Author Topic: Newbie--scheduled for surgery in October 2008  (Read 31271 times)

dufreyne

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Newbie--scheduled for surgery in October 2008
« on: September 29, 2008, 06:09:46 pm »
I would like to share some of my story for those inclined to read.
Like many, my story had an unusual series of events that led to the diagnosis of a right sided, 5 x 6 x 9 mm Acoustic Neuroma on February 13th, 2008(Valentine's Day has taken on a new, special meaning!).  Initially, it was not 100% certain that it was, in fact, an acoustic neuroma.  There was a slight possibility of 'inflammation' instead of tumor.  The MRI was repeated on August 13th and it had grown slightly and continued to appear consistent with an acoustic neuroma.  During the preceeding 6 months, I did my homework.  Despite the fact that I am a practicing M.D., I really had very little knowledge of the details of this diagnosis nor the treatment options available (I'm embarrased to say).  I've read post after post of individuals who are frustrated by the lack of real guidance given the 3 main treatment arms as well as the sub-arms.  I found myself equally frustrated.  I have read hundreds of papers and abstracts (many of which contradict each other) and it can be overwhelming.  After going to 3 places (House--Schwartz +Slattery; Univ. of Washington--Sekhar; Stanford--Jackler + Harsh), ultimately I decided on Stanford with Jackler.  Although, admittedly, all 3 seemed like very good choices.  It is scheduled for the end of October.  If anyone has had experience with Jackler + Harsh I would appreciate your point of view--especiall for intra-canicular tumors with good hearing.  Also, anyone who has any words of wisdom at 3 weeks pre-op, it would very much be appreciated. 
If anyone is interested in the story that led to the diagnosis, I would be happy to relate it on the next post (it included a bad sore throat, a tonsillectomy, the loss of taste and lots of other fun events :).

leapyrtwins

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Re: Newbie--scheduled for surgery in October 2008
« Reply #1 on: September 29, 2008, 06:24:43 pm »
Hi, Dufreyne and welcome  ;D

By all means, give us the details leading up to your diagnosis; we love to share our AN stories here.

I don't think that most practicing MDs - unless they are specifically practicing on ears or brains - are "up" on Acoustic Neuromas, their diagnosis, or their treatment.   I've found that my ENT was even freaked out by the "growth" in my inner ear canal and couldn't hand me off to a neurotologist fast enough  :D  The number of AN patients on this forum who were misdiagnosed for years used to amaze me, but now I've come to realize just how common it is.  Afterall, we're a rare bunch  ;)

I've also found that most MDs don't have a clue as to what a BAHA is.  Do you? 

I've heard good things on this forum about Dr. Jacker and Stanford; you're in good hands.

Words of wisdom - don't sweat the side-effects until they happen to you.  Yes, there are many, but you may never encounter most of them.  Don't overdo it post op - the fatigue is phenomenal; lots of patience is required.  Have complete and utter faith in your treatment decision and absolute confidence in your doctors.

BTW, we have another MD on this forum who had an AN (Sam Rush).  Sam had the unique experience of diagnosing one of his patients with an AN just this past year. 

You don't mention your surgery date, but we like to keep track of such things so we can wish our fellow forumites well.  You can find the AN calendar link at http://www.my.calendars.net/AN_Treatments

Good luck,

Jan   

Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

Kaybo

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Re: Newbie--scheduled for surgery in October 2008
« Reply #2 on: September 29, 2008, 06:27:42 pm »
Hello and Welcome!
Thanks for sharing with us part of your story.  I know that you said that you are an MD so I know that you probably look at this with different eyes than the rest of us (except maybe Sam), but you won't find a better, more caring group of people.  And the best thing...we have all experience the EXACT same things you have/will.  I am VERY interested in your story of discovery...I have a little story about reoccuring strep throat before I had surgery (& have not had it ONCE since) so I am very curious - I haven't ever heard of anyone else with sore throats!  Please don't be a stranger - you are not in this alone!!  Feel free to contact me with a PM or I can call you if you would like to chat!

K
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

dufreyne

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Re: Newbie--scheduled for surgery in October 2008
« Reply #3 on: September 29, 2008, 07:00:46 pm »
Big thanks to Leapyrtwins (there has to be a good story behind that name!) and Kaybo for replying with encouraging words of wisdom.  I can't tell you how much that means right now.  I am a practicing ER physician and i've spent the last ten years taking care of patients and walking around 'landmines' and now i've tripped one myself.  It's almost surreal.  Although, I must confess, that it hasn't all been bad.  In fact, there has been a fair amount of positive that has come out of this whole ordeal.  More on that later...

