re off and running. Following the surgery, Dr. Jannetta went to the waiting room to explain to Karen that he found two arteries and a vein compressing the facial nerve. He decompressed the two arteries by inserting shredded Teflon foil and burnt off the vein. At some point in time I began to wake up in Recovery with a feeling of shortness of breath and total confusion. At some point I do recall Dr. Jannetta being there and he was asking me to close my eyes tightly and then open them. He would then ask me to stick out my tongue and smile so he could see my teeth. (Closing your eyes tightly should trigger spasms if the problem persists, there were "NO SPASMS"). He was pleased with what he saw. I also recall seeing Karen at some point for a few seconds, then it’s back to sleep basically, for the next three days. It seems that for most of the time I was in Recovery I felt like I needed to urinate but couldn’t. So on at least three occasions they used a catheter.
Thursday, October 19, 2000, The Day After:
Early in the morning I was visited by a group of residents and then later by Dr. Kim. Everyone seemed pleased with the surgery, but all I was concerned about was getting ice chips on my lips and sleeping. Due to a lack of beds, I stayed in the Recovery Room all Wednesday night and until about 10:00 AM on Thursday. It didn’t matter to me where they put me as I could sleep anywhere and that’s all I was doing. I do recall that when I was awake, my head hurt all over. 360° of discomfort. Not major pain but major discomfort. A few times I asked for something for pain and was given Percocet. Seemed to do the trick. When lunch came around noon I had two small containers of Apple Juice and some orange Jell-O. Within five minutes I began burping and within seven minutes vomited up my liquid lunch. It was then back to sleep again. On the few occasions I was awake and somewhat lucid, I didn’t feel any spasms and could hear out of my left (HFS) ear, but the ear did feel clogged or full. Shortly before dinner arrived, I again asked for some Percocet and took them about fifteen minutes before my two small containers of Pineapple Juice and cherry Jell-O arrived. This time I got out of bed (extremely off balance) and sat in a chair beside the bed to have my juice and Jell-O. Well surprise, surprise, just like earlier, within five minutes I began burping and within seven minutes again vomited up my liquid dinner. The good part however was that I noticed that when I was sitting in the chair, I had no head pain. I had remembered that on Wednesday while waiting in the room for the trip to the OR, Karen was sitting in a recliner. So, I asked the Nurse if they had recliners on the floor and she said yes, so one was brought in and I spent the night sleeping in the recliner. It seemed that the entire night consisted of ten minutes asleep, five awake, and so on and so on. However, since I wasn't lying on my head, there was no head pain at all A few times each day, I would be tested by squeezing my eyes shut tightly and then opening them, sticking out my tongue and smiling so that my teeth could be seen. Then someone would rub their fingers on each side of my face from the chin to the side of the eye and ask if it felt the same on both sides. Thankfully, it always did.
Friday, October 20, 2000, Two Days Post-op:
Dr. Jannetta stopped in early and when I told him about the vomiting he suggested that I stay in the hospital another day to see if the vomiting would stop. He noticed that I was lying in bed without a pillow and asked if I wouldn’t be more comfortable with a pillow and I said no, the pillows were too hard. He then turned to one of his residents and said they should suggest that patients bring a soft pillow with them. He then asked if I was pleased with the way my face looked and I told him I hadn’t even looked, as I was more concerned with how it felt, and it felt great, as there were NO SPASMS. I asked Dr. Jannetta about the feeling of fullness in the ear and he said that was normal and to start taking Actifed and it should go away in a few days. He also said he would be away for the weekend and that Dr. Kim would be handling my case. When Rick arrived later in the day, he took the big bandage off the incision and just left the smaller bandage that was underneath. He suggested I get off my ass and shower and take a walk. He also suggested, since the weather remained nice, that I spend a lot of time outdoors over the weekend walking. Finally he said that in the morning someone would come in with a prescription for a pain medication, give me the once over, prepare my discharge instructions and I should be able to leave between 11:00 AM and 12:00 PM. When breakfast came it was Orange Juice and Jell-O. Since I didn’t think Orange Juice was easy on the stomach and since I knew I needed to be able to keep down regular food before being discharged, I sent the tray away. Instead I asked for scrambled eggs and toast. I ate one of the scrambled eggs even though it had a cardboard texture, but passed on the burnt toast. I think the cardboard texture was me and not the hospital food, because I had the same impression of the Jell-O. Everything remained inside the stomach as intended. Progress! Although I didn’t really care to, I got up and brushed my teeth, shaved, showered, and shampooed my hair. The shampooing was the hardest because of the caked in blood. Well, walking to the bathroom like a drunk wasn’t real easy either. The fullness in the ear was affecting my balance. When dinner came, they must really be testing me; it was Veal Parmigan and Wild Rice. I ate half the rice and about three bites of Veal. Didn’t want to press my luck. Again all stayed down. On about five occasions I strolled the halls, hugging the walls due to my lack of perfect balance. Friday night my head felt so much better I returned to the bed to sleep and was able to do so with only the slightest discomfort.
