Van Gogh Was Right

CATScan Results

2005-08-15T10:27:00.000-05:00

You know when you get a call from a doctor's office right after some exam was done that the results can go either way. Good or bad. I got a call from my surgeons office the day after my CT Scan last week and since I was not home there was a message on my voicemail that revealed nothing. Just call back as soon as I can. So I waited a few minutes and prepared myself for what might be bad news, then called. The nurse told me straight up that the CT Scan was normal and that despite my recurring head pain I am essentially normal. Whooo Hoooo

No more packing in there any more.

The one oddball thing that will continue to be a "problem" for the rest of my life are my disfunctioning estacheon tubes. In a normal ear the tube drains fluid and opens the air pockets from the ear to the throat a couple times an hour or more. In my ears they don't do it themselves at all. I have to snap my jaw every 30 minutes or so to clear the tube. It's a wierd feeling but one that I am now used to doing. I try not to let anyone see me do it since I look alot like a creepshow monster when I snap my jaw open.

Things are looking up.

All for now.

Love To Everybody

Email from a very dear friend and my answers...An Update

2005-08-11T18:59:00.000-05:00

My dear friend Babette wrote me and wanted to know what was up. Here are the questions and answers...

Hi Jimmy,

Let me know what the doctor says about your headaches....I did not know you were having such problems still. I am very sorry to hear this.

He told me the same thing as last time...neuralgia...the reconnected verve endings on that side of my head where the operation was are still sending pain messages to my brain and then they shoot out all over the left side. I sometimes forget things now...he retold me the whole story and told me it could take some time for the pain to go away. I had stopped taking two 600 motrins a day about 3 weeks ago. I was afraid of screwing up my kidneys. Thompson told me today that motrin at that dose for a person my size is OK. So back to the motrin. I have been taking the neurontin off and on the whole time. Now he wants me to take 2 in the morning and 2 in the evening. Even though it makes me tired it DOES work. Speaking of sleep...I haven't slept more then 3 or 4 hours at a time since the operation. I have not been able to use my bipap machine hardly at all, first because I couldn't...it may have blown out my new ear drum if I had used it. Later as everything was healing up I tried to use it and found that since my nasal septum was rebuilt, the air passages are much more wide open than they were with my old "twisted" nose. It feels like a jet engine now blowing up my nose. So another sleep study has to be done to determine how much my settings need to be decreased.

Are you still having the white noise?

The white noise and tinitus have decreased markedly. Just a faint shhhhhhh sound now. All the packing is now out which is a miracle. There must have been a pound of the stuff in there to start with.

Have you had a lot of memory loss? This also is a worry I have.

Not so much memory loss but there are some significant cognitive pauses sometimes when I am speaking. I just stop for a second, think, then start talking again. As if my brain sometimes can't keep up with what I want to say.

Are you working at all?

Selling on ebay. Want to buy something?

Teaching?

Still doing lessons on Saturdays

Any gigs?

Playing 5 gigs a month average. Two with ORB and two or three with CB.

Are you going to start school soon?

School's on hold until I can establish more routine sleeping habits.

Sorry to bug you so much....I would like to sit down for a cup of coffee and chat with you, only if we had the time.

Coffee anytime. Decaf though.

Please keep in touch

Babs

I will. Thanks for the mail!

Much Love,

Jimmy

Honorariuminus?

2005-07-16T06:36:00.000-05:00

I've been asked to start posting on The Liberal Avenger which is currently my favorite spot to follow centrist and liberal thought.

Check it out.

I am Jimmy26YrVet there.

2005-07-15T08:00:00.000-05:00

Band Logo

2005-07-15T07:59:00.000-05:00

The Crew

2005-07-15T07:53:00.000-05:00

The Boss

Birthday & Band Management

2005-07-15T07:32:00.000-05:00

I have over the past years minimized the importance of my birthday. I figure why remind myself of the fact that my journey is at its midway point? My three sisters and my brother have slowly over the past years minimized this as well by not calling me, nor I them, when our birthdays occur. I do usually go do something nice for myself or make an impulse buy on July 14th. Something for myself that I dig. This year it was a San Diego Padre fitted baseball cap. Now if I could just get used to turning it backward like everyone else is wearing ball caps now. So, everyone 45 years or older...do something nice for yourself on your birthday.

Don't Think You Can't Be Replaced

It's obvious to me that the reason most well paid bands have a manager. When a majority of a band run in a democratic or even federalist way decide that someone is not working out, the manager does the dirty work and fires the offending person. The reasons can be many and varied. Booze, drugs, refusing to show up for rehearsal, no transportation, playing poorly, offending the crowd...these are just some of the reasons you might get shit canned from the band you are with. As the leader of a band that does make pretty good bread at most gigs I decided early on that it is my job to hire and fire. It's not happening all the time and I really do have deep respect and love for the people I play with. But as the boss I know, and so do they that if screw ups become chronic or if use of the chronic becomes a screw up, then the end of employment with my band is nearing its end. I don't like doing this nasty little job. Who would? I'll tell you who...managers. Band managers live for this type of thing. I hate it. My ability to evaluate the benefits and drawbacks of a specific firing are sound. I have pretty good common sense when it comes to this. The planning, reasons and motivation behind my decisions are sensical and real. It's just the bottom line that gets to me. I have to call or meet with the offender and solve the problem. It's not a big deal once it is done but I do oh so hate giving someone the axe.

