It has been a month and a week since my tympanoplasty surgery. I am sitting down to write a brief chronological narration of the events leading to the surgery, the surgery itself and my experiences till date.
There are two main reasons for me to jot down what I remember from the surgery.
(1) When I was about to go through the surgery, I really wanted to read a first hand experience from someone who had been through the surgery. While there were so many medical literature online, there was only one person I could find who had blogged his surgery experiences as such without any bias and that really helped.
(2)On the other hand, when I talked to a friend who had been through a related surgery years ago by the same surgeon, she had forgotten some of the details.
I realized that unless I write down these things somewhere, some of these things are going to get more and more vague in my memory with time and I may not be able to clarify things either for others or for myself.
For these two reasons, I decided to write what I feel is relevant about the surgery.
It was on August 31 2016 that I had some kind of strange water gushing feeling inside my left ear on a Sunday evening, several hours after a hair bath.
Mothers generally don’t have time time to ruminate on such insignificant things. I went about my work and slept at night. In the middle of the night, I had some kind of sharp pains inside my ear and when I kept my finger to check, I could feel there was a wet discharge. This happened all through the night. With a child who was sleeping on my other arm and would wake up if I took my hand away, I slept like that till sunrise with no idea of even the color of discharge.
The next morning, I was worried to see a brownish watery discharge and after asking for recommendations online, I went to Dr Krishnakumar of Global hospital.
He told me that there is an infection which can be cured. But the underlying cause is a huge hole in my eardrum which needs surgery to repair.
This came as a huge shock for me. How can a person who seemed generally healthy with no symptoms in ear before, suddenly have a large hole that needs to be operated on? I asked him if it can heal on its own. He said the hole does not seem recent to him and is very unlikely to close by itself.
I decided not to hurry into a surgery and went for a second opinion at a far away place in Nungambakkam based on recommendation. The ent doctor there gave me hope saying confidently that “It is a traumatic perforation caused by ear buds and will heal by itself in ten days and that is the beauty of it”. I was elated. (And promised myself never to abuse earbuds again). Ten days later, nothing much had happened and he also recommended surgery.
By now, there were strange clicking sounds in my right ear as well.
Then I decided to take a third opinion from MERF (Madras ENT Research Foudation, RA Puram) and met Dr Sudha Maheshwari based on recommendations from a neighbor. She spent the most amout of time to debug the issue and give me a proper diagnosis and prognosis.
She said I have a deviated nasal septum. That, coupled with my nasal allergies has led to negative pressure in my Eustachian tubes and one eardrum has burst, while the right eardrum is very thin but as of now, intact.
She said we can give it three more months and asked me to come for regular checkups every fortnight. She had given nasal spray and antihisthamine like my second opinion doctor.
She had initially given some hope of slight healing, but after three months, she also suggested to go for surgery as there is some formation in the eardrum which indicates it is no longer going to heal.
I was worried about further allergies leading to eardrum popping again, about which she was not willing to give any guarantees. (No ENT doctor will give guarantee on this)
At this point, I talked to two homeopathy practitioners from Salem and Bangalore. They both told me, once the allergies are dealt with , the hole will close eventually and take atleast an year.
Then I found a good Siddha doctor in Chennai and visited him. His honest opinion was that, the allergies can be cured, the hole may not be reversible. But he said the hole need not be closed surgically as long as it gives no issues. There is a high chance of the hole recurring after surgery, is his argument.
So long, I had been asked by ENT doctor to make sure no water went inside my ear, esp during hair bath. I shortened my hair a bit, put my hair in front during hair bath and plugged my ear with a cotton coated with Vaseline (Later I switched to coconut oil- dip cotton in oil, squeeze well and use, after I realized Vaseline itself was leaving thick wax like layers inside my ear. More on this later).
I started taking siddha medicines- loads of them and my allergies magically came under control in a month and they got better and better. My nose blocks had stopped,but I had a constant need to clear my throat of phlegm, but this also gradually stopped . I was meeting the siddha doctor at monthly or so intervals and getting revised meds based on progress.
After another year had passed, I knew my eardrum was not going to heal by itself and I wanted to get it operated. In the meanwhile my right eardrum got a traumatic perforation and eventually healed by itself within a month.( Thank God for that!) I went to a fourth ent doctor near to my place, who mistook the Vaseline buildup in my left ear (See two paras back) for ear wax and told me he was 90% sure the left ear had healed because there was wax build up and gave me drops to dissolve ear wax. (Mistake from my side was I didn’t mention to him about using Vaseline and didn’t realize there was a relation). As the Vaseline dissolved, the ear drops went through my hole into my inner ear one fine evening and I had the most scary nausea ever, throwing up several times and dizzy and hardly able to walk till the washroom attached to my bedroom).
