A new window

I may have mentioned having some hearing issues since the accident.

I have now visited four otolaryngologists, in an attempt to diagnose and correct the problem. Well, two to diagnose, then two more to find someone I trust to perform the surgical correction.

The first otolaryngologist gave me a hearing test, which returned results consistent with an aging punk rocker. My attempts to explain my experience was not adequate to pull his eyes away from my chart, even though he did conduct the one tell tale office exam that should have pointed him in the right direction. He offered to write a prescription for hearing aids, even when it was evident they would not correct the problem.

The problem, you see, is that I hear too much. There is a “fullness” in my right ear, much like the pressure you feel when changing altitude, except swallowing doesn’t clear it. I hear my heart beat in my right ear from the time I sit up in the morning. The shower hitting my spine is deafening. My voice has a bass resonance in my right ear. Sound builds, so in a short time all I hear is the resonance (autophony). These sounds are heard through bone conduction, which is why I hear them and you don’t. Normal people hear sounds conducted through air, and entering the ears.

The test the first otolaryngologist performed that should have pointed him in the right direction was placing a tuning fork on my skull, then holding it over my ear. I could not hear the tone in my right ear, but it was loud and clear when the fork was placed on my skull. Opposite results for the left ear. So he suggested a hearing aid, and I suggested a different doctor.

Doctor number two recognized the symptoms right away. He called it “a third window,” a reference to an extra opening in the Superior Canal of the vestibular system, which is attached to the cochlea. The medical name for the condition is Superior Canal Dehiscence, or Superior Semicircular Canal Dehiscence, Syndrome (SCDS or SSCDS). I’ve learned lots of new words, but I’m still not sure about the pronunciation of “dehiscence.” As you can see from the CT image below, and probably guessed from the explanation, corrective surgery takes place within the cranium. The canal is a bony structure adjacent to the temporal bone, on the “in” side. A hole is drilled for access.

 

The third window

The “third window”

 

Doctor number two could not perform the surgery, and referred me to a specialist at the University Hospital in Newark, NJ. This doctor did more tests and did a CT scan of my temporal bone. She definitively diagnosed the SCD, but was so disorganized and scattered I wouldn’t trust her to open a can of tuna, much less my cranium. I remembered my neuro surgeon from the accident, and contacted her. She referred me to doctor number four.

Doctor number four is Dr. P. Ashley Wackym. I have seen a few dozen doctors in the last year alone, he is the first to impress me. Alright, he has a lead initial, so there is a sense of kinship, and he dresses well, a nice suit and sharp shoes; but what blew me away is that I did not have to explain my symptoms, he asked me about each of them with familiarity. Another thing which gave me an odd comfort is that many of the symptoms of my TBI are also symptoms of SCD, in other words, correcting the SCD may assist with the issues I am working on with the TBI. Wouldn’t that be lovely?

From what I have read, SCDS is very rare. This may be because it was only identified in 1995 at Johns Hopkins. An estimated one percent of the population has the dehiscence, and many do not develop into the syndrome. Not every doctor knows it even exists. Severity varies, and in the big picture my case is not serious compared to patients who cannot stand because their balance is impaired beyond therapeutic correction. I just have so much annoyance with my hearing that I would be most comfortable as a hermit. I am frustrated because going to hear a band requires a day of rest before and after. I have considered putting a spike in my ear to relieve the pressure, but other than that my life is not in danger. When I was diagnosed with multiple sclerosis it was relatively rare, largely because diagnosis was so difficult. With the advent of better diagnostic tools, we hear about people with multiple sclerosis every day. I knew a woman diagnosed at the same time as I, who had been searching for fourteen years, trying to maintain a grip on her sanity. The stories I hear from other SCDS patients are much the same.

I look forward to the surgery for a variety of reasons. An end to the noise will be wonderful, and the experience should be fascinating. I will spend two days in the hospital and recover at home for six weeks, and I’ll probably have a scar on the side of my head which will alter my choices of hair styles. Maybe it won’t work, I could lose my hearing completely (which would not be terrible if the autophony goes away), it could simply not work, or any of the myriad of surgical complications could happen. Anything could happen with the surgery, without it one thing is certain, the noise will continue until I lose my sanity and find a window large enough to leap from.

 

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Closed Captions

We watch television with closed captions. In part it is due to our impaired hearing, but there is also the benefit of being able to follow a program without the volume interfering in other activities. Lieve is quite used to it, in Europe almost everything is subtitled, due to the multiple languages in use. I have found it helpful in learning Flemish, watching films in Dutch with English subtitles, and in English with Dutch subtitles.

It works very well with films, television programs are hit and miss. Live television, such as the evening news, makes me cherish my hearing. Misspellings and flat out wrong words are common, and often distract us from the storyline, as we laugh about the failures of the writer of captions. “The Daily Show” with John Stewart would be incomprehensible to someone who was actually deaf, the dialogue is rooted in double entendre and puns,  missed words destroy a joke. sometime the captions fall behind the dialogue, and the writer will just skip segments to catch up.

Were we to depend on captions in the news, we would be even more confused than we already are about why a story is broadcast.

“More on the polar plunge” is about a weather story, I’m not sure what “Maureen the polar plunge” means, the meteorologist’s name is Cecily. “Trailers perpetrators” didn’t mean the police were trailing the perpetrator’s trailers. My favorite is “yxxzztqpp@zzx” which I think means the person writing captions has spilled their coffee on the keyboard.

As more of us reap the “benefits” of our proximity to amplifiers in our youth, closed captions will become more necessary than ever, I certainly hope they work out the glitches.