Author Topic: Newly Diagnosed in Charlotte,NC  (Read 7662 times)

ANGuy

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Newly Diagnosed in Charlotte,NC
« on: July 06, 2014, 06:33:58 pm »
Hi all,

A little background on my symptoms/condition.  I am a 47 year old male in otherwise good health.  I started getting what I thought were "hangovers" here and there about 8 years ago.  I drank, so I just figured it was from the drinking.  The hangovers seemed to be unrelated to the amount I drank.  I would drink a fairly large amount and not be hungover, and yet other times I would drink considerably less and be vomiting for hours the next day.  The solution was simple, so I thought, no more drinking.

The funny thing was, one morning I was violently ill.  I had a full blown vertigo attack and spent an hour crawling back and forth to the bathroom to vomit.  I hadn't drank in months and I was spinning out of control and vomiting.  Go figure!  My wife drove me to the emergency room, because these types of things only happen on a weekend,  and they shot me up with phenergen and diazepam and it worked like a charm.  A follow up with my regular Dr showed everything normal and I was feeling fine.  I was told these things happen due to various transient reasons and it was no big deal.

I went years without an episode.  In the interim 7 or so years I probably went 5 years symptom free and then had maybe 2 or 3 attacks over the last couple of years.  A couple of months ago I had a doozie!  My left ear was roaring and I couldn't hear a darn thing out of it.  My balance was fine, but I was "sea sick" and vommting.

Off to an ENT I go.  Intially they figured it was Meniere's but scheduled an MRI (WITH CONTRAST!) just to rule out a tumor.  Sure enough, I have a 1cm AN.  They bumped me up to Neuro-otology guy in their practice and he makes his suggestion, surgery.  I have no issues with the Drs. I've seen in this practice, but I'm not in love with them either.

By default, I'm watching and waiting right now while I gather information.  My main issue is, where do I find the "guru doctor" in my area to help me make the decision about what to do?  I am in Charlotte,NC.  Duke and Johns Hopkins are not out of my travel range.  For all I know, the best people in the world could be right down the street from me, or maybe the only way to go is to travel to LA.

To all of my fellow AN family, what Drs. or facilities in the South, mid-Atlantic, or even New York City area are considered the best?  My folks live near NYC, so I could travel and recover there as well.

Thank you in advance for any help you can give me!
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

CHD63

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Re: Newly Diagnosed in Charlotte,NC
« Reply #1 on: July 07, 2014, 09:03:30 pm »
Hi ANGuy and welcome to this forum .....

I am sorry no one has replied to your post yet.  I suspect the holiday week-end has had something to do with it.

It sounds like you are doing all of the right things now by being pro-active in seeking answers to what is the best option for you, in your particular situation.

For what it is worth, my first AN surgery was done by Dr. Fukushima (2008) at Duke Raleigh Hospital.  I had a very good experience with him and the hospital.  Unfortunately (and it is very rare) my tumor grew back.  My second surgery was done by Drs. Friedman and Schwarz at House Ear Clinic in Los Angeles in 2011.  So far the pesky thing has not regrown.

I only mention my situation because you are considering going to Duke, which, as you know, is highly respected.

That being said, at 1 cm you should have the option for either Cyber or Gamma Knife treatment, as well as a surgical option.

There are several medical facilities around the country who will do free evaluations (both for surgery and for radiation treatment) with no obligation to go there for treatment.  You just need to send them a copy of your MRI CD and your latest audiogram (if available).  Let us know if you want names of places.  It never hurts to get a second or third opinion, especially when it is no cost to you.

As for someone telling you what you should do, no one can really do that when your treatment (or watch and wait) choice needs to be yours and yours alone.  You are doing the right thing to gather all of the information you can, but ultimately when you know the pros and cons of each, you need to decide for yourself.

Many thoughts .....

Let us know if you have specific questions.

Clarice
Right MVD for trigeminal neuralgia, 1994, Pittsburgh, PA
Left retrosigmoid 2.6 cm AN removal, February, 2008, Duke U
Tumor regrew to 1.3 cm in February, 2011
Translab AN removal, May, 2011 at HEI, Friedman & Schwartz
Oticon Ponto Pro abutment implant at same time; processor added August, 2011

ANGuy

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Re: Newly Diagnosed in Charlotte,NC
« Reply #2 on: July 08, 2014, 08:00:51 pm »
Thank you for your reply.  I just got confirmation that my records will be forwarded in "7-10 business days" to Duke.  Funny how I was going to go WW and now one month or so into it I want everything NOW! lol.

