Author Topic: Just Diagnosed  (Read 10572 times)

Lori101

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Just Diagnosed
« on: November 05, 2011, 01:32:40 pm »
Hi All,
I've just been diagnosed with a 2.6 cm x 2.3 cm AN (I didn't get a third dimension like most of you seem to have, odd???)  (edited due to a finger problem which made me type mm instead of cm!!!)

It all started back in 2006, when I went to my GP with tinnitus, vertigo, ear fullness, distorted hearing left side (inability to use telephone).  She initially thought Meniere's but said "there's a slight possibility of an acoustic neuroma".  She referred me to an ENT.  After checking me out, having me come in for an audigram (normal both ears), he told me I had a "dysfunctional eustachian tube".  No reason why, no treatments, no prognosis.  A real helpful guy.  Told me that since my audiogram was normal, I didn't *really* have hearing loss on the left, it just seemed that way because I was hearing differently out of each ear!!  My GP suggested antihistamines/decongestants - they didn't help.

The vertigo eventually subsided, I began to be able to hear out of my left ear (i.e. use the telephone with it again), and the ear stopped feeling like it needed to "pop" all the time.  I did still have a difference in hearing with the two ears (the dial tone was my testing device, and it always sounded flat with the left ear).

In summer 2010, I started having vertigo again and when it happened, I also got a roaring/pulsing noise in my ears and the hearing seemed to fade on the left.  It would only last maybe 30 sec. at most.  In  fall 2010, I started noticing the left side of my face feeling a bit numb and I had a small lump in front of my ear, and I went to my GP, she blamed in on dental work (I had recently had a cleaning, but that's it) and sid the lump was a swollen lymph node.  After several visits to GP and dentist (nothing found), she finally referred me to an ENT (same one as in 2006).

Go to the ENT, he tells me the lump isn't a lymph node, it's the parotid gland.  He schedules a fine needle aspiration biopsy for the following week.  I have to make a separate appointment to talk about the vertigo!  The aspiration just draws up clear liquid, he tells me it's probably just a cyst.  I have an audiogram (so I can see him about the vertigo), and I notice that I'm missing a lot with the left ear.

When I come back to discuss the results, he does a few checks, tells me I have hearing loss in the left ear (it's only in the high frequencies, the rest is normal)  (right ear still excellent).  Tells me I have benign positional vertigo, gives me a sheet of exercises.  Tells me it's not an acousitc neuroma but that he wants me to have an MRI to find out why I've got hearing loss in just one ear.

Eventually, 3 months later (pretty good time frame actually for our system), I get my MRI (no contrast).  When the tech says that if I they want one with contrast, my appointment will be in the daytime, I'm pretty sure they've seen something.

Two weeks later, I pick up my copy of the MRI report & disk.  This is how I find out I definitely have an AN.  MRI report refers to mass effect, and pressing on the brainstem.  The day after, I get a call from the ENT's office to come in.

Go in 2 days later, ENT seems very unconcerned about the whole thing.  I ask why I didn't get sent for an MRI 5 years ago and he goes into a big rant about how they can't send eveyrone for MRI's blah blah blah.  Very defensive.  Doesn't want to answer any questions about neuromas or surgery - he's referring me to another ENT who does the surgeries (Dr. Westerberg here in Vancouver).  I'm rushed out the door after less than 10 minutes!!

I phoned Dr. Westerberg's office myself to see when my appointment is going to be (since the first ENT forgot to tell me about the MRI appointment), only to be told it will be a few weeks before they even get to the referrals and they are already booking into next year!!

So the only info I have on my brain tumor is what I've found on the internet.

I go to my GP, and she tells me they're slow growing and not to worry and if it was her, she wouldn't be panicking about it.  She seems to think that I'll get in to Dr. Westerberg faster because the receptionist can't make the decisions of how quickly I should be seen.

Through another doctor, I've also gotten a referral to Dr. Akegami in Vancouver and I have an appointment to see him in December.  I've also had my MRI sent to the Winnipeg Gamma Knife centre for a consult.

Looking at the treatment options, I think that only surgery or radiation are my options, seems too big for a W&W.

I'm very concerned about surgery.  Sounds like there can be a lot of complications and a  long recovery period.  I have a physically and mentally demanding job.  I'm on my own so I don't have anyone who can look after me if there's a long recovery period.  I have lots of useful hearing in my left ear (I can still use the phone with it, and unless the environment is very noisy, can hear conversations to the left just fine).  My face just tingles a bit, but functions normally.  Balance is only an issue when standing on one foot or turning suddenly.  I can move my head around without experiencing vertigo.  A cure that could be worse than the disease doesn't sound very appealing.  My friends tell me it's just that people put up the bad stories not the good ones.