My diagnosis was truly wacky.  I'm a healthy 42 year old male who woke up christmas morning 2007 with a wicked sore throat.  Prior to that I would get 1 or 2 strep infections per year and my tonsill were mildly enlarged.  At first, I thought it was a viral infection, but it was much bigger on the left side with pus (sorry for the graphic picture that just entered your brain!).  I made it through christmas present opening and then had to work the next day.  I was given an injection of long-acting Penicillin and thought it would be better in a day or 2.  No luck. 2 days later, it was significantly worse.  I started some different antibiotics (thinking I had a resistant strep infection) and tried to give this a few days to have effect.  Still no better.  I saw an ENT who thought, perhaps, I had a peri-tonsillar abscess.  He took a spinal needle attached to a syringe and poked it 5 times! into the back of my throat adjacent to the left sided, large tonsil.  No pus, no luck.  He started me on yet a 3rd antibiotic and steroids.  I did my best to muddle along until a week later.  I saw another ENT who was concerned about the possibilty of tonsillar cancer (given the fact that it was unilateral and not responding to antibiotics or steroids).  He recommended a tonsillectomy and said he could do it 2 hours from then.  I was not quite prepared for that, and reluctantly agreed.  They wheeled me in (at the hospital where I work).  Everyone was asking what it was like to be on the "other side." The OR staff asked me what music I wanted to hear prior to being put to sleep--I was a bit somber and requested peace and quiet.  They said OK and then put me to sleep--I'm sure they were cranking Def Leppard while I was out!  When I woke up I came to complete consciousness quickly.  I looked in the mirror and was amazed at the crevices he had carved out of the back of my throat.  I had seen many post-tonsillectomy patients, but was still amazed at the size of the craters he left.  Over then next few weeks it filled in nicely and now looks normal.  I was discharged the next day and went back to work 6 days later.  About a week after surgery I noticed that sweets tasted bitter and I couldn't taste things well at all.  I brought this to the attention of my ENT who didn't have an explanation.  That lasted 2 months and finally came back.  As I get older, a good meal means more and more!  The pathology came back as no cancer, but multiple mini abscesses and one large abscess on the left side.  Also, a viral culture done at the beginning came back for 'Adenovirus'. 

4 weeks after surgery I was working and had a sharp pain in my right throat.  It lasted all day as I was seeing patients.  I looked in the mirror and couldn't see anything out of the ordinary.  Then, I was walking in to see a patient when I noticed sudden onset of hearing loss and a high pitched noise in my right ear with vertigo.  I sat down in the patient's room.  Fortunately, she was quite verbose and had a non-emergent condition which allowed me the luxury of sitting until the vertigo improved and the buzzing eased.  I saw a different ENT who ordered a hearing test right then.  It showed a 'low frequency' hearing loss at 500Hz.  She prescribed prednisone X 5 days.  My hearing seemed better by the time I got home.  I took the prednisone anyway.  Two weeks later, I went in for follow up with my normal ENT.  He thought it was a viral labrynthitis.  I questioned the utility of an MRI.  He agreed that it would put the issue of tumor to rest.  I went for the MRI a few days later.  When I finished the MRI, the Technician was gone (now I realize that she didn't want me to show her the images and put her on the spot).  The next morning my ENT called and he sounded nervous (not his normal tone).He simply said  "I'm glad we got the MRI--you do have a tumor, it's an acoustic neuroma."  I drove to his office to have him prove this to me.  It didn't make sense.  How could this be the cause of my symptoms afte the infection, adenovirus, tonsillectomy.  Surely, I thought, this must be inflammation.  I looked it up and sure enough, there are a number of AN mimickers--including mononeuritis (inflammation of the nerve).  I was convinced that this must be the case.  I decided to be patient (best I could) and repeat the MRI in 6 months.  In the meantime, I researched options.  I traveled to Seattle (Sekhar), House (Schwartz and Slattery) and Stanford (Jackler, Harsh).  I read WAY TOO MUCH about this.  It can drive you crazy!  After weighing the options, I've chosen Stanford and now I'm waiting for the surgery to take place.  I'm donating autologous blood this week and filling out the insurance paperwork as well as my medical leave of absence paperwork.  Still seems surreal...

Kaybo

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Re: Newbie--scheduled for surgery in October 2008
« Reply #4 on: September 29, 2008, 07:40:00 pm »
Dufreyne~
First, explain that screen name, please!!  It's a lot to type!  Sounds like you have been thru the ringer with your throat!  AN's can change your life, but that is not all bad and everyone has VERY different outcomes!  Check out my blog to see what life is like for me 12 years out!  The address is below in my signature line!

