MVD #2 Diary - Marlene Montgomery

Surgery performed by:   Drs. Peter J. Jannetta & Raymond Sekula
Surgical Location:         Allegheny General Hospital, Pittsburgh, PA
Surgery Date:                May 15, 2008

Diary prepared by:        Marlene Montgomery
Date diary finalized:      June 26, 2008

For background on my HFS I'd suggest you see my Member Profile.

 

Monday, May 12, 2008 - Day of Departure/Arrival:

 My husband Bob and I took a morning flight from Phoenix to Pittsburgh arriving in the afternoon. It’s 47 degrees in Pennsylvania. We’re staying at the Quality Suites and they sent a shuttle van to pick us up – waited only about 20 minutes and the drive to the hotel was about the same - 20 minutes. Pittsburgh is green, but the sky is gray. There isn’t much around the hotel as far as restaurants go. We have no car and it’s too cold to go out exploring on foot. We order a pizza for delivery. Dr. Jannetta’s office left a message with the front desk asking me to come in tomorrow at 8:30am – was originally scheduled to see him at 11:00am after other tests.

 

Tuesday, May 13, 2008 - Pre-Surgical Testing:

 6:00am – Woke to get ready for the shuttle leaving at 8:00am. Didn’t sleep much and my face is going wild as a result. Bob enjoyed the complementary breakfast (likes anything “complementary”). I’m scheduled for tests all morning so don’t know what/if I should eat so I’m skipping breakfast. Yesterday the shuttle driver said it would take about 20 minutes to get to the hospital; it took 55 because of traffic.

9:00am – Meet Ann, Dr. Jannetta’s nurse, whom I’ve spoken to several times. She’s just as pleasant in person as on the phone. Bob and I go into an exam room. Ann takes my blood pressure (just fine). I get a patient wristband. Within five minutes Dr. Jannetta comes in, introduces himself to Bob and I. We start with conversation; Dr. Jannetta is having trouble with his knees; he jokes about it. Interspersed with questions about our hotel, our trip, my work, etc., Dr. Jannetta has me squeeze my eyes shut and open, look at the ceiling, floor, left and right. My face isn’t betraying me as it sometimes does – can’t make it spasm on cue – but it’s not an issue this morning; it’s acting up big time.

Dr. Jannetta says I have typical HFS. He advises me about the risks of surgery – the really bad stuff is always a remote possibility – the bad stuff like facial paralysis, hearing loss, while unlikely, are not as remotely so. I was aware of these risks before making the trip; despite my trepidation's, I’m here and determined to go ahead. We talk a little about my first surgery in 1999 (Dr. Kris Smith); Dr. Jannetta says 2nd surgeries are easier on him and he believes it will be easier on me too. He explains that the surgery will take about three hours; the majority of time is spent getting in and closing up. Bob asks him if he will do anything with the Teflon pads that are in my head from the first surgery; Dr. Jannetta answers that he doesn’t think it will be necessary to disturb that area, and that he believes he will be going deeper. We spend about half an hour together. The highlights are that he believes I will be out of the hospital on Friday (the day after surgery). He says he foresees a good outcome. He tells Bob what he can expect as far as being updated after surgery; he tells us both that he is scheduled to give a speech on Friday so we won’t see him. Dr. Sekula will be in on Friday (he isn’t present today because he is serving on jury duty).

9:50am – In the basement for the MRI - The tech raves about both Drs. Jannetta and Sekula. He puts an IV in my arm, takes me to the machine, makes me comfortable, and explains the process: first they take the first series of images without dye, then they roll me out, he feeds the dye through the IV and the second set of images are taken with the dye. I’ve had MRIs before but never had the IV. It was unnerving at first, but proved to be no big deal. The whole process including the waiting, undressing/dressing, and imaging was about 90 minutes.

11:30am – I’m in the hearing center for the ABR hearing test. The technician puts me in a sound proof room, sticks some microphones in my ears (like ear buds that go in pretty far but aren’t uncomfortable), then the test consists of him saying two syllable words, at varying volumes first in one ear than the other, for me to repeat. The next part is one syllable words, then some tones that I raise my hands in response to. He says my hearing is normal. Then he takes me into another room and has me lay down while he sticks some electrodes on my head and earlobes; then he sticks some ear buds in my ears, warns me that the sounds may be annoying (like a large bee buzzing) but I’m not required to do a thing.

1:00pm – I’m in the basement again for the EMG. The young doctor who performed the EMG did all she could to make me comfortable. This is not a pleasant test; the best thing about it is it doesn’t take long. After prepping me by placing electrodes on my nose, forehead, corner of my mouth, cheeks, she takes some two-pronged wire thingy, places it on different areas of my face and sends electrical shocks of varying intensity through it. About this time, for the first time, I begin to get somewhat stressed; tears start rolling past my temples. It isn’t the pain that makes me well up, though there is some, it’s a wave of anxiety. I compose myself as best I can. The second phase of the test involves a small needle being placed right under the outer part of my eyebrow (no worse than a Botox shot) and the doctor records some data using a computer.

