Cholesteatoma and the one good thing to come from COVID-19

I started my shift to work remotely on March 16, 2020. That morning, I onboarded a new employee to my team and had her set-up with a new laptop, headset, and mobile phone. We double - and triple - checked that she could log in to our VPN. We went our separate ways around noon. I returned home, plugged in my headset in my makeshift office, and got to work.

A gray cat sit on the back of a chair in front of a computer desk.
My new co-workers were... fun?

As you know, we all continued to work remotely - almost uninterrupted - for the next 16-18 months before our corporate overlords toyed with a return to office plan. During these 16-18 months, I was on calls almost constantly with my headset. I began to notice that my right ear was experiencing some hearing loss - nothing major, or so I thought. I brought it up at a yearly wellness check with my Primary Care Physician and he referred me to an ENT at St. Louis University Hospital.

The ENT proctored a hearing test in one of those sound isolation booths. They tested all sorts of stuff, and as it turns out, I had significant negative pressure in my right ear. I was referred to an in-network specialist at St. Louis University Hospital, who ordered a CT Scan of my head. They found a mass – a Cholesteatoma – and it was wreaking havoc in my middle ear leading to the loss.

Because I am decidedly not a doctor, here's what Wikipedia has to say about Cholesteatoma:

Cholesteatoma is a destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process. Cholesteatomas are not cancerous as the name may suggest, but can cause significant problems because of their erosive and expansile properties. This can result in the destruction of the bones of the middle ear (ossicles), as well as growth through the base of the skull into the brain. They often become infected and can result in chronically draining ears. Treatment almost always consists of surgical removal.

I decided to schedule surgery quickly – the sooner I could get this taken care of, the better. I was told that I could not fly on an airplane for up to 3 months post-surgery and that I wouldn't be able to swim/submerge my ear for quite some time as well. Seeing as how we 1) want to go on a proper vacation; 2) I have business travel opportunities; and 3) have a swimming pool, I made the first appointment I could for Friday, April 8.


I'm a worrier by nature. I handle stress well, but not so much anxiety. With this being my first "major" surgery, I had no idea what to expect. We saw the kids off to school in the morning, then my wife and I headed to St. Louis University Hospital in Midtown to check me in and start the pre-op procedures.

Because I was a worrier, the Anesthesiologist graciously hooked me up with a "Margarita" - a beautiful cocktail of drugs to calm me down. I was wheeled into the operating room, given some oxygen, and got to hear some doctor banter before I was knocked out cold.

When I came to after the almost 6 hour procedure, I found out from the surgeon that the Cholesteatoma was incredibly sticky and worse than the CT Scans showed. Being very data-driven, I wanted to see everything I could about the surgery. In the MyChart Post-Op notes, the following procedures were performed:

  1. Right tympanomastoidectomy
  2. Microdissection
  3. Tragal cartilage grafting
  4. Perichondrial grafting
Stephen still has a lot of pain meds and it shows.
Turns out the drugs you get at hospitals are freakin' great. And, I had two helpings of chocolate pudding.


It's been 28 hours since I made it home and I'm doing okay, all things considered. I've lost the Princess Leia head wrap in favor of some different gauze, I had a somewhat decent night of sleep, and I was able to take down half of a Sauce on the Side Calzone.

Pain has been manageable thanks to alternating between a heavy prescription of Ibuprofen and Tylenol. I'm wrapped up with new, clean gauze and packed with a new Vaseline-coated cotton ball.

I have a follow-up appointment with the surgeon next Friday where he'll give me a once-over and we'll talk about any next steps. I'm really excited to have this behind me, and, slowly get back on the road to recovery.

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