K   ;D
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

dufreyne

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Re: Newbie--scheduled for surgery in October 2008
« Reply #5 on: September 29, 2008, 08:02:03 pm »
First, "Dufreyne" comes from one of my all time favorite movies entitled "Shawshank Redemption".  But, I spelled it wrong the first time I used it and it stuck.  It's french and I think it's supposed to be spelled Dufresne.

Second, Kaybo, I really enjoyed your blogsite.  You have a beautiful family and those girls look like they keep you quite busy! You should be very proud.

Now that I'm "off the sidelines" and starting to post a little, I'm trying to figure out a few details.  My current challenge is how to post a picture and how to post my specs at the bottom of each post (as I've seen others do).  Future posts will be a testament as to whether I'm successful or not!


Sue

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Re: Newbie--scheduled for surgery in October 2008
« Reply #6 on: September 30, 2008, 12:38:24 am »
Welcome Dr. dufreyne!

Sorry you are joining our ranks, and I have to say, your story is different from any others that I've read.  But, we all have a little different story to tell on our AN journey.  At least you have the medical knowledge to help you along.  Most of us never have even heard of such a thing before.  I'm not even sure my ENT had heard of such a thing before, as he didn't diagnose me at all.  It took another symptom of facial numbness and then and only then did I rate an MRI.  And of course, a diagnosis was made and I finally found out that I wasn't crazy, that I did have something wrong with me!  But, that was partially my fault for not throwing a tizzy fit in the ENT's office. >:(  I should have been more aggressive.  Live and learn, I guess. 

You have a small AN, and as you know, you can pick and choose a little bit on your treatment.  I do wish you the best and hope your treatment and recovery go smoothly.  I'm also rather pleased that a doctor chose to come on a patient support forum with his story, because my doctor warned me away from this site, and other's have said that too.  They are afraid that only the ones with bad outcomes are on here spreading gloom and doom.  Such is not the case.  We support the patients right to his or her choice of treatment and then cheer them on through treatment and beyond.  There are some very knowledgeable people on here and I think you'd be impressed with their understanding of this medical condition and treatment options.  I know I am.  ;)

Wishing you all the best,

Sue in Vancouver WA USA
Sue in Vancouver, USA
 2 cm Left side
Diagnosed 3/13/06 GK 4-18-06
Gamma Knife Center of Oregon
My Blog, where you can read my story.


http://suecollins-blog.blogspot.com/2010/02/hello.html


The only good tumor be a dead tumor. Which it's becoming. Necrosis!
Poet Lorry-ate of Goode

Omaschwannoma

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Re: Newbie--scheduled for surgery in October 2008
« Reply #7 on: September 30, 2008, 06:00:26 am »
Just returned from a week-long vacation??? babysitting my one-year old grandchild and your post caught me by surprise!  An MD with an AN--hmmmmm and seems you have been through what we all have in regards to too much reading--info overload.  It makes me feel better to know someone "in the know" reacts the same. 

Very sorry to read of your diagnosis and sorry you had to go through much before you got there.  It took 12 years before I got my dx with alot of embarrasing moments with specialists (?) of all kinds and I know I'm not alone as many of us have a similar story here. 

I'm glad you came forward to tell your story and glad you have chosen your tx and team.  Hope you continue to stay with us during your journey as someone above me mentioned we are not all doom and gloom and no you will not "pick up any symptoms" by reading about someone else's problems!   ;)

1/05 Retrosigmoid 1.5cm AN left ear, SSD
2/08 Labyrinthectomy left ear 
Dr. Patrick Antonelli Shands at University of Florida, Gainesville, FL
12/09 diagnosis of semicircular canal dehiscence right ear

tenai98

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Re: Newbie--scheduled for surgery in October 2008
« Reply #8 on: September 30, 2008, 06:24:05 am »
Welcome to our elite group Doc....We are a family here and a great source of info and suppport.  Sorry you had to go thru so much to find your AN.
As for the picture, well that is problematic...took me hours of playing around with Flickr, Frappr, and websites to no avail. Then Joef on here did it for me. Thanx again Joef..
As for the signature, go to ur profile....
JO
14mmX11mmX11mm left ear
TRANSLAB 04/07/09 2cms at time of surgery
Dr. Benoit and Schramm, Ottawa Civic Campus
SSD ,some facial numbness
Baha surgery sept 22/09
residual tumor 13mmX7mmX8mm
2016 new growth.  25mmX21mmX22mm
cyberknife on June 7

Sue

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Re: Newbie--scheduled for surgery in October 2008
« Reply #9 on: September 30, 2008, 10:22:13 am »
Dr, as far as the photo goes, I posted my picture on Photo Bucket, then they have tags on there that you can copy.  You want the one that says Direct Link.  At least  that's the one I used.  Then you go to your profile forum information and you can see at the top of the page that there is a place where you can paste that information. You want to say that yes you have your own picture.  Then at the bottom be sure to click on the change profile button.  That should do it.  It did take me a few tries to choose the right choice on Photo Bucket, but finally figured it out.  Hope this helps.  And if anyone sees that I've not said it right, please correct me!