2:00pm – Phew, tests done. Bob and I walk to downtown Pittsburgh. It’s a beautiful sunny 70 degree afternoon.

 

Wednesday May 14, 2008 - Day before Surgery

1:00pm – Called the Ambulatory Clinic to find out what time I have to be at the hospital tomorrow; they say 5:00am. We make arrangements for transportation since the hotel shuttle doesn’t run that early. Ann told me that Dr. Jannetta was performing four surgeries; two of them involve older people who the doctor prefers to operate on first. Either Rosemary Moore or I would be third. Yes, everyone probably wants to be first, or possibly second; I’m no different, but it is what it is. We workout in the little gym at the hotel, clean up, and spend the day exploring Pittsburgh; I’m feeling calm and Bob seems fine too. His support makes this, and all good things in my life possible. I’m not allowed food or drink after 11:30pm – no problem – I’ll hit the hay by 9:00pm.

 

Thursday, May 15, 2008 "MVD-Day":

5:00am – Bob and I arrive at AGH 11th floor and sign in. Turns out, mine will be the first surgery of the day. When my name is called I go into a room where my blood pressure and temperature are taken. Then I’m sent into a room and given a hospital gown to put on. Bob came in. A nurse asks about the last time I ate or drank, about any medications I take and other general health questions; I put on these heavy, tight white hose that go from toe to hip. I lay down and she put the inflatable “boots” around each leg which inflate and deflate rhythmically. She told Bob where to wait. Bob and I kiss goodbye, and I tell him not to worry, ha!

I’m wheeled to an area where I meet the anesthesiologists. Half a dozen patients were lined up in their beds on one side and the surgeons were across the room. I waved to Dr. Jannetta and he smiled and waved. Dr. Sekula came over and introduced himself, remarked at how calm I was and assured me they would take good care of me. Then Dr. Jannetta came over and marked the left side of my face under my chin with a marker. We chit chatted a little and then he and Dr. Sekula left. There were two anesthesiologists; one asked me about past reactions to anesthesia and I told her that after my first MVD I had terrible nausea. She asked me if I wanted to try a “patch” that might help with reducing nausea. I said sure, and she opened a packet and stuck the patch low behind my right ear. The other anesthesiologist put an IV set up in an artery on my right wrist. They were informing me of every possible complication but, for some odd reason, the only one I fixated on was the possibility of chipped or broken teeth (probably a common warning for patients who are intubated). They wheeled me in front of Operating Room #7 and another doctor came out and introduced himself. He said he would be preparing me for surgery. I said okay, please don’t break my teeth. He said not to worry. The anesthesiologists took my arms out of the arm holes of my gown, said the surgery would begin promptly at 7:00am, talked to each other for a few seconds and then one said to the other: start the first set. I saw the OR door start to swing open and I was gone…

10:10am – My recovery nurse, Christy, wakes me up and tells me I’m alright – surgery is over. There’s a digital clock hanging from the ceiling in front of me. I ask Christy if the surgery was a success; she says she wasn’t told any different, but she didn’t really know. I feel disoriented but not too bad. I sleep. 12:10pm, Christy tells me Bob is anxious and raising a ruckus because he hasn’t seen me. She lets him in the recovery area and pulls a curtain around us. I’m weak, sore, and a little nauseous, a bit of a headache but that’s the worst of it: discomfort yes, pain no. Christy tells Bob he has to scram; he comments that my face hasn’t spasmed throughout our conversation; we both smile. I don’t have a catheter and I have to urinate so I tell Christy I’m able to walk; I don’t want a bedpan. There are no patient facilities in recovery, but Christy helped me over to the staff restroom. First she asked me if I had a gown on, I said yes, but to my surprise I picked up the sheets and blankets and I didn’t. Christy brought me a gown, removed the inflatable boots; I had a pulse oxygen monitor attached to one of my fingers and a blood pressure cuff that periodically took my pressure reading automatically; she undid these. She helped me to that restroom three times over the course of the 10 hours that I spent in recovery. I looked like the bride of Frankenstein in the bathroom’s mirror, yikes! Usually patients spend two hours in recovery but no rooms were available. Christy asked me if I wanted something for pain but I didn’t need it. I mostly slept; Bob came in to see me once more; I was aware of the patients nearest to me. I took tiny sips of water.

8:30pm – I’m wheeled to a double room on the 11th floor. The nurse comes in to show me how to use the remote and takes my temperature. I ask for water. Bob comes in to make sure I’m settled before he leaves for the hotel. He tells me that Dr. Sekula met with him after the surgery and explained how a vein was attached to the bottom side of the 7th nerve; they broke the vein with a micro-hook and the spasms stopped; he drew a picture for Bob. When the nurse comes in I ask her to remove the IV in my hand (it’s not attached to anything) and she does. I get up and use the restroom while she waits outside to make sure I’m steady on my feet, which I am. I have 5 or 6 round pads stuck on my ribs and chest which I peal off. I watch CSI and drink some water; my throat is dry and a little sore, and I’m coughing on and off which makes my head ache. 10:00pm – I have a slight fever so I’m given this handheld plastic apparatus to suck on which raises a ball and makes me cough. I do this during TV commercials. It is supposed to force water out of the lungs, which I’m told is causing the fever.