Radiation sounds like it's got a much quicker and easier recovery period.  Downside is the "thing" is still in there and could grow.  I gather they also swell from the radiation and this could cause more problems with the nerves/brain.  Depending on what site you read, GK has less or more complications than surgery!

I'm very concerned about the facial nerve.  My job involves talking to people too, and I need to be understandable and not to cause them distress wondering what's wrong with me.
 
Any Canadians on here gone to Winnipeg GK Clinic?

Thanks for listening to my rant!

Lorraine
« Last Edit: November 06, 2011, 02:26:12 am by Lori101 »
2.9 cm x 2.5 cm x 2.7 cm left side AN - MRI Oct 6/11
Retro-sigmoid Apr 24/12 - Dr. Akagami at Vancouver General Hospital. Vancouver, BC
Released after 3 days
SSD Left, very slight delayed onset facial weakness, resolved except eye issues
Working on balance issues

ppearl214

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Re: Just Diagnosed
« Reply #1 on: November 05, 2011, 02:25:34 pm »
Hi Lorraine and welcome. Sorry you joined our special little club but thrilled you found us.

By standards, if the measurements you are noting is accurate, your's is a very very very teeny-weeny AN.  Barely on the map.  Doesn't mean its not symptomatic but tiny.  We have folks on these forums with extremely larger AN's... as much as 8cm.

Again, if the measurements you are noting is accurate, you most certainly don't have to jump into any kind of treatment option, whether radiation or surgery.  If at that size, you have plenty of time to do your homework, but please do not allow yourself to become overconsumed with the homework.  You will need to take a step back every now and then to take a breath. I know... easier said then done but at some point, you will recognize it and yes, take a step back to catch your breath.

There is a wealth of info here on these forums. We have many from Canada that participate on these forums and can provide insight  regarding Canadian healthcare for AN's, including facilities you seek.  We have folks in W. Canada here and from the Forums Home page, you can also utilize the "Search" Option(top/right) to seek out info as well.

Please hang in there.... but extending a "Welcome" to you.
Phyl
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

Jim Scott

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Re: Just Diagnosed
« Reply #2 on: November 05, 2011, 02:47:47 pm »
Hi, Lorraine ~

I'm sorry you've been (finally) diagnosed with an acoustic neuroma but glad that you discovered this website and the discussion forums.  I'm not Canadian so I cannot respond to your question regarding the Winnipeg GK Clinic.  However, the long time it took for the various doctors you consulted to finally order an MRI that enabled you to discover the tumor and their defensive posture when asked about the long wait doesn't speak well about these physicians.

To address your perfectly logical concerns regarding treatment: radiation may well be a viable option for you but that is up to a doctor to decide.  If your AN is pressing on your brain stem, radiation may not be feasible.  Again, only a physician familiar with your MRI scan and other medical information can make that determination.  Surgery is always an option but your fears are not without some merit.  However, radiation carries it's own set of risks so neither treatment approach can guarantee the results will be complication-free.  The key to having the best odds of success (defined as no complications) is to chose a doctor/team that is well-experienced in dealing with acoustic neuroma patients.  Don't be rushed into any procedure.  However, don't be complacent to the point of thinking this can be postponed indefinitely or until a more convenient time.

Your concerns about damage to the facial nerve are common to just about all AN patients.  That was a big concern to me, too.  I was fortunate to find a local neurosurgeon with 30 + years of experience performing AN removals.  This doctor, while not famous, was the neurosurgeon that my wife's doctor chose to perform his spinal surgery, so I knew he was good.  He proposed a 'de-bulking' procedure wherein he would reduce the size and density of the tumor and sever it's blood supply, then team with a radiation oncologist to have it radiated via FSR  (Fractionated Stereotactic Radiosurgery) with the goal of destroying the remaining tumor's DNA and the ability to reproduce.  Long story short: it all worked.  No post-surgery complications and no ill effects from the radiation.  That was 5 years ago.  Today, I'm doing great!  My hearing had already been lost on the 'AN side' (my left ear) but other than that and a mild loss of normal balance, I'm pretty much back to normal. 

So, who says all you see on the AN message boards are the 'bad stories'?  We have lots of very positive stories to share, here.  Yes, some of our members have struggles and not every AN patient has a trouble-free recovery from surgery or radiation, but many do.  I urge you to stay connected with the ANA site and these forums as we strive to inform, advise (when asked) and, most of all, support AN patients.  We understand your concerns because we've been where you are, today.  Let us help you in whatever way we can and know that you are not alone in this battle. 

