Surgery is done! 1/30/2006
Adelina’s implant surgery was on Friday and it went so smoothly we can only attribute it to all the prayers people were sending up on our behalf. I’ll try to tell you how it all went down.
We got up early, around 5. Adelina woke up too and decided to have a shower. I thought this was a good idea since she wouldn’t get to wash her hair again until Monday night (that’s tonight!) We got in the car when it was still dark and drove to the hospital. We went through all the admitting procedures and eventually were ready for surgery. Adelina was dressed in a gown and pants and Steve for now had on surgical scrubs. Adelina wasn’t even scared. She enjoyed watching a movie in the playroom prior to her surgery. Her surgeon came in to confirm which ear he would be implanting, and he wrote a big “YES” on her right ear lobe, which is still there and which Adelina thought was a riot. When it came time, Steve went back to the O.R. with her, and she had practiced with the mask, so there weren’t really any surprises. and the anesthesia gas was so fast, she was out before she even realized it. The hospital did a fabulous job of preparing all of us for what to expect. It really helped minimize our anxieties. Surgery ended up being around 2.5 hours long. When she first went back, we actually went out for breakfast - we were starving! We hadn’t had anything to eat or drink since Adelina couldn’t either. We didn’t think it would be very nice to eat or drink in front of her…
Once in recovery, our little girl was a bundle of bandages. Almost all of the bandages were on the right side, so she looked rather lopsided. Adelina knew her head would be wrapped when she woke up, but she wasn’t really expecting to feel the way she did - basically, in pain, a bit nauseous, and in a drugged stupor. Despite this, she insisted on her hearing aid for her left ear almost immediately. We weren’t expecting this and had to go out to the car to retrieve it. Our girl really wants to hear!! Once she was more awake, she perked up even more and started in on the popsicles. She had fun rotating between the different flavors. She only took one dose of anti-nausea meds right after surgery, and within 5 hours, she was eating solids and was switched to oral pain meds, which she has pretty much already weaned herself off of. She seemed to enjoy the attention and royal treatment she got in the hospital after surgery. The doctor ordered her to remain in the hospital for 23 hours of observation (still considered outpatient), and we were so fortunate that the room they put her in was on the pediatric oncology ward, which was brand new and super nice. The room had a decent flat screen TV with VCR and DVD player, and a couch that pulled out into a bed for Steve and I to both be able to stay. The unit had its own playroom, though we also ventured to the regular pediatric unit playroom, which was bigger and had more toys and the little drivable cars. Adelina really surprised us with how quickly she was ready to play and move around, though she still preferred movies from the comfort of her adjustable bed, which was probably her favorite toy of all! She slept hard through the night, while Steve and I played the restless parents, worried that she might disrupt her bandages or roll onto her tender ear, but she didn’t and continues to sleep well since we’ve come home. Our weekend was largely like any other full of visitors, church, and a trip to the mall. Unless you saw her stitches, you wouldn’t know she had just undergone almost 3 hours of surgery on her head!
The only negative from the experience was the look of frustration and disappointment on her face when we reiterated that she would have to WAIT for her processor and implant activation. As soon as her head bandage came off, she started signing “CI device” again and again. I think she thought that as soon as the bandage came off, she’d be hearing with her new processor, but we have to wait until Feb. 22 for her activation and to get her processor. Once we came home, she seemed to accept this a little better, and when she finally saw her stitches in a mirror, she started to become a lot more protective and cautious. I think now she better understands why she has to wait. She has been wonderful about not touching her stitches, and is able to pull her hair back to “show off” her stitches (and the word “YES” still prominently displayed on her ear lobe) without coming in contact with them at all.
So what’s next after her activation? Many have asked us what she will be able to hear and how well. That is actually a very difficult question to answer. The implant will receive and process almost all sounds in her world - environmental noises, machines, animals, water, and the most important - speech. The sound input is processed and then sent to her brain as electronic signals through the implant in her head. The question becomes how quickly and effectively will her brain be able to receive and comprehend these signals. The human brain takes a long time to do this, and most of us start at birth and are finally able to begin speaking after about a year of hearing and “making sense” of what we are hearing as well as having opportunities to “practice” and explore (babbling and other oral play). Older children may have a slight cognitive advantage, and Adelina might have a further advantage if her Ukrainian audiograms were in fact correct, and she heard at 55 db as recently as January of 2005. Still, only time and experience will tell for sure how effectively she will be able to make use of her implant and processor.
In the meantime, we are thrilled to report that since getting her hearing aids in November, she has shown amazing progress in hearing and speaking just with those. As a point of note, effective use of hearing aids will often render a child a poor or ineligible CI candidate, but Adelina’s circumstances were somewhat unique because of her age and developmental delays incurred from being institutionalized. Since her surgery, she can only “hear” with one hearing aid and yet she continues to hear and add new words to her speaking vocabulary even since then. She is currently at around 50 words she can use consistently and several more she uses more imitatively. This is not much for an almost five year old, but considering she is learning both sign language and english simultaneously we think she is doing phenomenally.