I'm sorry your AN regrew.  If you can deal with this twice, I can find my way through this.

I'm glad to hear Duke is a good facility.  The Dr they have reviewing my records has very impressive credentials.  Duke itself is impressive.  I spent most of my life 15 minutes from NYC and one of the things my mother was worried about was the level of medical expertise in "The South".  I am relieved that one of the things I won't have to deal with is travel.  One member on here flew to House, got her surgery, and flew home in just a few days all by herself.  I can't imaging getting on a plane after that kind of operation.  She credited it to the skill of the surgeons.  I credit her for being that tough.

Reading stories like hers, and yours, makes all of this less intimidating.  Thanks again to you and the others who have posted their experiences for someone like me to benefit from!
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

michelej

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Re: Newly Diagnosed in Charlotte,NC
« Reply #3 on: July 12, 2014, 08:41:34 pm »
Sorry to hear of your diagnosis. I also have an AN about 20 mm now. I have had it for three years and watched and waited without knowing I was. The AN was present three  years ago however I was told that it was a normal MRI. The doctor reading it didn't diagnose it and even I could see it when I saw the old CD. (duh)I had some hearing loss in the beginning and some feeling of being off balance. Now I have tinnitus all the time and am still a bit off balance. My hearing for speech discrimination is almost gone. I am having a translab. procedure done in Iowa City, IA by an ENT. He has excellent credentials so I am hoping for the best. My surgery is this coming Thurs. I have only known about this since the end of May. I have done my research and am hoping for the best. Radiation even with a GK does not sound good to me either. I am kind of freaked out about sending radiation into my head for fear of it not going where they need it to. I refuse to let this stupid tumor slow me down. I am only 52 and have tons of stuff to do. We just went ziplining the last weekend. It was a blast. I wish you luck.

Cheryl R

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Re: Newly Diagnosed in Charlotte,NC
« Reply #4 on: July 12, 2014, 09:38:17 pm »
Hello and we assume you mean your surgery is by Dr Gantz who is a neurotologist and is head of the Oto dept but is more than just an ENT.       There are many of us on here who go to Iowa City.      I personally have NF2 and have had 3 tumors removed by him.      You'll do fine.      The nursing staff is well trained in your post op care.      How a person does post op varies with each person depending on how your body may have adjusted some already.   Just know to take it easy and don't push yourself as things do get better with time and being somewhat active.    Getting out and walking helps.               The forum can be nerve wracking at times as many who do have harder issues stay on here and many  who do fine leave after a time and are back to their lives.   There can be adjustments with the losing the hearing on the one side and balance issues for a time.                  Are you an Iowan now?        I am near Des Moines.      Actually am going down to visit relatives by Iowa City tomorrow and back Tues.        Too bad isn't Fri or Sat going down there.             Before surgery is scary and try to take it easy this week.     Know that your are being thought of from us on here.                           Cheryl R
Right mid fossa 11-01-01
  left tumor found 5-03,so have NF2
  trans lab for right facial nerve tumor
  with nerve graft 3-23-06
   CSF leak revision surgery 4-07-06
   left mid fossa 4-17-08
   near deaf on left before surgery
   with hearing much improved .
    Univ of Iowa for all care

Hokiegal

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Re: Newly Diagnosed in Charlotte,NC
« Reply #5 on: July 13, 2014, 12:40:48 pm »
Hi ANguy, I'm in Greenville, SC, not too far from you.  When my AN was diagnosed in 2011, the local neurosurgeon referred me to Duke and MUSC in Charleston.  I opted for MUSC and was very pleased with the care I received.  My case was complicated, but I was able to return to work in four months.  I never went for the Duke consultation but have heard nothing but good things about them.  I should mention that my tumor was too large for radiation.  Other semi-local options, especially if you want to consider radiation, are Emory, Wake Forest, and Vanderbilt.  There have been recent posts about all of these on this forum, and also on various AN Facebook pages.  Please feel free to PM me if you would like more information about MUSC.  Best wishes to you!
3.0cm AN diagnosed 08/11, age 47
surgery 09/11, Dr. Patel (MUSC), 95% removed
SSD with tinnitus, right side facial paralysis, vision and balance issues
facial movement much improved, and still returning after 3yrs
"We are better than we think, and not quite what we want to be."  Nikki Giovanni

ANGuy

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Re: Newly Diagnosed in Charlotte,NC
« Reply #6 on: July 13, 2014, 03:12:16 pm »
Thanks Hokiegal for the encouragement regarding Duke and for sharing your positive MUSC experience.  I googled MUSC and AN and got youtube videos of Dr. Patel performing a resection.  It was worth watching, but I have to tell you, I have a knot in the back of my neck from watching it lol!  I'm watching him do it and I still couldn't figure out how the heck they do it.  Everything in there looks the same and they are pulling some stuff out and treating other stuff with delicate care and I keep thinking of the opening of Buckaroo Banzai where he is doing the neurosurgery.   "NONONO!  Don't tug on that, you never know what it might be attached to!"