Happy Birthday To Me!

On St. John's Road

2005-06-12T06:47:00.000-05:00

I have been paying the mortgage on my house now for three years. Notice I did not say I have owned my house for three years. The bank holds the note right? And if I don't pay they throw my ass out in the street. The payment is a bit stiff for a middle class liberal but it's a 15 year loan and we throw a little extra scratch at it every month to push down the principal. Something I alway wanted to do in high school by the way.

In the Highland neighborhood in Austin there is a veritable fruit salad of races, colors and creeds. We all get along pretty well. There are a few violent crimes around here and the majority that happen are either drug dealers on the street or domestic violence cases. The numbers are low on these and have been continually decreasing over the past months. Thanks in good part to the poepoe cruising the area. Yes we have to thank our men in blue. But there is something else happening out there. I see it every day. People are not ignoring each other. And this is making my side of town a much more pleasant place to be. Is this something to look forward to? Is there a move towards massive societal caring of one another, more forgiving, more diverse friendships, more moderate thinking?

I found early on that Austin is and always has been a bastion of free thinkers, humanists, liberal students and teachers and many many dems with a few right siders along for the ride. Redistricting by the senator from Texas has carved up this for the sake of the repubs and really only benefitted them. But Austin stays dem and it drives the right nutty. Which with everything going on is great...we all need more things to be cheerful about.

It just makes me wonder...are things starting to get better? Even in the face of daily death of Americans in a war that a vast majority of us disagree with now. Or is this the motivating factor?

I don't claim to have my finger on the pulse of US attitudes but I do know a little about my street and the people that live on and near it.

1901 German Lowendall Full Size Violin

2005-06-04T08:35:00.000-05:00

Here's the 1901 Lowendall Violin after all the cleaning, etc. from the luthier. I love that word...Luthier. Sounds alot more romantic than "Repair Guy" doesn't it?

I've Got To Admit It's Getting Better

2005-06-04T08:09:00.000-05:00

I never pass up a chance to relate to others by quoting a Beatles tune, thus the title.

My back has loosened up and my ear has only about a quarter inch of outer packing left. The ringing and white noise in my ear has decreased first from a 747 jet engine to a Lear jet engine to now a medium size Sakorsky helicpter jet engine. Each bit of packing pulled out, each bit of gel foam absorbed into my dome decreases the noise suffering.

I haven't posted in over a week, partly because I have been busy (classic excuse) and partly because I just needed a break from the blogosphere. I have been hanging mostly at Salon.com (thanks to my son Ryan gifting me with a one year sub.). I've got to say this...that Salon is a way better source of info and editorial than my local fish wrap (the Austin American Statesman) and blows to hell any and all the cable news networks. I know that much of the coverage is wire produced but there certainly are more choices and numerous entertaining columns reported on Salon.

I haven't played a gig in a week...slowly getting back in to the leading/drumming/singing mode. Tonight I play with a 7 piece band as the leader (left right left right) and singer at a wedding at one of the best BBQ places in the world the Salt Lick but after speaking with the nervous wedding planner I found out it's not going to be a BBQ dinner at the wedding. Damn, I was looking forward to ripping tender morsels off of the bone tonight. Instead it's probably going to be salad, chops and water. It's from 8 to 11 so the gig ought to be smooth and easy. The wedding planner emailed me an 8 page excell file with all the wedding details. Talk about efficient. One fourth of one page pertains to me. Hell, I don't need to know when the garter gets put on or when the bride gets her make up or when the groom gets dressed. Just tell me when to start playing. Which of course she did.

If you've been following you know I am selling a violin for a friend of a friend. I had about 350 bucks of work done on it and now it's ready to sell. It's on Craigslist and also posted to Usedviolins.com and I expect plenty of people to check out the pictures which are here at webshots. Gee whiz what a fine violin. The repair guy and 2 othe teachers at the shop played it and didn't want it to leave. I was told not to take less than 2K for the instrument. Nice commission on this one when I get it sold.

That completes the roundup in my life for now. Back to Salon.

And Now My Back?

2005-05-25T05:53:00.000-05:00

I played a gig Saturday night with Casey Just who is pretty much the top Psycho-Billy guitarist in town. I did his CD with him a year ago and since have been doing gigs here and there with him since then. Of course six weeks of letting my ear heal meant that I wasn't playing many jobs. This means I wasn't moving my gear around on a regular basis. So when I took my stuff home after the gig I noticed a twitch and a pain in my lower back. When I got up the next day sure enough I pinched one or two nerves in my lower back and since then I've had to deal with a new pain. My back. Is this a bad year for me physically or what? My next job is coming up this coming Saturday again with casey but it looks like I won't be able to help move gear at all. To top this little vignette off I am supplying the PA for the gig as well. I have a large Mackie PA system that weighs a ton. So Casey and the bass player Gary are coming over way before the gig starts to move all my stuff. Yay! In the mean time I am going to be doing stretches, taking Motrin and drinking lots of water to try and heal up my acheing back.

