Summary: Appreciating Beethoven in a completely new way.
I. Hearing and Music
As a musician, my hearing is precious to me. I love listening to and playing music, and when I’m doing neither, during almost every waking hour, some music is playing inside my head.
Sometimes I can get earworms that last for days. If the song is one I don’t like, I’ll listen to other music or concentrate on any of a handful of favorite works to push the offending earworm aside.
The idea of losing one’s hearing is so disturbing to contemplate, especially to musicians, that I imagine many may superstitiously avoid even thinking about the possibility.
I studied ASL years ago, was given a sign name, and find the language and Deaf Culture beautiful and fascinating.
I have been careful to protect my hearing. I almost always have earplugs in my pocket, wear them whenever I travel, and have musicians’ ear plugs I wear in every rehearsal and concert. Well into my late 50s, I have enjoyed excellent hearing with minimal loss.
Last September, the Newport Symphony performed a stunning work called “A Silence Haunts Me” by Jake Runestad.
This 2019 work for chorus and orchestra is inspired by a letter Ludwig van Beethoven had written to his brothers.
Beethoven wrote this letter, known as the “Heiligenstadt Testament” in 1802. He never sent it, and it was discovered after his death. In it, Beethoven despairs over his hearing loss.
It was emotionally profound performance. Playing in the orchestra, we could not hear all the words being sung. But we heard enough. At one climactic moment, the chorus sings:
“Why? — Silence is God’s reply
— and so I beg me take my life —”
I highly recommend attending any performance of this extraordinary work. If you are a choral director or a member of a chorus, I encourage you to seek out this work and consider it for performance.
Since it is a recent composition, there are not many recordings, but here is one:
Just thinking about this piece can stir deep emotion in me. Little did I know I would soon understand it at a wholly new level.
II. Sudden Silence
A little over a week ago I underwent minor surgery during which I was put under general anesthesia. The surgery was successful.
I woke up with a dry, raw throat, most likely an after effect of intubation. It took a day or two for my throat to recover to where I could eat and swallow normally.
My left ear was also plugged when I woke up. I figured drainage and sinus congestion was the cause, but while my throat recovered, my left ear did not.
I took antihistamines, used nasal spray, took throat lozenges, and tried steam inhalation. Although all were successful in clearing any congestion, I still could not hear anything in my left ear. Maybe I had some other blockage either in the external or middle ear? I went to Urgent Care to have my ear inspected.
No fluid or infection was detected. They prescribed Prednisone and instructed me to see an Ear, Nose and Throat (ENT) doctor immediately. Since it was the weekend, I had to wait, worried and impatiently for Monday to try to see an ENT.
When Monday arrived, I called multiple ENT offices around the city to find an appointment. Most had no openings for a couple days. I found one office on the far side of town that had appointments available for an audiologist and an ENT. I got in my car and drove nearly an hour, anxious and worried about what I might learn.
The audiologist did a full battery of tests. I had gone through this just four years earlier, so I had a good baseline against which to measure.
The results were unnerving. My left side hearing loss was serious to the point where I could not distinguish words. The audiologist suspected I had SSNHL (Sudden Sensorineural Hearing Loss).
SSNHL is idiopathic – we don’t know what causes it. There are many theories, but none has been verified. The treatment is steroids, and it is important to take them as soon as the sudden hearing loss occurs – ideally within days. If one waits one or two weeks before treatment, chances of recovery greatly diminish.
To make matters worse, the ENT I had hoped to see was tied up in the operating room and wouldn’t be able to see me the same day. I would have to wait two excruciating days more to see an ENT.
Driving the long way home, thoughts of “A Silence Haunts Me” filled my head and overwhelmed my heart. What if I were to lose my hearing permanently? “Dr. Google” indicated I should have started taking steroids within 72 hours of onset, and I beat myself up for waiting longer than that period.
Wednesday finally came, and I saw an ENT. Thankfully, he was very thorough, compassionate, and explained everything to me. Yes, I do have SSNHL.
Since the Prednisone did not seem to be helping, the ENT recommended the next step, which he admitted sounded scary. He would be injecting steroids into my ear. I would receive three shots, one per week. He assured me this is the “gold standard” of treatment for SSNHL.
As unsettling as that treatment sounded, I would have let him do anything to increase my hope of recovery.
He also ordered an MRI to rule out any circulatory, growth, etc. conditions that could be the cause.
I asked him what the chances of recovery are. He said that about one-third experience complete recovery, another third gain partial recovery, and the last third do not recover at all. As stark as those odds were, they were better than I had been contemplating before meeting him.
He also said that because a) I had started my Prednisone regimen early (within two weeks) and b) that I still had some hearing in my left ear, he was optimistic about my chances of partial to full recovery.