Sorry for the gallows humor, it comes from my years on "The Job"  (police work).
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

drowland1134

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Re: Newly Diagnosed in Charlotte,NC
« Reply #7 on: July 20, 2014, 06:48:00 pm »
HI AN Guy. I am 28 years old and I am currently 8 weeks post translab surgery. I live in Charlotte also and traveled to Duke Raleigh to have my procedure done by Dr. Cunningham and Dr. Zomorodi. Dr. Cunningham has been working for years with Dr. Fukishima and now does a lot of his surgeries with Dr. Zomorodi. I was very impressed with their bed side manor and number of surgeries they have done. I think Cunningham does around 75 a year and has done around 700 in total. Overall my surgery was very successful. As I had the translab approach done, I lost the hearing in my left year, but have had minimal other problems. I have a little facial weakness, but that is expected to return back to 100%. Just make sure you are comfortable with whatever doctor you choose and make sure you see at least more then one doctor so you know all your options. There is definitely a life after having AN surgery. I started riding my bike 4 weeks after surgery and i am already running 3+ miles on the elliptical. I am very thankful i got the surgery done and that sucker taken out. I had so much anxiety when i found out i had a tumor that i just wanted to get it out and get on with my life. Good luck and let me know if you have any questions

ANGuy

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Re: Newly Diagnosed in Charlotte,NC
« Reply #8 on: July 20, 2014, 08:34:32 pm »
HI AN Guy. I am 28 years old and I am currently 8 weeks post translab surgery. I live in Charlotte also and traveled to Duke Raleigh to have my procedure done by Dr. Cunningham and Dr. Zomorodi. Dr. Cunningham has been working for years with Dr. Fukishima and now does a lot of his surgeries with Dr. Zomorodi. I was very impressed with their bed side manor and number of surgeries they have done. I think Cunningham does around 75 a year and has done around 700 in total. Overall my surgery was very successful. As I had the translab approach done, I lost the hearing in my left year, but have had minimal other problems. I have a little facial weakness, but that is expected to return back to 100%. Just make sure you are comfortable with whatever doctor you choose and make sure you see at least more then one doctor so you know all your options. There is definitely a life after having AN surgery. I started riding my bike 4 weeks after surgery and i am already running 3+ miles on the elliptical. I am very thankful i got the surgery done and that sucker taken out. I had so much anxiety when i found out i had a tumor that i just wanted to get it out and get on with my life. Good luck and let me know if you have any questions

I'm so glad you had such a good result.  There's some selfishness in that statement since it gives ME some peace of mind about my own situation.  Again, thank you for taking the time to make a post that is relieving some of my anxiety.
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

ANGuy

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Re: Newly Diagnosed in Charlotte,NC
« Reply #9 on: July 24, 2014, 05:36:49 pm »
Update:


I went to see a guru at Duke today, a neurosurgeon.  He thinks my 1cm tumor is NOT the cause of my symptoms as my symptoms are not consistent with AN symptoms.  AN's typically present with hearing loss as the main issue and balance etc as minor/secondary issues.  Also, AN symptoms should be progressive, not fluctuating over a period of a decade or so.  My symptoms are mainly balance issues, my hearing isn't that bad, and they come and go, and have come and gone, for years.  Also, he thinks my tumor is too small to be the likely cause of my symptoms.  He referred me to a high-level ENT at Duke to explore inner ear disorders like some type of endolymphatic hydrops.  This is what I thought all along, but was told it wasn't the case, by the people I saw in Charlotte.  So, Without me even mentioning my theory about all of this, this Dr at Duke came up with the same theories about MY problem as I did.  The other guys were all going with percentages, NOT what my symptoms/history had shown.

Score one for Duke!