Jeeez.

"NAME THAT INSTRUMENT"

2005-05-23T08:49:00.000-05:00

I'm only showing the back of this right now because ladies and gentlemen...."It's I.D. The Instrument Day here on VanGogh Was Right." You name it right and you still don't get it. You will recieve though a custom extra large T-Shirt from one of the bands I play in or one of the tours I've been on. You need to note in your comment more than what KIND of instrument it is. We all know that one. Rather you must name the date produced and the maker! Good luck!

Good News From The Front (And Back)

2005-05-20T18:00:00.000-05:00

The hearing now is improving. Slowly. The buzz is still there but markedly less than just days ago. I am now decided that the reason for the big buzz and roar I was dealing with was the amount of packing in both the inner and outer canals. Since Dr. Supersurgeon started taking out the outer packing (you would not believe how much of this stuff is in the outer canal) I have really started hearing in my left ear again! WoooHoooo! When exposed to large noises the roar increases but after getting in a quiet envirnment again it decreases again. So I am hoping that as the packing is removed (the rest is due out in 2 weeks) and the packing in the inner ear is absorbed into my body then the hearing will increase and hopefully get back to where it once was. Even close to that would be a hoot.

I have 9 gigs coming up in June, three of which are long money where I am the leader. So I believe I will be ready for them!

Forward I go.

Forward!

2005-05-18T10:53:00.000-05:00

Here's a microscopic look at the inside of my ear before the surgery.

It actually happened at a festival I played in Oregon some time ago. Some of the pranksters were there and well....you see the results.

Best Checkup Yet. Ouch!

2005-05-18T10:11:00.000-05:00

Had my checkup with the surgeon yesterday and things went very well.

I sat in the magic ear exam chair and he whipped hic microscope around and took a good look at things. The first thing he did was ask me why there was a piece of cotton ball jammed up in my ear. I guess when I changed it I pulled the old cotton wad out and left some of it behind because there it was. He was pretty impressed with that. He got his torture device and started pulling out pieces of the packing in the outer canal. The last time in he took out the first third of it. Now he would go for a little bit more than a third more. This stuff is small and comes out a few micro pieces at a time. My outer canal was rebuilt during the surgery (I found out about that yesterday). The area he was removing stuff from had some granuloma and he saw a bit of an infection under the new skin right near the ear drum. The drops I am using will hopefully clear these minor things up. Otherwise it looks great in there. And best of all there was some actual clear hearing in the ear. There's still quite a bit of packing but that ear is working my friends and is way louder than it was 2 days ago. Now the bad news. The jet engine sound is still there but it's a much smaller aircraft. Still a C Major chord but lower freqs. Still pretty high though. Less intense and maybe 50% less db. So better but bad on the tinnitus front. The pain is still there and gone sometimes but less intense. Motrin 600 every once in a while. Eh, maybe every 10 hours or so.

I played a rehersal with Casey Just (Psychofunkabillyjazznick guitarist/vocalist) for a 1 hour showcase he's doing at Emo's on Saturday. 9:00 and a small cover for the whole night at Emo's. Hell, if you show up tell them you're on Casey's list and have them come get me (Jimmy). In Free. We kept the overall db to a way minimum during the rehersal. What I plan on doing at the gig is keep the monitor pretty f*@*#*% low and I'll wear semi-closed phones (and get this) a big skie cap over that. I tried it on and I look like Rasta Drummer. Cool. I'll lay back too and let the sticks to the work. No sense in banging away senselessly.

And so it goes.

Things are beginning to look up a bit.

2005-05-17T06:47:00.000-05:00

I've been spending alot of time right here on my butt writing.

2005-05-17T06:43:00.000-05:00

On a lighter note, here are some of my drums. These are my favorites to play right now. They were economical and US made so that's part of why I dig them. They look like Ringo's old kit too even though they were built in 2001. Ludwig makes the best drums for the money right now in a USA made kit, bar none. All my other stuff has been temporarily put away in favor of these.

No I Do Not Play Drums In A Civil War Reinactment Group

2005-05-17T06:35:00.000-05:00

This picture was taken the night after the first surgery was done. I took it to send to my surgeon by email to ask him why there was so much drainage coming out on the dressing. His answer was - "It's not supposed to do that. Let's see you first thing in the morning and do the surgery again."

My reaction? Wooooo Hooooo!

