Eleven days after my countdown to cochlear implant surgery I head to the hospital for 07.30 admission, starved from midnight as instructed. I’m nervous. This will be the first time I’ve had a general anaesthetic, the first time I’ve had surgery. Having said to someone that I felt I had nothing to lose, I suddenly feel I have rather a lot to lose! A healthy woman, putting herself up for elective surgery under general anaesthetic – gulp… Unbidden, John Betjeman’s poem ‘Before the Anaesthetic, or A Real Fright’ comes to mind. Lying in an Oxford hospital, he contemplates his mortality while listening to the bells of St Giles:
“Swing up! and give me hope of life,
Swing down! and plunge the surgeon’s knife.”
The drama! Still, at least he could hear the bells! The sunrise that morning looks particularly beautiful, as does the texture and twist of a tree as I cross the grass to the hospital.
I am having my NHS operation under the care of the Oxford team but at a private hospital, where they do lots of their cochlear implant lists. As a former nurse, and with a healthcare worker daughter, I am very familiar with NHS hospitals; this private hospital strikes me as rather swish. I’m shown to my room (somehow I’d expected a bed in a bay!) and soon ‘my’ nurse arrives and introduces himself. What a difference a friendly nurse makes!
In the next hour I have a visit from the anaesthetist and then the surgeon, Mr R, who tells me that I won’t be going to theatre until about 1pm, and so can drink water until 11. A longer wait than anticipated and it feels long too. I’m starving hungry! My room has a view of a nearby terrace café, from which I help myself to imaginary food and drink. At least it takes my mind off my impending operation, for a while at least. Over the next few hours, I alternately read and knit, glad of an absorbing book and the soothing process of making one stitch after another. I imagine I will spend the post-op hours the same way – idiot!
To my surprise, Mr R pops in about half an hour before my op, confirming the time I will go down. Soon a theatre nurse arrives and walks me the short distance. I think of Shakespeare’s Cleopatra and her women preparing for death – Iras and her “Finish good lady, the bright day is done, and we are for the dark”! Honestly, I need to get a grip! But I am frightened of the anaesthetic. I am met by my nice anaesthetist and confess to my nerves. She and her team are kind during the short time I am awake with them. It’s hard to put myself on that trolley, to surrender myself completely to this process. I spare a thought for people preparing for riskier surgery, with much scarier possibilities, and for those unfamiliar with the anaesthetic room environment. I know what the equipment is, yet three people preparing me for the anaesthetic, applying blood pressure cuff and ECG sensors, cannulating me and getting me to the right place on the trolley, still feels scary. I indicate that I hate the oxygen mask, feeling claustrophic, and the anaesthetist releases the seal. Thankfully I am out of it quickly – what a mercy!
I wake at about 4, in the recovery room, and take in a nurse by the bed, but feel pretty out of it. Mr R visits and I am able to engage my brain enough to listen to him telling me that it has been a bit tricky but that he’s happy with the result. He asks me to smile, checking no damage to my facial nerve. I’m happy to oblige! All is well.
It is only later that I think about the fact that someone has put my glasses on me and my hearing aid into my non-implanted ear, so they were in place when I woke up. THANK YOU!
I am wheeled for a head x-ray, as is standard, then back to my room. I feel groggy, but not sick, not dizzy and no tinnitus, which were all possible after-effects. Hurrah! It’s not long before I am enjoying a pot of tea – yes a pot! It’s hot too. And then another, with biscuits. I am very happy about this! Before 7pm, I’m ready to leave, clutching antibiotics and painkillers, a sick note and post-op information, and kind friends come to pick me up. The evening sky looks as magnificent as the morning’s and I am filled with relief, gratitude and hope as I head home. So begins my recovery. I’m off-balance, staggering a bit, and feeling groggy still. I’m told I may take a week to feel normal. But I’m home!
Things that surprised me
- My relative fear of anaesthesia compared with surgery. I think this may be to do with the fact that you have to actively engage with having an anaesthetic, give yourself over to it. As far as I know, too, there remains some mystery around anaesthesia, with the exact mechanisms involved unclear. I’ve never been entirely keen on the whole business of sleep either. Being unconscious… hmm.
- The difference between waking from sleep (I am someone who is fully awake straight away and raring to go) and waking from an anaesthetic. Brain fog!
- No bandage after surgery. I had been led to expect that and had thought this might be a barrier to wearing glasses or my hearing aid in the recovery room. There is no wound dressing – just steristrips over dissolvable sutures.
- I’ve no idea what’s in my hair but it hasn’t been this stiff since the 1980s. I can’t wash it for a week so I’ll have to put up with it!
Things that made a positive difference to me
- Communication, communication, communication. So often, things come back to this don’t they? Especially when it comes to the difference between a good or bad experience. This was good throughout. Everyone made adjustments for my deafness, including removing masks. They told me their names and roles, gave me appropriate and timely information, listened, checked understanding and invited questions, and were friendly and kind.
- Having my hearing aid(s) and glasses for as much time as possible really mattered to me and everyone took this on. This may seem a small thing but it was a big thing to me.
- Having Wifi! Being able to exchange messages with people really helped during the hours of waiting and meant that I could reassure my family that I was back from theatre afterwards. (I’ve got data but some hospital areas are digital wastelands aren’t they?!)
- The tea! The biscuits!
- Kindness combined with efficiency – quite often there’s one without the other. Everything was really slick, meaning no wait for the drugs to take home, for example. The things I needed to take were ready by the time I was.
Things that could be better
It wasn’t ideal that the pre-op checks in the days before my surgery were done over the phone. However, I did have a follow-up email from the pre-op assessment specialist nurse after her call, with the information she needed to give me and an apology for not being able to see me in person, as would have been the case pre-pandemic. As it was, my daughter was able to take the call (and another asking about Covid-related things) and we had quite a jolly time of it. For instance, in answer to a question about how far I could walk, she toyed with saying 30 miles (!) before settling on “well, really far.” At which point I interjected, “yes I can walk to theatre!” It is fortunate that I live with others who can take a call for me and relay questions and answers, but I wonder what happens to those who don’t? Surely, with all the communications means that many of us have at our disposal, alternatives could be offered?
All in all, I have had a really good experience of surgery, and I am so relieved to be onto the next stage of my hearing journey. With the internal parts of the implant now in place, the next thing will be an appointment (in about two weeks) to receive the external parts and to be switched on. Watch this space!