Next, the tumor itself and what to do about it.  He has seen enough slow growth and no growth tumors to think that observation is not a bad idea for me.  He thinks, as I have all along, that finding the tumor was an accident as a result of investigating my other problem, some type of inner ear disorder and that letting the tumor go for 10 years will not cause any worsening of my symptoms.  He thinks it is entirely appropriate to engage in a course (watch and wait) that will result in me being 57 years old and having a 1.5 cm tumor.  That is if it grows at all.  Even if it progresses faster than I would like, say it needs to come out in 5 years, he thinks that is 5 years of healthy living with no risk of surgical side-effects.  Again, this is what I was thinking all along and the Dr down hear made me think that the longer I waited, the worse off I would be.

Score 2 for Duke!

It's not that the people I have seen down here are incompetent, it's just that they can't have the experience that the people at Duke have.  The local Dr's looked at the likelihood of this and that and decided what I had and needed.  All three of them were wrong.  The Dr at Duke looked at what I was presenting with, and what his EXPERIENCE showed him, and what would happen in the interim periods between MRI's. 

There is just no substitute for experience and a Dr who is in charge of skull-base tumors, at a brain tumor center, at a world renowned medical center, is just going to have more experience in these matters.  He's "been there, done that" many times and has a better ability to navigate his way through these situations.
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

mesafinn

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Re: Newly Diagnosed in Charlotte,NC
« Reply #10 on: July 24, 2014, 06:05:06 pm »
Hello ANGuy,

I'm sorry for all you have been going through.  Truly.

But I do suggest you get another opinion.  I don't pretend to be a AN guru, but I don't fully agree with what you're describing as your doc's input.    ANs can grow sporadically--and suddenly quickly.  Watch and Wait CAN work.   But it also cannot.   Your balance and hearing issues can remain minimal.   And they can change almost overnight.   Absolutely, you can make it to 57 and be virtually symptom free.   But regardless of what led you to discover your AN, you do have one from what you're saying---and so it will require monitoring.

My own AN was 1.4 cm, discovered when I was 47.  I had been having symptoms for years---at least six or seven---before I investigated further.  I had consultations with individuals from the east coast to the west coast, in the U.S. and in Canada.   Everyone told me something different, but I armed myself with as much information as possible.   I didn't rely on one expert.  I received multiple pieces of information.

You mentioned NYU, and one of the leaders in AN treatment is Dr. Douglas Kondziolka at NYU Medical Center.  It wouldn't hurt to get his input, if you're interested.  Another gentle recommendation:  send your MRI disk to the House Clinic in LA.  They will review it for free and give you their input.  Nothing to lose (although they will likely recommend surgery...but maybe not given the size of your tumor).
http://www.houseearclinic.com/consultation/acousticneuroma

You may end up with the same decision and that's great.  But at least you will have made a more balanced and informed decision.

Wishing you only the best.   Peace to you,

P.
Oct 2012:  Constant Pulsatile Tinnitus
Feb 28, 2013: Dx AN 1.4 cm X .9 mm
April 19, 2013:  GK at UPMC w/Dr. Lunsford

Some things in my life need to matter less, and other things in my life need to matter more.  So yes, I'm taking this as a "lesson learned experience."

ANGuy

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Re: Newly Diagnosed in Charlotte,NC
« Reply #11 on: July 24, 2014, 07:13:21 pm »
Yes, I will be seeing another expert, at Duke, a teammate of the Dr I saw today who is an ent that specializs in vestibualr disorders AND skull base tumors AND does radiation in addition to surgery, so I am covering a lot of bases with these two Dr's.

Observation, yes, I am getting an MRI in 5 mos which is 6 mos from the first one.  I can track my AN through MRI and make a move if and when needed.  There is simply no reason not to watch this thing for a while, or forever as I can pull the trigger on treatment at any time if and when it is needed.

Simply put, there is no reason to do surgery right now.  There is no evidence that my symptoms are caused by my AN.  There is NO evidence (yet) that my AN is growing.  There IS evidence that my symptoms ARE NOT caused by my AN.  Why do AN surgery when we don't even know what is causing my symptoms?  AN's are not like a mountain that is to be climbed simply because it is there.  Before someone performs the single most difficult brain surgery known to Mankind on me, I need to have a some reason WHY it is to be done.
I could have had this AN for 20 years now for anyone knows.  This surgeon does surgery on people in there 60's with 3cm AN's for the most part.  I have 13 years and 2 CM before I get to that point.  In that time I will be able to earn at least half a million Dollars, and send my kids off to college as opposed to driving them to two different soccer fields at the same time.


All this guy does is skull base tumors.  He treats them, researches them, and teaches others to treat them.  He says that mine doesn't need surgery and may never need surgery, I'm going to listen.
« Last Edit: July 24, 2014, 07:15:12 pm by ANGuy »
Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.