He told me about one patient that had absolutely zero hearing from SSNHL. He was not optimistic about that patient’s chances, but they actually recovered most if not all their hearing.
III. My first rehearsal
I had not performed in four months. I was recovering from a shoulder issue, and the evening of the same day as my ENT appointment was my first rehearsal. I didn’t know what to expect.
For the first hour, I could not hear myself at all.
As musician, especially a string player, this is akin to flying blind – you have no idea whether you are playing in tune. My fingers moved with muscle memory to their spots on the neck of my viola, and I just had to hope and pray.
Gradually, my right ear began hearing a little of my own playing, and it wasn’t bad. I made it through rehearsal without incident.
This weekend we will perform an ambitious concert including Bernstein, Verdi, and Korngold.
Beethoven is not on the program, but he will be in my mind and heart as we perform.
The next month will reveal if and to what extent my hearing returns.
Update 1: Post-Concert (4 Days After the Onset)
I was able to make it through 4 hours of rehearsal Friday, two hours of rehearsal Saturday, and concerts both Saturday night and Sunday afternoon.
Although I haven’t noticed any change in my left ear, I have been able to adjust to hearing myself playing a little bit with right ear. Only at moments, though.
My next shot in the ear will be in a couple days. I am also scheduled to get an MRI on the same day.
I wait with hope with as much grace and as little anxiety as I can muster.
Update 2: Second Shot and MRI (15 Days after Onset)
I received my second shot in the ear today. I will get a third one a week from today. Amazingly (and rather scarily), they administered no anesthesia and were able to insert the shot through the tiny pinprick created by the shot one week earlier. I experienced no discomfort, heard some odd noises, and could slightly feel the drops that were injected. I experienced no pain, dizziness, or nausea.
Less than an hour later, I arrived at medical imaging for an MRI. I spent 30 minutes inside the massive tube listening to classic Rock punctuated by whines, pounds, and buzzes.
Since my left ear is so impaired, it sounded like they were only imaging the right side of my head. I guess, having reduced hearing is one small advantage to enduring an MRI scan.
I will receive my third ear shot next week, and the following week I will have a comprehensive hearing test to see if any of my hearing has been restored, and to what extent. I remain quietly hopeful.
Update 3: Acupuncturist (17 Days after Onset)
I had appointments with both my chiropractor and my acupuncturist. The good news is that my shoulder is healed. I still need to exercise it to strengthen it and increase flexibility, but after the rigorous and extended workout it endured rehearsing and performing last week, I experienced no pain.
I informed my acupuncturist about my hearing loss. He said he could assist me in healing my ear and promptly inserted about four needles around my left ear. He gave me added hope for recovery.
Update 4: Acupuncture and Ear Shot #3 (22 Days after Onset)
Up to this point, I have mostly kept a calm demeanor, letting myself rest and heal and keeping note on any changes, however small, I might be experiencing. I woke today, though, with some dread and heavy sadness I haven’t felt in a few weeks regarding my condition.
Today I had my third acupuncture treatment focused on my hearing. I always concentrate on anything I notice or experience during and after my acupuncture treatments, and when I shared with my acupuncturist, he was upbeat and gave me some confidence things were happening. That gave my mood a boost.
I then visited my ENT to receive my third and final shot in the ear. When asked if I was noticing any improvement, I answered, “no” and saw their face fall. That hit me hard.
There are instances where hearing recovers weeks or even a couple months after the shots have been administered. But they normally see improvements by now.
She gave me a larger shot, filling my middle ear with corticosteroid, then left me for 20 minutes to let the drugs hopefully permeate my thus far recalcitrant hearing anatomy.
I will return next week to get a full audiological test which will provide quantitative measurements of any changes or improvements.
I remain as calm and patient as I can, although today am experiencing more fractures in my equilibrium and serenity.
Update 5: Audiologist and ENT Appointments #3 (30 Days after Onset)
Today, I received another in depth hearing exam to compare with the one I had a little over three weeks earlier. The results showed no improvement in my left-side hearing. In fact, there was one higher frequency at which my hearing had degraded from “serious” to “profound.” The ENT does not think there is any chance that I will experience recovery. I have scheduled an appointment with another audiologist to discuss various technological solutions, the most likely being a crossover hearing aid (CROS) designed specifically for single-sided deafness.
One day later I met with my acupuncturist (who is also an MD), who encouraged me to not to lose all hope. He allowed that the odds are long, but that in every group of people, there will be outliers. Additionally, he believes the second hearing test was performed too early, and that healing and recovery may still occur. HIs words were encouraging, although I have to acknowledge my odds are slim.
I have also reached out to my neurologist to make sure there isn’t anything else going on which could either explain my hearing loss. Additionally, I want to rule out anything that might neurologically being going on. I certainly don’t want to risk losing any more neurons or sensory capabilities.
Blatant Calm 