There comes a point in most movies, late in the first act, when protagonists are forced to consider a difficult course of action that has been presented to them. Blake Snyder, a deceased screenwriter and author, called this section of story “The Debate,” as the protagonist is literally debating what should be done about his/her problem. According to Joseph Campbell’s “The Hero’s Journey” paradigm, in this same section of story, a character often “refuses the call to action.” Most human beings (and good fictional characters who seem like real human beings) resist change at first, shy away from fearful things, and tend to do everything possible to avoid leaving their ordinary world. People do not typically fling themselves into the unknown until the stakes are significantly high at a moment of no return; a situation where there is no longer any choice as to what they must do. If my SCDS journey were a screenplay, I’d be right in the heart of “the debate” and “refusing the call.”
I just got off the phone with my surgeon, Dr. Wiet, and wanted to get the gist of our conversation down before it slips away and out of the hole in my head. He’s a very honest man, a straight-shooter, and I trust he has my best interest at heart.
I told him that with the aid of the valium, I’ve been able exercise, shovel snow, and write. I still hear my heartbeat in my ear and have brief swoons of slight dizziness (mostly at the computer — which is where I spend much of my working life), but there has been a tremendous improvement in my quality of life on this drug. It’s a very small dose taken once a day before bed. So why have my head cracked open?
I know I’ve had bad, bad times with this syndrome, and I can remember some of them well, but the risks with surgery are total loss of hearing in the right ear, increased tinnitus, and the chance that nothing gets better and only gets worse. Doctor Wiet has told me in no uncertain terms that those are possible outcomes. Not to mention a long, painful recovery of up to six weeks or more. And yet, there is a stronger chance, in his mind, for full, symptom-free recovery. His concern for me, and his reasoning that I should do the surgery now, stems from the fact that my right tegmen, the shelf that upholds the brain, looks like a sieve on film, when in fact it should it be solid bone. He believes that eventually it will completely collapse and create a spinal fluid leak which will necessitate an emergency surgery with the potential for more complications. He also feels my 3mm superior canal dehiscence (which is a significant size in his opinion) will only grow with time, exacerbating my current symptoms.
The less invasive “transmastoid approach” is not an option for me given the degeneration of the tegmen.
From what I’ve been reading online, most people feel their lives improve after surgery, but many of them have suffered some complications from the process. In addition to hearing loss, increased tinnitus, and incomplete restoration of balance, some people have had nerve damage to their facial muscles, and some experience long-term pain at the surgery site, caused by the titanium plates used to fuse the skull back together.
So…I’ve actually gone off the valium in hopes of feeling bad to remind myself why this is necessary. The drug has 72 hour half-life. I’m half way there at this point and still feel relatively good. It’s stupid, isn’t it, to be trying to induce debilitating symptoms? I just feel that if I can have a bad episode and be reminded of how it feels, then I’ll feel better about the surgery. I’m trying to raise my own stakes in order to end the debate and accept my call to action! If anyone who knows me well is reading this and remembers how bad I seemed to feel or look in any given moment , please tell me, from your point of view, what you saw or heard. It will help me to know how I seemed to others.
Oh, and if anybody has a time machine or crystal ball I can borrow, I’d be much obliged. I asked for a new head for Christmas, but I suppose Santa’s Elves haven’t perfected that technology yet.