This ent (Hariharan ent clinic, Medavakkam) was not reachable at that time though it coincided with his working hours. So we went to Global hospital emergency. (Now it had been rebranded as Gleneagles Global health city). They injected emeset and made several simple tests to make sure I was oriented. After things got under control, things got funnier when they called a neurologist to see me as they had no on-call ENT doctor.
I told them I was sure this happened after the ear drops and I knew this was an ent problem and there was no point calling a neurologist. But they called a neurologist and he made the same simple neurological tests already done by duty doctor and recommened an MRI for the 1% possibility of an impending stroke, saying it was my choice.
“Seri dhan ponga da”nu, I started home, only to be shocked by Rs. 1000 added to the emergency bill for the neurologist visit. I should have fought with them asking why I should pay for a neurologist because there was no ent doctor. But in that chaos, I didn’t think of those things.
By now, I had stopped my siddha medicines for few months and my allergy symtoms became severe again. I didn’t get an appt with my siddha doctor. But I met his assistant and got medicines and my allergies were better again (They were naturally on the path of betterment before I met the doctor).
Once my symptoms were better, I decided to “Get the surgery done with”.
I chose Global over MERF because it was much closer to my house (easier logistics), global had cashless insurance and seemed cheaper (due to insurance tie ups terms and conditions) than MERF. Dr Krishna kumar had already operated my friend Vidhya years ago, and she recommended him too.
There was also a disagreement between the various doctors I met on tympanoplasty vs tympano mastoidectomy. My temporal bone CT scan showed a mastoiditis in the left ear. So Dr Sudha and ENT Dr Mahalingam (in Trichy) suggested mastoidectomy (which includes work on ear bones apart from eardrum). Other doctors suggested that a simple tymapanoplasty (repair of eardrum) is enough, as I never had discharge from ear after that one time.
In between, Dr Krishnakumar had suggested that my nasal septum needs to be corrected first, then eardrum. Else, my chronic allergies will make sure the eardrum surgery doesn’t succeed. A couple of other doctors said this is not needed. So I told him I don’t want to get this optional surgery done.
Now that we decided on “Tympanoplasty” by Dr Krishnakumar from Global hospital, I went on 6th feb 2018 announcing my desire to get the surgery done. Doctor ordered for an audiogram (done several times earlier also) and a temporal bone Xray. The anesthetist ordered for a package of ECG, blood tests and chest xray.
I didn’t realize that they have given a HIV test until I was billed. Once I was billed and went to take the blood test, I was asked to sign the consent form that I was taking HIV test out of my free will. Only after giving the sample, I did a google search and came to know that HIV test cannot be forced on anyone. So I inferred this is not a mandatory test and I have probably been taken for a ride for another 1700 rupees. But it was too late now (Lesson learnt , for alerting others and if I ever need it in the future ).
All the tests took a couple of days to get completed, thanks to the lethargic attitude and lack of communication in some places (Anesthetist meet, xray report collection). ENT dept itself seemed to function efficiently though.
I was given an option between getting admitted on Feb 8th evening and Feb 9th early morning. Since I stayed closeby, I opted to spend that extra hours with my kid and got admitted on Feb 9th morning.
I was put in touch with a coordinator from Global hospital regarding the insurance and other logistics. When I came to know I had eligibility for a private room from insurance (this info had to come from global hosp after contacting cashless insurance), I confirmed that I need a private room.
When I called up this coordinator on feb 8th evening regarding something else, that is when he told me that the availability of private room (or any level of room for that matter) is not guaranteed and will get to know only at the time of admission and that he is doing his best. This came as a shock. If he had told this earlier, I would have planned the surgery at a time the private room was available. I am still disappointed about this.
We got a three sharing room when we got admitted (and came to know that if we had got admitted previous evening, we had better chances of getting a private room. This was again not conveyed to us by the coordinator).
The three sharing room was not just less private (one bathroom shared by three patients +attenders), but even the patient robes given were very poor quality with some or most of the ropes for tying missing, even after it is changed multiple times on our request). This was definitely not expected from a premium hospital like this.
After rushing through the shaving of hair (close to ear), prepping the surgery area (I was given a solution to do this), bath, robe change, IV, antibiotics, anesthesia test dose etc, I was rushed to operation theatre (we were late, mistake being mine that I got admitted bit late). Surgeon was already waiting.