10:30pm – Rosemary Moore is brought into the room. 11:00pm Dr. Sekula comes in to check on Rosemary and me (amazing since I saw him at 5:00am). Rosemary seems still firmly in the grasp of the anesthesia. I meet her husband, Allan. Dr. Sekula checks me out, presses against my feet, has me raise my knees and arms. Then he covers my right ear and talks into my left. What I hear is a garbled sound like I’m under water and someone is yelling at me; I’m startled and frightened. He checks my right ear and I can hear fine from it. He tells me he’ll discuss the surgery with me in detail later, but they monitored my hearing and the readings were normal when they closed me up. He didn’t make any promises about my hearing but what he said made me feel better. After he left, I felt my left ear and there was lots of dried blood in it.

 

Friday, May 16, 2008, Day 1 Post-op:

2am – The nurse comes in to take my temperature – it’s normal. I sleep.

9am – I eat a few dry cornflakes and drink orange juice. Dr. Sekula comes in with two other doctors. After checking on Rosemary, they ask me how I’m doing. He talks into my left ear; I hear what he says at a very low volume, but it’s clear, not garbled. I tell him I’m up to leaving the hospital. He says let’s take a walk, so we walk up and down the halls for a few minutes and he says he’ll release me but I have to rest at the hotel till I see him again on Monday.

10:30am – Bob comes to get me; I’m dressed, and the nurse comes in with prescriptions for Tylenol3 for pain and pills to reduce nausea and tells me it’s okay to leave. She asks me if I need a wheel chair; I don’t. We say goodbye to Rosemary and Allan. I spent about 30 hours total in the hospital for the surgery.

11:30am through the next two days – At the hotel I mostly sleep, watch TV, answer some e-mails, eat a little, shower, and take walks around the parking lot. I finally wash the nausea patch off and wash a lot of blood out of my left ear. Bob treats me like a queen. I’m a little nauseous, have a headache off and on, incision area and left side of face and head feels sore, and I’m tired. I haven’t taken any pain medication because I don’t feel that bad, and I want to be able to walk, shower, etc. without impairment.

 

Monday, May 19, 2008 - Day 4 Post-op - Doctor visit and fly home:

1pm – I see Dr Sekula in Dr Jannetta’s office. My incision was closed using glue, not stitches, but he put a few staples in to keep it closed. First thing he did was painlessly remove the staples. He showed concern over the reduced hearing in my left ear. I told him while it would be great to fully recover it; I was completely satisfied with the results of the surgery. I tell him he’s changed my life and I thank him from the bottom of my heart; I resist the urge to smother him with kisses. He writes a prescription for a hearing test in September, and then he assures me that if I need anything, I just need to call. Dr. Jannetta comes in next. He tells me that he believes the partial hearing loss in my left ear will be temporary, most likely due to fluid in the ear or nerve irritation. He says it will take longer to see improvement in the facial weakness (I have no more facial weakness after the surgery than before and never really expected improvement). I hug and thank him too.

9pm – We’re home sweet home. 111 degrees in Phoenix never felt so good; okay, that’s an exaggeration. The flight seemed long but uneventful. I didn’t notice any problems with pressure in ears.


 

Thursday, June 26, 2008 – Six weeks Post-Op:

I’m "SPASM FREE", so happy, and enormously grateful to the HFSA membership, to my brilliant surgeons, Drs. Jannetta and Sekula, and to my husband. Surgery and its aftermath sapped my energy, but it’s returning. I didn’t schedule work during the summer (I teach) so I have time for afternoon naps. I’m getting back into my routines, but taking it easy at the gym, no weights over 5lbs yet. My incision is healing nicely; it is in my hairline and not noticeable. There’s no discernable change with the hearing in my left ear since surgery, still about 50%, but the loss is only perceptible when I answer the phone or use my Ipod – I’m not even sure it’s that bad since it’s the dial tones I hear low, but voices seem to be getting louder. Regardless, I’m hopeful for a full recovery with time. No regrets – thrilled with the outcome.


 

Update - September 12, 2008 - 4 Months Post-Op:

My hearing is back to normal. The diminished hearing in my left ear (HFS side) since surgery seemed to get better as time passed. Before I left Pittsburgh, Doctor Sekula wrote a prescription for an audiogram to be performed after September 1, 2008. Last week, a local audiologist, Tina Jesse, performed the test. My hearing was in the normal range, but she saw a blood clot in my left ear that she was unable to remove. I was referred to an ENT, Raquel Redtfeldt, who removed the rather large, hard clot. I’m happy to report that it was nothing more serious, and I’m feeling fully recovered from surgery and wonderfully spasm free. Drs. Jannetta and Sekula rock.

Permission granted the HFSA to post MVD Diary on website.
Marlene Montgomery, August 06, 2008 (Updated 09/13/08)

 

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