VNS: Very uNexpected Surgery

Welcome to this special Wednesday edition of Misdirected!

I know – two days late, right? But I have been busy. Like busy, busy. Like the kind of busy a bee would aspire to if it aspired to be a busy bee.

Holy smoke, how can someone fit that many uses of the letter “b” in three sentences?

Anyway, to draw back the curtain a bit, here is what has been happening since the last time we visited…

A Little Background Music

As most of you know, I suffered from massive, life-changing clusters of seizures from 2004 until 2009. These seizures were so debilitating that I required 24-hour care. Like, diaper-changing kind of care. My parents actually both took early retirement from their professions so they could commit themselves to being my full-time caretakers – presumably for the rest of their lives.

Thanks to a very forward-thinking neurologist, we discovered a potential treatment – the Vagus Nerve Stimulator. It is an implant that is surgically inserted into the chest, with two leads attaching to the vagus nerve in the neck. Every 5 minutes (or so) an electrical impulse gets fired off from the VNS, up the vagus nerve, and into the brain. This impulse somehow regulates the electrical activity of the brain, bringing over-excited neurons back down to a normal state.

It sounded like science fiction to me. At that time, fewer than 10,000 people had this procedure performed on them. But further research performed by my mother seemed to support my neurologist: this thing worked. Especially in cases of “temporal lobe epilepsy with intractable clusters of seizures.”

I will give you three guesses what my official epilepsy diagnosis is.

In March of 2009, I had the implant installed. By the end of the year, I was already no longer suffering from clusters of seizures. I still have seizures, but they are no longer day- or week-long events. I have a seizure, I recover, I move on. And I have an almost normal life.

Almost.

The Price of Loose Skin

Now, the VNS is installed at the top of the left breast, almost directly above the heart. This gives the implant a steady shelf to operate from and gives the leads emerging from it an almost straight shot up into the neck to attach to the vagus nerve.

So, the human breast is a muscle (the pectoralis major) covered by a sheath of fat and skin. (This is true even for men, boys.) A pocket is carved into the tissue on top of pectoralis, the implant is installed on top of the muscle, and the whole thing is sewn back up. Within a year you have a lump on your chest underneath a fairly impressive looking scar. 8 years later, the scar isn’t even that noticeable.

Now, you did notice what I said the covering of your breast is, right? Skin and fat.

You know, the kind of fat I just lost about 120 pounds of thanks to my bariatric surgery last year?

So, what happens when you remove the material making up the majority of the pocket that your VNS sits in?

This:

VNS Sideways
No, the VNS is NOT supposed to be able to do that.

When I woke up one morning a couple months ago to find that my VNS had turned completely sideways and was popped up under my skin like a circus tent, my immediate thought was “Maybe I should see a doctor about that.”

So, I demonstrated the problem to my neurologist last month. He turned a very unusual color, swallowed hard, and immediately started making phone calls.

And, so, here we are – with me scheduled for VNS replacement on Friday. This week has been spent getting blood tests, meeting anesthesiologists, etc. All the normal precursors to surgery.

A Week On My Back

Now, it isn’t as bad as all that. A VNS is a battery-powered device, which means I was going to have to get it replaced sooner or later anyway. Usually at around the 10-year mark, which is only 2 years from now. So, in one respect, I am just advancing the timeline by a couple of years.

On the other hand, this is happening right in the middle of one of the busiest periods of my life. My novel is getting ready to be published. I am scheduled for my Personal Trainer certification exam next month. I have my 1-year bariatric follow-up appointment in 12 days!

Just at the time I am wanting to spend every day at the gym to make sure I am in the best shape possible, I am going to have to spend about a week on my back.

This does give me a chance to really sit around and study for the exam, so that is good. I also have a lot of Fiction Vortex correspondence and reading to catch up on. But, seriously, I am faced with the possibility that I may go in for my one-year follow-up no longer at my lowest weight.

I am torn between irony and embarrassment, really.

Someone (probably me) will let everyone know how the surgery turns out, either on Friday or Saturday. I expect no issues or complications – the procedure itself takes less than an hour. We should be back to our normal publication schedule on Monday.

After all, I will have nothing else to do, right?

I Am Spending My Life In Waiting Rooms,

Jeremy

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