I was made comfortable by the anesthetist. Then they kept an oxygen mask. I felt some difficulty breathing. She said it is okay. That was the last I knew.
When I woke up, my first thought was “Oh God, I slept in the hospital”. Then I realized I had been given an anesthesia and the surgery had been done. I was taken back to the ward after some wait. I had a heavy sense of wanting to urinate. I told the nurse and one of them accompanied me.
Surprisingly, I just was not able to pee despite the urgent sensation. After a very long time, I peed in drops and even after several long minutes, I didn’t feel done. I conveyed this to nurse, who said we will wait for the anesthesia effect to wear out. When this continued till evening, some junior from urology dept visited me and he showed no sense of knowledge/ authority over situation. He prescribed a tablet (which I am familiar with, as my dad had been taking it for several years). I was constantly followed up on the urological issue by nurses (never did the doctor turn up to meet me).
After a lot of pestering and recommendation from doctor, we got a two sharing room (and a much better robe). This was to be shared with an international (AKA Arabian) patient. This was a true pain in the neck, as the Arabian patient had a lot of attitude problem and insisted on owning the remote for the common AC, reduced temperature without informing us, kept the TV loud and had the lights on beyond 11 PM. Basically, they neither behaved like a patient, nor with a realization that they were sharing the room with another patient. They had a surprising sense of entitlement (probably because they pay higher and the hospital was intentionally promoting that sense of privilege/ VIP status on them). The nurses were always in a fix when we wanted them to convey the Arabian patient to switch off lights, reduce TV volume etc because they responded very rudely. Eg: I am also a patient. So I have the rights to keep lights on after 11 PM. Very disappointed that the hospital is not giving priority to local patients. Despite making use of huge amount of local resources in terms of space, water, electricity etc, they were thinking in terms of money and giving privilege to Arabian patients. Huge let down, there.
The nurses were quite good with us, responding every call very promptly. The urologist still didn’t meet me in person and recommended a ultrasound scan over phone (which I refused, because my condition was slowly getting better). When there was 1000 rupees added for the urologist fee, who was only available over phone, it certainly didn’t make me feel good about the hospital.
We got discharged on 10th evening and came home. My experience with the surgery was neither bad nor great. All went well so far and I was glad. I was on pain killers and didn’t feel much pain. (Once,there was pain during hospital stay and when I mentioned, I was given pain killer through IV)
There was a first week followup to remove stich in the outside of the ear (the inner one in eardrum was absorbable). But in two days after discharge, I had a swelling under left eye. So I went to see the ent. The ent said it was too minor for concern and removed the dressing, now that I have turned up anyways.
Stitch removed after one week. It was more time consuming and bit scary than I thought (maybe due to junior doctors doing that along with surgeon). Inner padding in ear removed after two weeks.
All the while, I had little difficulties like my temple aching when eating chapathis etc, not able to turn my neck on one side, some sounds inside left ear, difficulty hearing etc). I had mentioned these to ent during the visits and he assured all of these are normal and will settle.
I was asked to keep my ear dry for five weeks and avoid hair bath for atleast three weeks post surgery.
I had a hair bath the evening before surgery and cut my hair short, so that it doesn’t get much dirty. (Stylish hair after surgery is quite a confidence booster, u know? I can easily hide my cotton plugged ear in the free hair when I have to go out). I applied no hair oil and I could easily manage 2 and half weeks without wetting my hair (surprise!!). But then, I mostly stayed indoors. So not much “hair pollution”. Then I was asked to apply t bact ointment on the side of cotton and plug it in ear and have hair bath. (No Vaseline or coconut oil). Done, successfully.
Meanwhile, we had Krishna’s birthday coming up 2 and half weeks past the surgery and we celebrated that well, as well.
At nearly a month post the surgery, I started experiencing more pain in the temple (midpoint if u draw a line between top of ear and starting of eyebrow), while yawning or opening my mouth wide for popping a pill). There had always been some pain in this place and when I had mentioned this to doctor earlier, he said this is normal and will settle gradually. While all other discomforts had settled, this one had amplified. To my shock, doctor said this was not related to surgery as he didn’t operate that bone and asked if I have had this complaint previously before surgery!
He gave me anti inflammatory tablets for a week, which has reduced the pain, but it is certainly not gone. I am pretty sure this started after surgery and as of now, I am keeping my fingers crossed that this goes away permanently. Hopefully I will keep this blog updated and I really hope this helps some people down the line. Best luck to you all and me too!
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