Re: Re: help - just had surgery

August 15, 2008

For what it's worth, I'd probably do this if I were in your situation. Go into the Emergency room tomorrow, and mention that you were sent home post op without instructions. Indicate that you believe that the bandages should come off the next day after surgery, but that since you were not given instruction, you want to have this done by an ENT doctor on duty.

Realistically, I think you're safe to take them off 24 hours after, but I am not a medical expert, hence the advice that you have one remove the bandages. If they perceive a risk, they'll probably tell you to wait till Monday when you can speak to the doctor first hand.

Incidentally, I agree with your assessment on nationalized health care. I originally come from the UK, and if I had not moved to the USA I am sure that I would have zero hearing by now because of the 2 cholesteatomas. It's not that the doctors in the USA are necessarily better than anywhere else, but the system here gives you one very important feature - choice. If you're well insured, you can pick the best surgeon. Clearly the downside is for those who are not fortunate enough to have insurance.

Good luck with the bandage situation. Incidentally, my head bandages both filled up with blood after the surgery, so as scary as it might appear, I think that's pretty normal.

From: jackiekylekatelyn <sjcolwell@...>Subject: Re: help - just had surgerycholesteatoma Date: Saturday, August 16, 2008, 12:57 AM

> >> > Hi everyone,> > > > I'm recovering from a radical mastoidectomy I just had this > > morning. This is my second surgery on the ear - this surgery being > > a more radical one, as the c-toma had already grown back in less > > than a year and a half.> > > > I was sent home from the hospital with my head totally wrapped in > > bandages/gauze/ packing. I must say it's quite attractive, > > especially since I have long hair, which is sticking out at all > > kinds of interesting angles! The packing has already soaked thru > > with blood and is draining

down the side of my face. As you can > > imagine, it's pretty disgusting. > > > > What I'm wondering is can I change this dressing and remove some of > > the bandages before my doctor appointment on Thurs. I wasn't able > > to talk to my doctor following the surgery, as he was already in > > another surgery by the time I woke up. Now he's unavailable for > the > > weekend. (And, yes, in Canada unavialable doctors are not unusual > > unfortunatly) . I'm really dreading spending the weekend with this > > (bloody) bandage draining constantly down my face and neck! Yuck!> > > > After my previous surgery, I had an incision in front of the ear > > with a smaller bandage, which just covered the ear, not the entire > > head. This time the incision is behind the ear.> > > > So I was just

wondering what experience others have had with this. > > Did you keep the bandages on all week? Were you able to change > them > > yourself? Any information and comments would be appreciated.> > > > Jackie> >>

August 16, 2008

Hi,

My doc took the bandage off two days later... i cannot believe they are still doing radical mastoidectomies ... it so unnecessary.

Good Luck!

From: dskempton <dskempton@...>Subject: Re: help - just had surgerycholesteatoma Date: Saturday, August 16, 2008, 12:29 AM

For both of my Cholesteatoma surgeries (one on each ear) the head bandage came off the following day (I got the doctors to do this, although for the second surgery he said I could do it myself if I preferred). It's unfortunate that your doctor didn't leave you with instructions though - since I think ultimately the advice should come from him.Good luck!>> Hi everyone,> > I'm recovering from a radical mastoidectomy I just had this > morning. This is my second surgery on the ear - this surgery being > a more radical one, as the c-toma had already grown back in less > than a year and a half.> > I was sent home from the hospital with my head totally wrapped in > bandages/gauze/

packing. I must say it's quite attractive, > especially since I have long hair, which is sticking out at all > kinds of interesting angles! The packing has already soaked thru > with blood and is draining down the side of my face. As you can > imagine, it's pretty disgusting. > > What I'm wondering is can I change this dressing and remove some of > the bandages before my doctor appointment on Thurs. I wasn't able > to talk to my doctor following the surgery, as he was already in > another surgery by the time I woke up. Now he's unavailable for the > weekend. (And, yes, in Canada unavialable doctors are not unusual > unfortunatly) . I'm really dreading spending the weekend with this > (bloody) bandage draining constantly down my face and neck! Yuck!> > After my previous surgery, I had an incision in front of the ear > with a smaller bandage, which

just covered the ear, not the entire > head. This time the incision is behind the ear.> > So I was just wondering what experience others have had with this. > Did you keep the bandages on all week? Were you able to change them > yourself? Any information and comments would be appreciated.> > Jackie>

August 18, 2008

Hi Amber & Jackie -

There are other alternatives to the Radical Mastoidectomy that may be

appropriate for some. I have posted before on the Reversible Canal Wall

Down Mastoidectomy (See below) that my son's surgeon did. The article

is old, but has info. about the procedure that more doctors in the US

are doing. I think that his surgeon said that this procedure was just

coming out in the medical text books??? My son has NO water

restrictions and anatomy of the ear is near normal. He has had no

reoccurance of Ctoma. He also had a cartilage graft (that

referred to in a post) that helps the ear drum so it doesn't retract.