Saturday, November 21, Three Days Post-op:
Around 7:30 AM, Dr. Kim and a resident came in to see me, performed all the standard tests and tell me I can go home soon. Breakfast was Cream of Wheat and Pancakes with Maple Syrup. Ate all of the Pancakes and half the Cream of Wheat (not one of my favorites), very bland. Again all stays in the stomach where it should. I’m discharged at 10:50 AM and given a prescription for Lorcet or Tylenol (for pain), Actifed (for the clogged ear) with instructions not to drive, no strenuous exercise and no alcoholic beverages. Additionally I'm to keep the wound dry for seven more days and to call if I have chills, temperature above 100°, or areas of redness, swelling and/or drainage. As soon as we return to the Residence Inn, it's back to bed. Not so much because I'm tired, but from all the time in bed, my muscles hurt when I sit or walk. I’m only comfortable when I'm lying on my side, so it’s several more hours of sleeping and a few staggers up and down the hallway. A mid day grilled cheese sandwich tastes fantastic. Now that I’m back from surgery, I get the Queen size bed and Karen gets the sofa bed. We dine in the suite with dinner consisting of Chicken Pot Pie. After dinner, watched TV until 11:00 PM and then hit the sheets for a good night’s sleep, or so I thought. My head feels terrific, I can lie on my side or on my back, but there is one small problem. Since I basically spent the past four days and three nights asleep, there is no more sleep to be had. From 11:00 PM till 9:00 AM, I do nothing but toss and turn, sit-up; lay back down, BUT SLEEP DOESN’T COME ONCE. However, the muscle aches just keep getting worse and worse.
Sunday, November 22, Four Days Post-Op:
After showering and dressing we head to the drug store for BenGay and Mineral Ice and then out to eat. I won’t bother mentioning where we went because the food was only bearable and the cleanliness was not. After eating we return to the Inn, and since it’s 70° and bright sunshine, we head out for a walk. After staggering for ten minute (the balance problem) I decide to just sit down in the sun while Karen continues her walk. She was nice enough to pick me up on her way back and then it’s football on TV for me, and a shopping trip to Shadyside for her. We decide to eat in the room and after a Grilled Cheese and Cream of Chicken soup followed by some TV and a rub down with BenGay it's time to find out if I get to sleep tonight or again stare at the clock. If it’s the latter, I'm really going to be sorry I typed this today, instead of saving it for the long sleepless night. I should have waited, was only able to sleep for about four hours.
Monday, November 23, Day Five Post-Op:
I am so surprised how great I feel only five days post-op. The clogged ear, balance problem and resulting (temporary I hope) diminished hearing are the only problems that remain. As I mentioned yesterday, the biggest nuisance is the muscle soreness in my lower back from too much time in bed. Makes it painful and hard to get comfortable while sitting. I've been using a lot of BenGay the past few days, but it doesn’t seem to be doing much good. No headache, don’t feel all worn out with a need for naps, and oh yes, SPASM FREE. I spend most of the day listening to books on tape and watching TV. I am feeling somewhat lethargic, but I'm sure that will change as soon as I get home. Final dinner in Pittsburgh was at Outback Steakhouse on Mc Knight Blvd. Outback is one of my favorite chain restaurants, the food is consistent from location to location. Well the car is gassed up, I shower, shave, do most of the packing and I'm ready to roll in the morning.
Tuesday, November 24, Six Days Post-Op and Date of Departure for Home:
Again only slept about four hours last night. So I'm out of bed at 7:50 AM, tired of lying there staring at the clock every ten minutes, so it’s downstairs for some free breakfast and killing time until my 11:15 AM appointment with Dr. Jannetta. The hardest part of the trip home will be sitting in the car for so long with the sore back I've developed while here. Immediately upon arriving, at 10:45 AM, I ask to see Ruth Divosevic, whom I had spoken to and corresponded with in getting all of the pre surgery testing and medical record compilation accomplished. Before I can get to see Ruth, Rick sees me and says we can get started early. So to an exam room we go, where the bandage is removed and the wound examined. All looks well and I'm told the sutures will go away on their own. So we do the squeeze my eyes shut real hard and open them to see if there is a spasm test. We do this twice, NO SPASMS . Next, Rick asks if I have any questions, and of course I do. While we are reviewing my questions Ruth drops in so now I've met and thanked everyone I've previously been involved with. At this point Dr. Jannetta joins us. I then posed the following questions: Q: What are the chances of reoccurrence?Dr J, in my opinion, truly is "THE MAN".
For details of my HFS experience leading up to my MVD see my Personal HFS History.
Permission granted the HFSA to post MVD Diary on website.
Jack O'Donnell, September 1, 2001