Biggy Dayo

2005-05-17T06:24:00.000-05:00

Today I see the surgeon for possible removal of the outer canal dressing which for the past 5 weeks has been pretty much jammed into my ear and up against the new and improved sinus removed tympanic membrane (ear drum for us regular folks). So what's the deal with this new drum anyway? I know I have a spot up the left nostril of my nose that has had tissue removed. But was it like thinned out on a deli meat saw or what? I've got hair in my nostrils, growing like weeds at my advanced age and all I can think about is hair growing inside my inner ear. I guess the parts he took out of my sinus were hair free. At least I can hope that. I'll fill everyone in here on the blog later today.

Emotionally Unstable?

2005-05-16T16:54:00.000-05:00

I had an appointment with the very nice General Practitioner (as opposed to the Colonel Practitioner) and I kind of lost it in the exam room. It was the first time I had seen him since the surgery over 5 weeks ago. He had all kinds of questions about how it went and how I was. I told him my family was getting kind of tired of me being stressed out and angry alot of the time. He told me I was under alot of stress and that's one way people deal with is take it out on others. Well no shitzky. I was completely aware of that even though I could not reflect on it well when I was actually angry and taking it out on others. I told him I was very tired of the jet noise in my dome and if he could I would really appreciate something that would help calm me down. Xanax it was then. I'm now pretty muchignoring the noise in my head and just endjoying the decrease in my stressed out mood. No wonder people get addicted to this stuff. So it goes.

Drumming Did Not Cause It

2005-05-15T16:44:00.000-05:00

I was on the road with W.C. Clark when this picture was taken a little over 2 years ago. We were playing a radio show on PBS while in Lexington, Kentucky. Woodsongs Old Time Radio Hour. I have thought long and hard about how drumming has effected my hearing and ya I am half deaf in the right ear and now who knows what the left ear will eventually be. Hearing aids are in my future without a ding dang doubt. But drumming is not the biggest culprit here. It's the illness on the left side that got cut out of me. It's the hundreds of ear infections I have had in that ear over the past 20 odd years. It's my body's fault. But not fully drumming's fault. I'll live to play again and protect what little or big amount of hearing I end up with on the left side. That was my good ear you know. I had 80% hearing in that ear that was so messed up. Now it's going to get healthy again but who really knows what will be left in the jearing department.

Ryan

2005-05-15T16:30:00.000-05:00

As advertised here is one of my favorite pictures of Ryan from about two years ago. This is from his commencement at The College of Charleston, Charleston SC. Cool tux eh? They don't wear gowns there. Tuxes and evening dresses for the ladies. Ryan graduated with a degree in Mathematics and another in Chemistry (Magna Cum Laude to boot - hence the medal he's wearing) and finished them both in 4 years. Quite the schollar. He's now in graduate school getting his PhD in Theoretical Quantum Chemistry at Indiana Bloomington. His specialty is nano tech and yes, he will control the world one day. At least his small portion of it!

I Blame My Son Ryan

2005-05-15T16:09:00.000-05:00

I must say that I blame my son Ryan for getting this Blog started. I'm not blaming him for the surgery of course. He's filled me in on the how to's and the where fore's. Even directed me to hello.com where you can upload pictures from your hard drive right to the Blog. So basically the picture is his fault. I still love him though. I love him so much that I think I'll post a picture of him after I get done with this post.

Today has been a pain. Basically because I ran out of my neurontin 2 days ago. This is a neuropathic medication that helps take the edge off the pain by limiting the number of impulses from something painful to pain central which of course is the brain. I was taking a bit more of it than I was instructed to and sure enough ran out before the refill could be done. At this point I have to thank my wife for going to the pharmacy and practically begging them for a couple more capsules to get me through tonight. Then tomorrow I will go and refill it all the way. This stuff really does work and I have been following the instructions the last couple weeks. It was earlier on in my healing that I felt I needed more of them. Especially after I stopped taking the narcotic pain reliever. There were a couple days after that that I really thought I was losing it. What it really was though was my body going through vicodin withdrawl after using it for 3 weeks. The body does get oh so used to the feeling of a good pain reliever. So I've got enough neurontin now thanks to Carol who went begging at the pharmacy like I was some kind of head case addict needing some shiznit to get through the day.

Oh the miracles of modern medicine never fail to depress me.

Cut!

2005-05-15T15:59:00.000-05:00

My incision the day after the second surgery. Man this is gross looking.

Tinnitus Message Board

2005-05-15T12:27:00.000-05:00

Here's a site I found after googling for a tinnitus related message board. It is chock full of interesting information and some very nice people as well. You'll have to register to post but not to read.Just copy & paste: http://p080.ezboard.com/btinnitussupport92262