Amber is this what you were referring to or do you know of another

procedure? Thanks, Judy

Reversible canal wall down tympanomastoidectomy: An alternative to

intact canal wall and canal wall down mastoidectomy procedures

Auteur(s) / Author(s)

MCELVEEN J. T. ^ (1) ; HULKA G. F.^ (2) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

^(1) Carolina Ear Research Institute, Raleigh, North Carolina, ETATS-UNIS

^(2) Duke University Medical Center, Durham, North Carolina, ETATS-UNIS

Résumé / Abstract

Objective: To avoid the limitations of canal wall down surgery yet

maintain the exposure provided by canal wall down mastoidectomy, the

authors have developed a completely reversible canal wall down

mastoidectomy technique. The purpose of this case report is to determine

the feasibility of the reversible canal wall down mastoidectomy

technique in the treatment of a patient with an aural cholesteatoma.

Study Design: Having refined the surgical technique using cadaver

temporal bones, the reversible canal wall down mastoidectomy was

performed in a patient with a recurrent aural cholesteatoma. Setting:

The surgical technique was refined in the Carolina Ear Research

Institute's temporal bone dissection lab. The patient underwent the

surgical procedure by JTM in a standard operating room setting at a

private hospital in Raleigh, North Carolina. Patients: The patient was a

private patient, referred to the Carolina Ear & Hearing Clinic for

treatment of recurrent cholesteatoma. Intervention: A reversible' canal

wall down mastoidectomy was performed in this patient. Main Outcome

Measures: The surgeon determined the adequacy of cholesteatoma exposure

following temporary removal of the posterior bony canal wall.

Intra-operatively, the surgeon assessed the repositioned posterior bony

canal segment, looking specifically at its stability and the absence of

gaps along the canal cuts. Results: Temporary removal of the posterior

bony canal wall improved exposure of the cholesteatoma and facilitated

cholesteatoma removal. The repositioned bony canal segment was well

stabilized by the bone cement (Oto-cem) and no gaps were noted along the

canal cuts. Conclusion: Although it is premature to compare the

effectiveness of the reversible' canal wall down technique to other

mastoidectomy procedures, this case confirms the feasibility of this

approach.

Revue / Journal Title

The American journal of otology *ISSN* 0192-9763 *CODEN* AJOTBN

Source / Source

1998, vol. 19, n^o 4, pp. 415-419 (12 ref.)

jackiekylekatelyn wrote:

>

> > >

> > > Hi everyone,

> > >

> > > I'm recovering from a radical mastoidectomy I just had this

> > > morning. This is my second surgery on the ear - this surgery

> being

> > > a more radical one, as the c-toma had already grown back in less

> > > than a year and a half.

> > >

> > > I was sent home from the hospital with my head totally wrapped

> in

> > > bandages/gauze/ packing. I must say it's quite attractive,

> > > especially since I have long hair, which is sticking out at all

> > > kinds of interesting angles! The packing has already soaked thru

> > > with blood and is draining down the side of my face. As you can

> > > imagine, it's pretty disgusting.

> > >

> > > What I'm wondering is can I change this dressing and remove some

> of

> > > the bandages before my doctor appointment on Thurs. I wasn't

> able

> > > to talk to my doctor following the surgery, as he was already in

> > > another surgery by the time I woke up. Now he's unavailable for

> > the

> > > weekend. (And, yes, in Canada unavialable doctors are not

> unusual

> > > unfortunatly) . I'm really dreading spending the weekend with

> this

> > > (bloody) bandage draining constantly down my face and neck! Yuck!

> > >

> > > After my previous surgery, I had an incision in front of the ear

> > > with a smaller bandage, which just covered the ear, not the

> entire

> > > head. This time the incision is behind the ear.

> > >

> > > So I was just wondering what experience others have had with

> this.

> > > Did you keep the bandages on all week? Were you able to change

> > them

> > > yourself? Any information and comments would be appreciated.

> > >

> > > Jackie

> > >

> >

>

August 18, 2008

There is also an article about this procedure in the Cholesteatoma book edited by Danner. If Chloe ever needs to go CWD, I am definitely going to talk more with our surgeon about this.

