Yesterday I rode my beautiful Honda Shadow 750 (freshly polished!) into the city for an ear and balance test. It always makes me smile when I’m asked by neurologists “Do you have any balance issues?” Today I was able to point to my helmet and say, “Nope, I rode here on my motorcycle.”
Well, the tests showed something quite interesting. I do have balance issues. My left inner-ear is basically not reporting anything to my brain. But, the change has happened so slowly, as the tumour has grown, that my brain has adjusted where it gets its messages from to provide me with balance. Cool, eh?
Let me start from the beginning. When they booked me for a three hour ear and balance test I thought they must just build in buffer time for “waiting room time”. I was wrong! I was invited to join the audiologist right on time - 1:15PM. Over the next three hours I spent time in three different rooms with an audiologist and a student audiologist. Both were young women and not at all hard on the eyes or ears.
Room 1: Very quiet. They shut the door and it was VERY QUIET! (said in a whisper). It was quite a quiet difference from the busy city bustling outside on Swanston Street.
In room 1, I wore headphones and pressed a button. Sounds easy, eh? ... Not so! The sounds they play are soooo quiet. Testing my pitch and decibel hearing abilities was a frustratingly long procedure. It was revealed that both ears have hearing loss. The right is about normal for my age. The left was worse. The tumour is on the left.
Room 2: Goggles, dots and women blowing gently in my ears. Sounds nice? it was... Some parts more than others.
In Room 2, I wore a pair of eye tracking goggles that sent my every eye movement to a computer. In test 1, I stared at a dot on the wall. It moved. I stared at the dot in its new location. It moved again.
In test 2, I was told to relax my neck so the audiologist could jerk my head from left to right without warning while I tried to keep focused on the dot. Then the student got to have a go. Fun for everyone!
In test 3, I faced a different wall and watched a different dot. This dot played pong all by itself! I just watched it go back and forth.
In test 4, on the same wall, I stared at a smiley face for ten seconds. The next part was really hard! After fixing my eyes on the location of the smiley, they put a cover over the goggles that completely blocked out all light. It was DARK! (said with eyes closed). I had to keep my head perfectly still and my eyes in the exact position they were in while staring at the smiley face. The first time, I followed the residual image of the smiley face as it wandered off to the left. The next time, I tried harder. “Forget the smiley face.” I told myself. Just keep your eyes fixed in the middle. Not easy in the dark! Without a reference point, I’m not sure what my eyes were doing.
In test 5, I laid back on the bed with my head on a pillow. The blinder was put on the goggles (to keep me in the dark!) and I was told to keep my eyes open while they blew air in my ears through a tiny little tube and watched my eardrum through a otoscope. Each ear got a turn with cold air and then warm air. They did the right ear first. Cold air for about a minute. “Almost done. Twenty seconds left. Ten seconds left. Done.” Then they asked me to tell them a girl’s name starting with A. “Alexandra”. B. “Beatrice”. C. “Coriander” The ladies laughed. D. “Delilah”. E. “Emilia”. F. “Frieda”. “These are very unique names,” the audiologist said. “Frieda is my mother-in-law!”
“Ok, now look at the red dot.” A red dot appeared in my darkened goggles. I looked at it.
Then they blew the cold air in my left ear. Boys names. Red dot. They asked how I was feeling. “That felt good!” I said. The audiologist laughed and said she’d never had a patient say it felt good. “What is it supposed to feel like?” I asked. She told me that everyone reacts differently. “Why all the questions?” I asked. “To make sure you’re still awake,” she said.
“People fall asleep while you’re blowing air in their ears?” I asked.
“There are different kinds of responses. OK. Let’s do the warm air now.”
About five seconds of hot air in my right ear and the bed began to slowly rotate. Then it spun faster. And faster. And WOW fast! “Almost done,” I heard from somewhere outside the amusement park. “20 seconds.” Whizzing, whipping around the universe. “10 seconds.” My teacup reached maximum velocity. “Done.”
It was amazingly discombobulating!
“I am spinning,” I laughed. “Really spinning. It feels real!”
“How about countries.” It was the students voice. “Can you name a country starting with A?” Now all the questions made sense. I bet some people pass out from the spinning. It was vertigo heaven.
“Africa.” B. “Brazil.” C. “Congo.” D. “Denmark.” E. “ummm... England.” F. “Finland.” I. “What about G?” Both ladies cracked up. “Of course, G.” “Germany.”...
The dot appeared and I focused on it. Then they asked how I felt. “Like I just got back from Disneyland,” I laughed. “Well, you’re about to go back to Disneyland in your left ear,” the audiologist said. “Let’s see how it goes. Ready?”
Hot air began blowing in my left ear. I prepared myself for the slow rotating of the bed. I waited for the spinning sensation. The air was hot and blowing. I looked for the teacup. “Almost done.” But, I couldn’t even see Disneyland. “20 seconds.” Nothing happened. “10 seconds.” Not the slightest bit of spinning. “Done.”
After talking it through, it is clear that the tumour has been growing slowly and compressing the left balance nerve. None of the signals from my left inner ear are making it to my brain. I asked why, if I didn’t have any balance information coming from my left side, I didn’t have balance issues. Evidently, because the tumour has been growing so slowly, my brain has compensated each little step of the way and takes it’s balance cues from elsewhere. It was the most enlightening part of the day!
Room 3 was noisy. They put headphones on my ears and probes in my ears and tested my eardrums. They told to relax my jaw and lay still. They said it was going to be a long time with lots of clicks and bangs. They said I could go to sleep if I wanted. So, I did. And when the noise stopped I opened my eyes and said, “Now you know what my wife has to put up with every night.” They both laughed. A bit too much, me thinks! The audiologist said, “You were having a good sleep, that’s for sure.”
We had a short chat afterward and she explained all the results. Hearing is worse in the left ear, but not dramatically. Balance is non-existant in the left ear. The tumour has clearly done it’s work on the balance nerve, affected the hearing nerve somewhat and is now starting to irritate the facial nerve.
When Acoustic Neuroma’s are removed, the main physiotherapy need is usually relearning balance. It is quite possible I am already a long ways ahead in this area. My brain is already accustomed to receiving very little information from the left balance nerve. It will be interesting to see how much different it is when the nerve is cut. We shall see!
As I exited the building my hearing adjusted to the cacophonous world of downtown Melbourne. I threw a leg over my Shadow, put on my helmet and gloves, fired up my pipes and rumbled my way home.