Sue in Vancouver, USA
Sue in Vancouver, USA
 2 cm Left side
Diagnosed 3/13/06 GK 4-18-06
Gamma Knife Center of Oregon
My Blog, where you can read my story.


http://suecollins-blog.blogspot.com/2010/02/hello.html


The only good tumor be a dead tumor. Which it's becoming. Necrosis!
Poet Lorry-ate of Goode

dufreyne

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Re: Newbie--scheduled for surgery in October 2008
« Reply #10 on: September 30, 2008, 12:09:19 pm »
Thank you all for the kind welcome to this community.

 I've followed, without posting for quite some time.  I've heard similar comments about this site, but have found this to be far from the truth.  From all accounts, this site appears to be an online network of individuals traveling down a similar, difficult road.  It only makes sense that this type of site would form as a support to those navigating this journey.  Frankly, how could medical practitioners not expect such an online network, when patients are given such confusing information?  First, you're told you have a brain tumor, but wait...it's benign.  Next you're told there are 3 main treatment options:  do nothing, radiation, or surgery.  Then, your given the side effects of all 3 choices which appear both random and potentially serious.  This site simply allows for the free flow of information between patients who are experiencing the same tumor (although the details may be dissimilar).  In other areas of medicine this is, in fact, encouraged.  For example, Congestive Heart Failure patients often meet with the physician as a group.  This generates healthy discussions and often great questiions.  This type of networking should be encouraged.  This site is important and I'm so glad it exists.

With respect to treatment options, I wholeheartedly support those who opt for other choices.  Clearly, there is no true consensus at this point and therefore, you have to choose what you think is right for your situation.  I often wish I had a medical condition that simply had one treatment option.  Then you could simply find out who is good at that particular treatment and you could move forward.  Those of us diagnosed with Acoustic Neuroma are subject to a more complex algorithm.  It seems to test our intellect as well as our emotional fortitude like nothing I've experienced before.  I have to think that walking this path will cause me to grow in ways that I didn't think were possible.  I have found myself living in the moment and truly enjoying that moment like I never have before.  I've also re-learned the concept of gratitude.  These are all good things that I most certainly would not have experienced without this tumor.



OMG16

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Re: Newbie--scheduled for surgery in October 2008
« Reply #11 on: September 30, 2008, 03:15:49 pm »
Dufreyne first I want to welcome you to the best brain tumor forum on the web.  I believe most Drs are talking about the other brain tumor sites I have been on.  There are alot of crackpots which I do not find here and they are agressive and do tend to attack people for their beliefs on treatments.  Here you will find great support and knowledge without all the negative.  This is a patient to patient support group period.  Of course family members are welcome and you do not even need to have an AN to join.  Oh and of course Drs can join to.

As many of you are aware my son does not have an AN and had brain surgery and suffered a severe stroke at 16.  A very rare complication and unusual circumstances where at play also.  If you would like more info to put your mind at ease just pm me and I would be happy to tell you more.  I joined this support group with questions the Drs could not answer and the journeys were infact similar.  I want to say that the doom and gloomers are from what I have experienced on this website upbeat and positive and helping others with complications that can change you life in an instant only willing to help others reach the place we are in.  I know that despite what has happened in our lives since surgery has been a blessing in disguise and my son is doing so well and we of course are so proud of him.  This will make you a better person in the long run and also a better Dr.  Just remember in the tough times ahead we are here for you to make this just a little easier.  Many kisses to your forhead  OMG16 or maybe it should be 20 now  :-*  :-*  :-*

I believe you are given choices in life and it is not what has happened to you that defines who you are.  It is how you handle the situation and finding the positive in an almost hopeless situation that counts the most.  My son is my hero and I have had the pleasure of learning this from him.

Jim Scott

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Re: Newbie--scheduled for surgery in October 2008
« Reply #12 on: September 30, 2008, 04:01:06 pm »
Hi, dufreyne:

Allow me to extend yet another welcome to the site/forums as well as my regret that you're a member of this relatively unique 'club'.

I'm very pleased to read your analysis of the intent and scope of the ANA message boards, which I find both astute and correct.  :)

We don't have many physicians posting here, although the ANA does have many doctors as members, advisor's, etc.  The gifted neurosurgeon that performed my retrosigmoid approach surgery has been a member of the ANA since it's inception.  Its' always interesting to get a doctors perspective when he (or she) becomes a patient.  The confusion and contradictory information, as well as the negative aspects of surgery and radiation can, as you noted, drive one a bit crazy.  Sometimes I suspect that having medical training and education can exacerbate the situation because you 'know' too much, when the reality is that with acoustic neuromas, there are no hard-and-fast 'rules' and thus, no absolutes to lean on.  This can be threatening and frustrating for the ordinary patient and likely even worse for an experienced physician, like you. 

Your 'story' was compelling and definitely unique, although the long and winding road to an MRI and a definite diagnosis is all-too familiar.  I was somewhat fortunate in that I (foolishly) ignored my symptoms and they intensified rather quickly.  That triggered a (rare) trip to my PCP, a blood test based on a false guess on his part (hypothyroidism) and then, an MRI scan, intended to look for a 'sinus problem' but instead finding a large AN pressing hard against my brainstem.  From there, a rejection of the neurosurgeon I was initally referred to (clearly intimidated by the size of the tumor and too light on AN surgery expertise) followed by the serendipitous referral to a partner of my wife's neurosurgeon (she has undergone extensive spinal surgeries) who was the resident expert in acoustic neuroma removals (30+ years experience) and even instructed medical students at nearby Yale university.  We hit it off immediately (he's around my age).  This doctor was alarmed at the size and location of the AN and scheduled surgery within a week, the time it took to get his hand-picked team together; no residents or interns.  As he put it: "An acoustic neuroma surgery OR is no place for amateurs".  I liked his attitude.  During our initial consultation (50 minutes with absolutely no interruptions) I made it crystal clear that, along with ridding myself of the tumor, avoiding facial paralysis was a primary concern.  He understood and set out a plan of 'attack' on my AN.   First, a 'de-bulking' of the AN.  He termed it 'hollowing it out'  Then, after a 90-day 'rest period', FSR treatments, carefully calibrated with a radiation oncologist my neurosurgeon liked to work with.  I ended up with 26 FSR treatments - with no ill effects, except to the tumor.  :)  The AN surgery went well and I never experienced facial paralysis.  I was driving again within two weeks of the surgery, with my surgeon's approval, of course.  I had a few inconsequential after-effects from the surgery but they either resolved quickly or are insignificant and have no real bearing on my quality of life. As you would expect, my neurosurgeon is elated with my outcome.  I thank God for putting this fine doctor in my life at a time when I needed him.  I'm also grateful to have avoided, by sheer chance, the misdiagnosis runaround that so many AN patients suffer through, as you did.

I try to encourage the newly diagnosed, like you, that all is not 'gloom-and-doom' with an acoustic neuroma diagnosis.  I think your medical education and experience tells you that.  This website and the forums are definitely supportive and informative, filled with good folks who, as you noted, are all having the same experience with a myriad of manifestations.  They try to share their hard-won experience with others in the same situation, when there is little practical information available, even now.  Here, there is. 

I'm pleased you've found us and trust that you'll be a frequent visitor and valued contributor.  I hope we can help you, too. 

Jim

4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

yardtick

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Re: Newbie--scheduled for surgery in October 2008
« Reply #13 on: September 30, 2008, 07:29:19 pm »
So good to hear from you OMG16, you've been missed :-*

Welcome to the forum Dr.  Just wish it was for medical research! 

Good luck,
Anne Marie
Sept 8/06 Translab
Post surgical headaches, hemifacial spasms and a scar neuroma. 
Our we having fun YET!!! 
Watch & Wait for more fun & games

msmaggie

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Re: Newbie--scheduled for surgery in October 2008
« Reply #14 on: September 30, 2008, 07:36:47 pm »
Welcome to the zoo, dufreyne!

I have to admit it does cheer me up to read that a dr. is just as befuddled by the process as the rest of us mere mortals  ;).  It can all be so overwhelming.  This is the best place to be.  Everyone has a story to tell, advice to give, and loads of encouragement to spread around.  You can't go wrong hanging around here.  Sorry the price of admission is so high, though!

Maggie
Diagnosed  left AN 8/07/08, 1.9 CM
Surgery 12/10/08 at Methodist Hospital w/Vrabec and Trask for what turned out to be a cpa meningioma.