On Mon, Aug 18, 2008 at 1:41 PM, Judy Adkins <a2judyadkins@...> wrote:

Hi Amber & Jackie -There are other alternatives to the Radical Mastoidectomy that may beappropriate for some. I have posted before on the Reversible Canal Wall

Down Mastoidectomy (See below) that my son's surgeon did. The articleis old, but has info. about the procedure that more doctors in the USare doing. I think that his surgeon said that this procedure was just

coming out in the medical text books??? My son has NO waterrestrictions and anatomy of the ear is near normal. He has had noreoccurance of Ctoma. He also had a cartilage graft (that referred to in a post) that helps the ear drum so it doesn't retract.

Amber is this what you were referring to or do you know of anotherprocedure? Thanks, JudyReversible canal wall down tympanomastoidectomy: An alternative tointact canal wall and canal wall down mastoidectomy procedures

Auteur(s) / Author(s)MCELVEEN J. T. ^ (1) ; HULKA G. F.^ (2) ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)^(1) Carolina Ear Research Institute, Raleigh, North Carolina, ETATS-UNIS

^(2) Duke University Medical Center, Durham, North Carolina, ETATS-UNIS Résumé / AbstractObjective: To avoid the limitations of canal wall down surgery yetmaintain the exposure provided by canal wall down mastoidectomy, the

authors have developed a completely reversible canal wall downmastoidectomy technique. The purpose of this case report is to determinethe feasibility of the reversible canal wall down mastoidectomytechnique in the treatment of a patient with an aural cholesteatoma.

Study Design: Having refined the surgical technique using cadavertemporal bones, the reversible canal wall down mastoidectomy wasperformed in a patient with a recurrent aural cholesteatoma. Setting:The surgical technique was refined in the Carolina Ear Research

Institute's temporal bone dissection lab. The patient underwent thesurgical procedure by JTM in a standard operating room setting at aprivate hospital in Raleigh, North Carolina. Patients: The patient was a

private patient, referred to the Carolina Ear & Hearing Clinic fortreatment of recurrent cholesteatoma. Intervention: A reversible' canalwall down mastoidectomy was performed in this patient. Main Outcome

Measures: The surgeon determined the adequacy of cholesteatoma exposurefollowing temporary removal of the posterior bony canal wall.Intra-operatively, the surgeon assessed the repositioned posterior bonycanal segment, looking specifically at its stability and the absence of

gaps along the canal cuts. Results: Temporary removal of the posteriorbony canal wall improved exposure of the cholesteatoma and facilitatedcholesteatoma removal. The repositioned bony canal segment was wellstabilized by the bone cement (Oto-cem) and no gaps were noted along the

canal cuts. Conclusion: Although it is premature to compare theeffectiveness of the reversible' canal wall down technique to othermastoidectomy procedures, this case confirms the feasibility of thisapproach.

Revue / Journal TitleThe American journal of otology *ISSN* 0192-9763 *CODEN* AJOTBN Source / Source1998, vol. 19, n^o 4, pp. 415-419 (12 ref.)jackiekylekatelyn wrote:

>> > > >> > > Hi everyone,> > >> > > I'm recovering from a radical mastoidectomy I just had this> > > morning. This is my second surgery on the ear - this surgery

> being> > > a more radical one, as the c-toma had already grown back in less> > > than a year and a half.> > >> > > I was sent home from the hospital with my head totally wrapped

> in> > > bandages/gauze/ packing. I must say it's quite attractive,> > > especially since I have long hair, which is sticking out at all> > > kinds of interesting angles! The packing has already soaked thru

> > > with blood and is draining down the side of my face. As you can> > > imagine, it's pretty disgusting.> > >> > > What I'm wondering is can I change this dressing and remove some

> of> > > the bandages before my doctor appointment on Thurs. I wasn't> able> > > to talk to my doctor following the surgery, as he was already in> > > another surgery by the time I woke up. Now he's unavailable for

> > the> > > weekend. (And, yes, in Canada unavialable doctors are not> unusual> > > unfortunatly) . I'm really dreading spending the weekend with> this> > > (bloody) bandage draining constantly down my face and neck! Yuck!

> > >> > > After my previous surgery, I had an incision in front of the ear> > > with a smaller bandage, which just covered the ear, not the> entire> > > head. This time the incision is behind the ear.

> > >> > > So I was just wondering what experience others have had with> this.> > > Did you keep the bandages on all week? Were you able to change> > them> > > yourself? Any information and comments would be appreciated.

> > >> > > Jackie> > >> >>>------------------------------------

August 18, 2008

sorry, I forgort,

There is also great information in that book on the different types of Mastoidectomies and when each is indicated. It turns out that there are situations where radical mastoidectomy is completely appropriate cbecause of the location of the disease, so maybe that's why your surgeon felt it was necessary, Jackie.

Hope you heal quickly and completely!!!

On Mon, Aug 18, 2008 at 5:37 PM, s <thequeen.christine@...> wrote: