This is what happened to Chechi.......

Chechi = Malayalam for elder sister

In the eighteenth year of our wedding, Suja who was a 1st year medical student at the time of our marriage (discontinued since) started to complain about an irritation in her right ear. Naturally I took her to an ENT specialist in the nearby town. He examined her ear and found that she had a minor hearing loss and directed us to get an audiometer test done. The test confirmed his findings and we were asked to come after a year to repeat the test and if there was a significant increase in the loss of hearing go for further investigations.

Some months passed by and Suja started feeling as if an insect got inside her ear. Off we went to a senior ENT specialist in the city who happened to be the professor of the ENT specialist whom we consulted first. He examined her and came to the same conclusion of minor hearing loss and asked us not to make a fuss about it and to ignore it. Since a senior ENT specialist gave a concurring second opinion we totally ignored the fluttering sensation, as she used to refer, in her ears and did not go for the re-evaluation after one year as recommended by our original consultant.

A couple of years passed by and Suja started to get tired more often. One would find her taking rest frequently even after short journeys. Celebrations for the 50th wedding anniversary of her parents were planned and among the invitees was Dr. Paul Puthooran, a family friend. While talking to Dr. Puthooran, he mentioned that he had recently undergone a craniotomy (brain surgery) to remove a tumour the size of a tennis ball and made me put my hand on his head to feel the soft portion in his skull, where the surgeons had opened to remove the tumour. Casually I asked him what the symptoms were and how he suddenly became aware of it. He said that one day while examining patients in the OP he felt numbness at the tip of his fingers and called in the neurologist who conducted an MRI scan and the tumour was detected.

After the wedding anniversary celebrations, while we were driving back home I narrated the incident to Suja when she said she too has numbness at a particular spot on her right cheek. The next day morning we went to the ENT specialist whom we had consulted originally. On preliminary examination itself he said that the hearing loss had worsened and recommended a CT or MRI scan. The ENT specialist at the hospital where MRI scanning could be done was a close friend of mine. I rang him up and fixed a date for the scan convenient for the periodic servicing of my car!

We waited till the servicing date was due, gave the car for the routine servicing and went to the hospital for the scan as if it was only of secondary importance (I happen to be a perennial optimist). As the scan was in progress I found my friend, the ENT specialist, rushing into the scan room. After a while the nurse came and made me sign an indemnity letter, I did sense some danger then. Scan completed, the doctor friend took us both to dinner and admitted us in the hospital, (for purposes of claiming the medical insurance), saying that there was nothing serious and we’ll be discharged the next morning. By next day noon I found my mother, brother and sister at the hospital to break the news to me that the scan report showed a large tumour on Suja’s right acoustic nerve which had grown too large and had already started pressing other parts of the brain.

The ENT specialists we consulted originally as well as for second opinion missed to diagnose the tumour because she had told them about a fluttering feeling and not used the medical term ‘titinis’ or something to that effect (how are we, laypeople to know). We too had missed some tell tale symptoms like patches on the pillow cover caused by oozing of saliva at night due to weakness of the lip muscles.

The doctor friend said that the tumour called medically – Right vestibular shwananoma, has to be removed at the earliest but since the tumour had grown so large and that it was adhesive to the facial nerve, we need to find the expert in the field of CP angle surgery as facial nerve damage could cause severe disfigurement of the face. My brother-in-law who is a doctor contacted his colleagues and finally shortlisted two neurosurgeons, one at Hinduja hospital Mumbai and the other at Sree Chitra Tirunal Institute of Medical Sciences Trivandrum (SCTIMST).

Suja preferred to do the surgery at Trivandrum considering the logistics and language. At SCTIMST, were treatment is highly subsidised by the Govt. Of India, there is always a long queue of patients waiting for surgery, and only life threatening cases are given out of turn preference. It so happened that my maternal uncle was the Director of the State police at that time with HQ at Trivandrum. He got an appointment with the HOD of Neurosurgery as soon as I telephoned him. The surgery was fixed after two days and the tumour was removed along with the right acoustic nerve which left Suja permanently deaf on the right side. As expected it was a benign tumour as 99% of acoustic shwananoma tumours are found to be.

However since the tumour had grown too large and was severely adhesived to the facial nerve some damage was caused to the facial nerve which resulted in partial facial palsy. As a result she lost her ability to smile naturally as well as lost the functioning of the right eyelid to close and open. The atrophy of the lachrymal glands dried up the production of tears on the right eye; so she has to use artificial tears for the rest of her life for her right eye. This causes irritation and redness in the eye often while travelling due to dryness of the eye and she becomes tired after prolonged introductions.

Subsequently she has had two minor episodes of exposure Keratitis (cornea-the black portion of the eye, becoming white which could lead to eventual loss of sight) of the eye due to the failure of repeated tarsoraphy (stitching together of the eyelids at the corner of the eye to facilitate closure of the eyes). Finally a small gold (for its non infectious quality) plate was inserted in her upper eyelid as a weight to aid closure of the eyelid.

For a year after the surgery she shunned social interactions and public functions. Now she has got accustomed to or forgets the minor disfigurement of her face but still becomes uncomfortable if she is being photographed.

PS: This post is in response to the question from a friend during our recent visit to Chennai. “What happened to Chechy, She did look off colour?”.