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.

CHD63

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Re: Just Diagnosed
« Reply #3 on: November 05, 2011, 05:31:45 pm »
Hi Lorraine and welcome to this forum .....

Just for our clarification ..... is your AN 2.6 mm by 2.3 mm or 2.6 cm by 2.3 cm?  It is a little unusual for a 2 mm AN to be pressing on the brainstem.  A 2 mm AN is very, very tiny.  However, a 2.6 cm AN is in the medium to large range.

I do not know anything about Canadian AN doctors or medical facilities, but we have several members of this forum who do.  Hopefully they will chime in here soon.

Best wishes.

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

Lori101

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Re: Just Diagnosed
« Reply #4 on: November 06, 2011, 02:27:23 am »
Yes, oops, corrected it, it should be cm not mm!! 
2.9 cm x 2.5 cm x 2.7 cm left side AN - MRI Oct 6/11
Retro-sigmoid Apr 24/12 - Dr. Akagami at Vancouver General Hospital. Vancouver, BC
Released after 3 days
SSD Left, very slight delayed onset facial weakness, resolved except eye issues
Working on balance issues

schmidtkat

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Re: Just Diagnosed
« Reply #5 on: November 06, 2011, 08:56:09 am »
Hello Lorraine,
You have found a great place for information. This forum has a lot of wonderful people from which to draw support. It's unfortunate you had to experience such challenges in getting the AN diagnosis and even more unfortunate that it is an AN. However, now that you know what you are dealing with you can focus on what to do about it. While I know nothing of the medical care you could receive in Canada, or for that matter anywhere other than the location I went for treatment, I would recommend getting multiple opinions and doing your research from credible sources to find what's best for you. Many people told me to be sure you go to someone with lots of experience. I would definitely echo that advice. My AN was 3.2cm+ and I have been  blessed with wonderful results. I attribute that to the skill of my surgical team, support from family and friends and also my faith. You mentioned having a demanding job and limited support. With that in mind, I strongly encourage you to lean on the fantastic people you meet on this site. A tremendous support system is in place right here. I personally have found great comfort in the discussions on this site from people who have "walked the walk" so to say, and can relate to your needs, concerns, fears and questions. ~Kathy

mk

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Re: Just Diagnosed
« Reply #6 on: November 08, 2011, 11:41:53 am »
Hi Lorraine,

I missed your original message and just read your response to another thread. I am from Ontario, and as you can see from my signature I had GK in Toronto for an AN slightly larger than yours. Unfortunately this failed, and after a lot of research I flew to B.C. and had surgery with Drs. Akagami and Westerberg.

I am sorry for all the back and forth and delays caused by obviously incompetent doctors (not to say anything worse). However the team that you have been referred to is the best in Canada as far as I am concerned. Rest assured that these doctors will recommend what they really feel that is best in your situation. I know that surgery sounds scary (it sure did for me, that's why I opted for GK initially, together with many other personnal reasons like very demanding job etc, not unlike what you are dealing with). However the outcomes and recovery times of patients with ANs of similar size who had surgery with Drs. A. and W. are excellent. Dr. A. has a very long waiting list, but the wait is well worth it.

By the way, I don't know anyone who has been treated at the GK centre in Winnipeg, but I thought that they also do GK in Vancouver. Ask your doctors about that.

If you need more information feel free to PM me, I am glad to help in anyway I can.

Marianna
GK on April 23rd 2008 for 2.9 cm AN at Toronto Western Hospital. Subsequent MRIs showed darkening initially, then growth. Retrosigmoid surgery on April 26th, 2011 with Drs. Akagami and Westerberg at Vancouver General Hospital. Graduallly lost hearing after GK and now SSD but no other issues.

steph28

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Re: Just Diagnosed
« Reply #7 on: November 08, 2011, 12:49:12 pm »
Hi,
I was also mis- diagnoised. I first went to the doctors back in spring 2005 with hearing issue. After a hearing test I was told I had hearing loss in my right ear (AN) side, but they was nothing to worry about. Forward to summer 2009 and lots of hearing test did my new doctor refer me to an ENT who thank god sent me for an MRI, with no die, only to be called back within 24 hour to have any other MRI. That's when I knew something was wrong as they kept asking me questions, but not telling me what was wrong.
I have surgery in Dec 2009 as mine was huge.
I would say you might be better having surgery as its against the brainstem. But I sure your doctor will advise best.
Good luck & please keep us up dated on your journey
Xx