Cmaj+9+11

2005-05-15T09:29:00.000-05:00

I went out and saw my first film since the operation(s). I really enjoyed CRASH. It brings out and shows alot of the darkness we all carry around. The racism, anger, denial, suspicion, paranoia we experience sometimes when we narrow our look at someone. The semi-crooked cop played by Matt Dillon is exceptional as is the entire cast. This ones worth seeing, buying on DVD and watching once per month (once a week for some rednecks I know). Then "We would really...all just get along." Crash is what you do with a particular size cymbal on a drum kit as well. Drumming is everywhere.
Temper Temper There Mr. Fenno
"Here's my problem doc. I have this chord. It's in my ear. It is my buddy. It is now living inside my brain being produced by a really angry ottic nerve. It's kind of a cool. Cmaj7 sus9 sus11, but see it's about three octaves above the highest C chord on a western piano. Whenever someone talks to me or there is a loud sound nearby it wants to play and be heard. And playing my drums and singing, well unless the money's good it really makes no sense to suffer now does it?", the patient raising his voice in anger."No gigs no money doc. No respect for myself. So when the hell is this NOISE GOING TO STOP?!?"
"Temper, temper there Mr. Fenno. I understand your feelings completely. They are common after a surgery like that and you are right you have some painful days and weeks ahead of you. Now about this temper. Has this been a problem all yur life?
Said the patient, "No not really. Not unless someone drives me to anger by doing something offensive or potentially violent towards me. That I think is why the temper is bad and believe me, can get preetty DARN NASTY ARGGGGHHHH sometimes."
"I see. Well there is this little pill I can give you that will help calm things down for you. What was the name of the pharmacy you use?"

Let's Think Clearly Now

2005-05-13T09:07:00.000-05:00

I know there are things going on in the world that make my experiences noted here a little less severe. People getting killed for no reason. Our sons, daughters, mothers and fathers in a far away land doing the best they can to stay alive. Some failing. It's just a very tough thing I have been dealing with and I thought maybe, just maybe there would be someone out there that could use some info on what I have been through. So that's that.

Happy & Stupid

2005-05-13T06:03:00.000-05:00

This was written while I was high on pain pills. I read it and could not believe my eyes. Just terrible. This one is deleted. Don't worry, you didn't miss a thing.

Is This Running In The Family?

2005-05-13T05:49:00.000-05:00

My full grown nephew Noah has had some similar ear problems over the much shorter course of his life and has some fears about going through what i have...

email from Noah to me Early February 2005

Uncle Jimmy,

this story just continues to scare the fuck out of me

:D

i'm very very glad that you're doing better and that
your noodle and its associated juices are staying
inside your skull where it should be. we'll see what
your hearing is like in a few more weeks.

i'm going to have *my8 ENT visit #1 on May 16 to see
what's up with my left ear. my situation is far
younger than yours (my problems started up in October
2003) so i'm hoping the root issues of my infections,
drainage, etc. are far less dramatic.

stay well, uncle jimmy nad let me know if there's
anything i can do for you from afar!

Believe me I told him, I am here for him if he needs me . We talked for hours on the phone about how it really came down and how I was doing. He wanted to know everything efore talking with the surgeon he was going to, Smart kid. He's going to go a long way.

It's Chew You Know

2005-05-13T05:26:00.000-05:00

What got me to the point that I found someone to actually work on my left ear was the fact that a bass player I play with is one of the top allergists in the state. He taught me ways of circumventing the HMO and advised me that the best way to get them to go for the doctor I wanted and that he thought I needed was to have the GP or himself refer me to him. Dr. Thompson - the top Otolaryngological surgeon bar none was the guy I wanted. Bill made sure I knew and that I knew ways of getting around the docs that the HMO wanted me to use. Just for fun he contacted Dr. T and asked, just to make sure that he would accept my insurance. The answer was basically "anything for you Bill". Not "I would love to see this patient" or "I can really help him". Nothing like that. What it boiled down to was one doctor knowing another and the other way around and a favor here and there and budda bing budda boom I was in man. Another temporary acceptance issue. That's me...Mr. Temporary.

I had begun even then to have some really nasty and smell inflamation in my ear. It wasn't like the many infections I had. Nothing was doing anything to really get rid of the pain and inflamation I was suffering by now. the only thing that really kept me going was the fact that soon I would see the surgeon.

Looking back on these mails now it is so obvious to me that our health care system is in shambles. My insurance is not the best in the world. But we do have it. It's inexpensive and the prescription drug benefits are tremendous. The thing is my wife and I had to devote 26 years of our lives to the military, retire and pay the sign up fee plus a little bit more each year and we are covered. Not the best but at least we have it.

Left to their own devices and with no one to turn to to help me get in to the top doctor I so badly needed to see I would have never been able to do it. Without some political action by Bill I would still be seeing Dr. Headuphisass and getting nothing done. Be careful who you do not know when you go to get something like this done.

In The Beginning

2005-05-12T13:10:00.000-05:00

This is long, so if you don't have the time or the interest, see ya. Don't worry it won't hurt my feelings any more than they already are.

What Lead To My Brain Being Fixed

After 20 plus years of chronich left inner ear infections, sometimes occuring as much as twice per month, I began to wonder if the doctors were doing the right thing. After 2 decades (yes...20 + years) I began demanding from my ever changing general practitioner to get an ENT referral (not too enthusiastic about this, the doctor de jur turned down the request as he thought the HMO would refuse such an "unneeded referral"). So I went along with this for a couple more infections in a long history of infections, then demanded to see the g. practitioner's boss who after reading through the records (these records were 2 years old - the amount of time I had been being seen at this particular dead from the neck up clinic) and he demanded the internal medicine resident (my seventh GP in 20 years) to document the referral and get "the patient" to an ENT doctor ASAP. Wow, results from a decent doctor - "the patient" was so surprised!

THE FIRST ENT SPECIALIST

At the first ENT evaluation a CAT scan as well as an MRI of the chronically infected ear and left side of the head was done. A microscopic exam of the external ear canal was done and a pretty large hole (but currently apperantly uninfected) in the left ear drum was seen. The CAT scan and MRI also revealed some rather nasty infections in the left inner ear involving the mastoid bone, the bones of the ear and a rather large cholesteatoma (big old skin tag that grows off the inside of the ear drum - oh yay!) was attached to the inner ear drum. This well meaning but now surprised and upset ENT specialist wondered why things were so bad for so long. She reported back to the GP and the HMO of the startling and rather upsetting results. At this point I was told by the friendly ENT on the phone that she was unable to do any type of surgery to the ear as she was "not comfortable" with this procedure since she did not have the skill to do it nor the desire to possibly make me deaf on that side. Despite all this she was very happy we found this terribly upsetting disease which was about to begin eating my brain. Needless to say the patient (gee - I like writing in the third person singular - makes me feel kind of like a real writer - excuse me if I keep referring to myself as "the patient") was "not comfortable" with keeping the ear problems forever and wondered out loud who he would see next. My non motivated doctor of the day did some searching and a week later said there were no specialists in Austin and that I should go to San Antonio to get it done. That didn't excite me a bit. The patient wanted to stay in Austin. He told this to his now very nice and recently law suit avoiding and friendly GP, the head GP at Massive Incompetent HMO Clinic, Inc. that had been "treating" me for the past 2 years. So it came down from on high yet another week later that he would not travel to the city of the Alamo - ney - he would remain in Austin and see yet another ENT doctor, chosen this time by the friendly HMO, who he would soon learn should never ever (did I say never ever?) choose a doctor for you.

ENT NUMBER 2

ENT DR. NO. 2 looked over the evidence, CAT scan, MRI, notes from un motivated ENT and my GP's referral and did his own microscopic (with resulting cool photo) exam of the ear. After a quicky exam the new and obviously young (and rather curt) ENT doctor told the patient that "Many people live their entire life with a cholesteatoma", and that he thought "Surgery would do more harm than good". The patient reported to himself that at this point he knew things were just not going to work out with this new-fangled board certified ENT Dr. with the cool photographic micro examining tool and cheap ass office. The patient was told he was a very bad surgical choice as he has type II diabetese and was overweight and at age 46 that "bad things could happen". The patient was quite sure that "bad things were already fucking happening". The "rudey poop specialist ENT" (my new nickname for dr. asshole) spent alot of time ridiculing the patient and hurting the patient's self confidence by telling him he was such a bad risk for surgery htta no one would want to do it. At no time did dr. asswipe tell the patient that the condition of the ear was severe enough that it could lead to even more nasty results (including brain absess and death) if left alone and not done at all. In other words dr. assmonkey, ENT did not want to do the surgery either. DFr. wildly incompetent sent the patient home with ear drops. The patient over the next week decided to refuse to see him again. Eventually dr. knownothing sent the patient a certified letter telling the patient he needed to come back in and get some mistreatment again. The patient sent his own letter back him telling dr. certified mail that he was seeing a new doctor now and thanks alot.

NOW WHAT?

It was at this point that the patient (I love the sound of that) was not only fed up with the two ENTs he had seen in the past 7 months, he was also totally fed up with the poor care and ever changing doctors assigned to his regular family case by his general generally bad general practice clinic. It was at this point that the Grand Poobah MD Generalized Practice Doctor took me over from his ever failing underlings who had been misdiagnosing my ear problems for two years. It was the best of times, it was the worst of earaches. Frankly it was time for the patient to get a new clinic with a better doctor.

Finding a new high quality general practice doctor that would accept his cheapass HMO was quite the challenge. Ultimately why it worked out for him was the fact that he;

1) was a musician

2) A rock band he played in actually had a doctor as the bass player

-and-

3) he (the patient that is) was able to meet the new GP (Doctor) through the bass player (Doctor) who talked the chosen GP (Doctor) into temporarily accepting the HMO (Cheapass Medical Inc.) and then quickly let the HMO know he wold not be accepting new patients any more right after he accepted the patient. Wheeew.

After the acceptance (and quick ending to acceptance of anyone else) never more would another patient with Cheapass, Inc. be accepted by this high money GP. It really is who you know you know.

TREAT ME RIGHT

So what happened right after changing doctors by our patient was a full scale physical exam which revealed again chronic infections of the left and now the right ear. All other physical problems (the type 2 diabetes and weight problems being the most severe) were under control. The patient had lost nearly 50 pounds in the last 2 years and his diabetes medicine HAD BEEN reduced, his blood pressure was under control with minimal medications, chest X-ray was clear despite years of smoking and an EKG in the new doctor's fancy office revealed no heart problems. There was though, a serious concern by the new and improved GP doctor about the results of the recent CAT SCAN & MRI and the reports from the 2 wonderful ENT assdoctors seen so far that felt there was "no way" either of them would do the surgery. A new specialist (this one an Otolaryngology ENT Super-Duper Specialist) was referred to for the case and agreed to see the patient (this doctor was recommended to the patient by the bass player (Doctor) and the patient's new GP (Doctor). Finally something good was allegedly about to happen. Something that might find out for sure that whether my left ear was ruined or maybe not. So far his hearing had been pretty good in the messed up ear. Early audio exams showed it at about 80% hearing and working well. So what was up with that? Obviously the cholesteatoma was there but what was making his hearing stay OK?

IT'S REALITY'S HEARING PROBLEM, NOT MINE

The new specialist was completely dumfounded that after all the infections, all the exams, all the infections, all the labs, the infections and the cool pictures taken and oh ya, the infections...that no decision was made to do the surgery the ear needed. DR. SUPERspecialist knew immediately what to do. Surgery was planned for 3 weeks ahead. Mind you...this was the third specialist seen in a year and a month and the first with the experience, confidence and ability to actually do the surgery. What a relief this was. Wheeew! And now some serious concerns about this operation. The patient read a bunch of material including descriptions of actual surgical procedures and those they happened to. Most results were stright up and successful. A bit of hearing loss here and there but overall nice post-operative conditions and a 2 to 3 week healing time. There the patient was with some major surgery just a few short weeks away.

SURGERY HAPPENS

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THE FIRST CUT IS THE SLEEPIEST

Anesthesiologists are comics with a scrub suit on. Our beloved patient had two different ones throughout this surgical experience and enjoyed their spirited joking during loss of conciousness. Well, the big date of surgery came. Both patient and surgeon very confident that things were going to go well. The patient was not worried much, as he knew to wait any longer would mean things getting much worse. He was also confident that he would not give a rat's ass anyway since he would be under general anesthesia during the entire time. The new third non-monkey-ass DR. SUPERspecialist was a pro at this surgery, having done many of them on both adults and children over the years. He did not however expect to see the most severe case he had ever seen in the patients head. The most nasty and dastirdly inner ear he had ever seen...and I mean EVER. The initial incision was uneventful, a cut from the top of the back of the ear to the bottom, then disconnect the muscle, cartilidge and some of the adipose tissues, then fold over the ear (and I mean the whole ear) and look right in the inner ear section to see what is wrong. What was wrong was terrible. The pusstulated area was emense. White fluid, tinted red and thick and a powerful odor of shit. What used to be the mastoid bone, which normally separates the inner ear from the dura (the flexible lining between the mastoid and the brain) was completely dark brown in color from years of infection and had basically been eaten up by bacteria. Mmmmm...yummy. The ear hole which passes the nerve from the brain to the bones of the ear was in similar shape. The dead and near dead parts of the bone were then cut and chiznizzled away. This widened the ear hole a smidge. The dura (remember that lining theat covers the brain from the skull?) had some significant leaks in it from pressure built up in the inner ear, pushing cerebral spinal fluid from the brain to the now expanded left inner ear cavity. To complicate matters and in fact to take us back to the original cause of all this, the cholesteatoma which was attached to the inner portion of the timpanic membrane was leaking enzymes in the large but popularly crowded inner ear. A cholesteatoma for those of you who don't know is a gathering of skin cells. As everyone knows, the skin is the largest organ you have (unless you have a Hammond B3) and the skin is very organically aggressive. All you have to do is exercise or have sex or do strong physical work to learn this. Smell your arm pits after a little action and you'll smell what the skin lets go of on a regular basis. Better smelling through enzymes. Well, this is the same assortment of fluids that the patient's cholesteatoma had been leaking for decades into the now pretty much destroyed inner ear. Further on in the surgery was a removal of the damaged ear drum and the cholesteatoma. A new ear drum was manufactured from cadaver (yep, dawn of the dead) parts from a very generous at room temperature person. The new drum was put in place. The bones of the inner ear which by some sort of miracle had not been destroyed over the years, were cleaned, rebuilt and reattached to the new ear drum on one side and the ottic nerve (another miracle saved this part of the system as well) on the other. Stability of the area was achieved by inserting a firm absorbable foam to keep things in place. You know, like that stuff you spray into cracks in your house only alot more expensive and organic. The left temporal lobe was sitting over the enlarged ear hole and what was left of the recently removed mastoid bone and had been pretty comfortable lounging there over the years. It was pushed back in to the skull and superdoc seeing no leaks in the dura this area was also stabalized with absorbable foam. At this point everything looked pretty much done. The entire inner ear had been cleaned up after a very intensive removal of bad stuff and a rebuild. The ear was flapped back over where it was before and sewed up with absorbable sutures. Lots of sutures. Lots and lots of sutures. In recovery the surgeon actually spoke with the patient but due to the patient being on the general anesthesia still but somehow looking awake and logical, the patient remembered absolutely nothing of the conversation. He later spoke with the recovery nurse and again with the doctor (by phone) about how he thought things went. Instructions were given to the patient. He was told to watch out for excessive leakage from both the outer ear canal and the incision now sutured up. A large dressing was put on making the patient look like he has a new gig drumming for a US Revolutionary war drama team. Pain meds, antibiotics, antibiotic cream for the incision...all these were perscribed and picked up. The patient went home and went to bed as bed rest was also ordered and it just seemed the right thing to do for the now post surgically ailing patient.

At 3 in the morning, about 12 hours since surgery the outer ear canal began to leak like a beaver damn during a flood. Brightly tinged pink fluid requiring half-hourly large dressing changes started. The patient and his wife (did I mention the patient was married?) called the surgeon who I believe then regretted giving the patient his personal cell phone number. He told the good wife to keep changing the dressing and to be at the office at 8 in the morning. The patient was there at eight and immediately another intensive surgery was sheduled for that afternoon. At this point the surgeon (a very nice and competent man by the way) was not sure where the fluid was coming from. The only way to figure it out was to cut the sutures and fold the ear back then go into the inner ear and look. Oh joy!

RECOVERY TAKES A DAY OFF

The second incision (which was just the first one with the sutures removed) did not take long to do. Find where the fluid was coming from was easy too. Sure enough it was cerebral spinal fluid mixed with a little blood. Here's what happened: The pressure from the absorbable foam against the pressure of the dura and brain from the left temporal lobe (which missed it's old home leaning over the ear hole on the sofa) began pushing over the new, improved and slightly larger cleaned up ear hole causing massive pressure on the dura from the temporal lobe of the brain, that began exprssing itself by leaking fluid from the brain through the dura right out and into the inner ear cavity, pushing away the recently added cadaver ear drum (sorry dead guy or girl) and causing a river of this fluid to run out of the outer ear canal and on to whatever the patient was standing or laying on. There was only one thing left to do. The area of the ear hole that was infected (over 20 years worth) and removed during the first surgey had to be rebuilt so as to not allow the brain to stick out at high pressure and ooze the nasty fluid. The cadaver ear drum was removed and sadly sent away for buriel or incineration or whatever they do with failed dead stuff. A new ear drum was cut from the patient's inner sinus. Up through the nose holes. Also some bone and cartilidge were removed from the sinus area as well and used to reconstruct and enlarge the ear hole and not allow the brain to stick out like it wanted to. The whole thing was again stabalized with the now well known "firm-a-foam" and the ear was again flapped back into place and sewn shut. The patient was again talked to by the surgeon in recovery and again it was quickly forgotten by the drugged up patient who appeared to understand what the surgeon was saying but clearly didn't know nor remember diddly-squat because he was too busy working off an IV shot of demerol that the recovery nurse had gratiously given him not 15 minutes before.

I love good nurses.

RECOVERY STARTS AGAIN

After discharge from the outpatient surgery center the patient went home again and experienced no more massive leaks. Small amounts (expected) of fluids still leaked out but were obsorbed by the dressing now in the ear. Stabalizing foam (inner) and dressings (outer ear canal) were in place as was the replaceable cotton ball that was on the outer ear opening. That was changed every 4 to 6 hours as the patient continued with vicodin for the pain which was pretty good because the pain was pretty bad. There were a couple leaks on the incision site but nothing too impressive. The patient is seeing the doctor for the second time today after nine days post op. It appears that the hearing in the left ear is intact although the ear is filled on the inside and out with foam and dressing to keep everything in place during the first month or more of healing. If no hearing loss is found it will be nothing less than a miracle. Some loss of hearing is usually associated with this whole damn thing.

LAB REPORTS

The only surprising results in the pathology reports (which have to be done any time anything is taken from a body during surgery) was the presence of brain neurons in the liquid leackage taken during the surgery. Also noted were pieces of diseased bone from the mastoid (now completely removed from the left side of the brain) and the original ear drum with the ever popular cholesteatoma attached (the cholesteatoma was as big as a good sized pea). No malignancy was found - no cancer. Hip Hip Hooooray!

REALITY

The most startling thing was the severity of the disease and the way it was never found. Twenty years of left inner ear infections diagnosed over 2 decades. The surgeon reported to the patient that if this had gone on for another 6 - 12 months the dura would have been permiated and a large absess of the left temporal lobe of the brain would have started. There is usually no happy ending to an absess like this. Death is rather quick and the pain although not as severe as say an absess on your tooth, is not a good thing. The surgeon saved the patient's life by finally doing the right thing.How do I know? I'm the patient.

That's the beginning folks. Lots more of this experience will be posted over the next weeks, months and hopefully if I am around, years.

Welcome

2005-05-12T13:06:00.000-05:00

Welcome folks. Make yourself a cheese sandwhich and pour a glass of organic milk and enjoy the ride. There's some spooky stuff ahead.