Author Topic: starting AN journey in Seattle area, probably surgery, plus family history  (Read 3131 times)

CatzEyes

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Hi all --

I am very grateful to find ANAUSA has such great forums. I've visited the site in the past seeking information to help my mother, little realizing I'd need it myself one day...

Mom was diagnosed in 2005 at age 82 with an 8mm schwannoma, after having had gradual hearing loss and balance issues that she "just got used to." In 2007, at 14mm, she had gamma knife at Medical College of Georgia hospital, and recovered well enough that in 2008, my husband and I encouraged her and my dad to relocate to Olympia WA when we did (we came up here from Monterey). She's had monitoring MRIs every 18 months or so, and the last one, November 2013,  showed the little bugger had regrown slightly and was impinging on the balance nerve more than the auditory nerve where it started -- this means she now uses a walker rather than a cane, and complains often about the wonky-head dizziness. Bad data in...

As for me: this past October/November, I found myself experiencing a strange dizzy sensation if I stretched and reached for the sky, and a sensation of someone pressing a thumb to my right eye and cheekbone. I chalked it up to holiday tension until January-ish, when the sound I think of as aircraft-at-30000-feet hiss was superseded by dog-whistle high pitches in my right ear. When my GP couldn't find anything more interesting than ear-wax, I asked for a referral to my Mom's current ENT in Olympia, Dr Marlan. Bless him, I think he was humoring me when he scheduled an MRI, but he called me the day after the MRI and asked me to come see him the very next day.

Longer story short: it's an AN in the right ear, 6mm x 4mm x 3mm -- small by any standard, but there nonetheless. My balance is fine, hearing is excellent, tailing off only in the 6000-8000 hz range where the dog-whistle kicks in, and I'd like to try and keep as much as possible. At 57, I feel a little too young for radiosurgery, worrying if it'll come back (altho' I gather that can happen with any procedure), and see little gain in hanging around waiting to see if the darn thing grows fast or slow. There's a lull at work this spring/summer, before I travel in late August, but we get crazy busy again in October, then it's the holidays, and then it's next year this time... When it could be bigger, more troublesome to whack, and potentially more symptomatic.

My old college flame, now Dr Joseph Arguelles of Plattsburgh, practiced neurosurgery in Olympia for many years (he left a few years before we arrived). After the diagnosis, I emailed asking for his thoughts, and he recommended Dr Johnny Delashaw at Swedish Medical as "the person I'd want doing the surgery if I were in your shoes."

I met Dr Delashaw 4/24/14 and was immediately put at ease. He suggested Middle Fossa approach as the best likelihood of preserving hearing, but also because the AN appears to be perched on top of Spaghetti Junction (sorry, my flip way of referring to that tangle of nerves 7, 8, 9), and he thought that approach would give him a clear view of the work to be done.

Surgery, as yet unscheduled but probably in late May, would be tag-teamed with Dr Douglas Backous. I chatted with Barb, of the Seattle support tribe here on ANA, and she spoke highly of him, too.

After reading the many wonderfully generous threads on this site, it's beginning to sink in just what major surgery I'm letting myself in for, but all things considered, I don't see myself backing out... It ain't gonna get better, eh?

Anyway, many thanks for letting me join in the community. I'll keep folks posted as we progress on the road. Anyone else had experience with Middle Fossa or this team of docs, please chime in!

Laura
Middle Fossa surgery at Swedish, Seattle, Drs Delashaw and Bacchus, 5/5/14. Retained 98% hearing in surgical ear after 6 months recovery time.
diagnosed 3/15/14 :: 6mm x 4mm x 3mm AN in right ear.
mother diagnosed 3/2005 8mm; gamma knife 2007 at 14mm. some regrowth, pressing balance nerve, by 2012

volleymom

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Hi Laura,
I think you will do well if Dr Delashaw is on your team.  He worked in my head in 2009 at OHSU. I was back at work about 10 weeks after retrosigmoid.  You will probably have fatigue to deal with during your travels this summer, but pushing yourself will help you get ready to go back to work.
Good luck to you,
Kathy
9mm X 16mm diagonsed in August 2009.  Retrosigmoid Nov, 2009 at OHSU in Portland, OR.
post-op had some facial nerve weakness, nearly resolved. Mild tinnitus. Left sided deafness.

leapyrtwins

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Laura -

sorry about the AN.

You mention family history.  ANs aren't typically hereditary.  Has anyone tested you to see if you are NF2 ?  Unless I'm mistaken, NF2 is hereditary.

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

Cheryl R

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There have been posts on here of an occ family where it does happen to have the next generation of a family to also have an AN.   Not common but does seem to happen.       I do not think it is known why or else I can't remember if a reason has been found.    NF2  can be hereditary but is also seen now too where there is no previous family member with it.       I am one of those,         A person though to have NF2 must have bilateral tumors or 1 AN and other types of tumors to be NF2.      Spinal tumor, another benign brain tumors, skin neuromas.        People who have the hereditary NF2 are frequently of a younger age when show symptoms and have other issues than the brief description I wrote.         However with my no previous history my daughters have a chance of also having NF2 in the same pattern I have shown of no ANs until late 40's.      This was told to me by my neurotologist.  I would say in your case you would not know if NF2 unless another tumor was found on your mother.                     The choice of what treatment and when is hard.        Mid fossa does work for many if done by an very experienced surgeon.             I do my hearing on one side thanks to mid fossa.              I hope it goes well for you and feel for your mother.                     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

CatzEyes

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Many thanks for the replies, all. The good reports on Dr Delashaw and mid fossa both reassuring!

Neither Mom nor I have been tested for NF2, but neither of us have the 'required' bilateral tumors, so none of the doctors involved seem to find it a likely answer.

I offered her story for two reasons -- first being that our situation is pretty unusual. Our ENT told me he referred me for the initial MRI mostly because he had seen his first parent-child pair of ANs only one year earlier and it made him a little skittish -- we're only the second pair in his 20+ year practice. Secondly, because it illustrates why I was so ... attuned? ... to what these very small changes in balance/hearing might mean.

In other news, I took the advice of (I think it was) Leapyrtwins on another thread, and contacted a P/T who specializes in vestibular rehab to get a headstart on retraining the good ear to take on more work... It was easy to find one: I just called the woman who has been helping Mom!

Joyce's balance tests were more searching than the MDs, who were satisfied if I could manage 10-15 seconds of various standing/balancing tests. She had me close my eyes and do heel-to-toe squats or head-turns, and it all went to heck in a handbasket. What I could do for 50-60 seconds with eyes open dropped to less than 10 seconds the first time tried eyes closed.

Needless to say, I have been assigned three or four balance tasks to practice in coming weeks, 3x daily; I'll see her weekly until surgery, then whenever the docs approve me to go back afterwards. I even found an easy way to know if I'm practicing the minimum time on two tasks: I do them against the closed bathroom door while my electric toothbrush does its two minute cycle!

cheerio,
Laura
Middle Fossa surgery at Swedish, Seattle, Drs Delashaw and Bacchus, 5/5/14. Retained 98% hearing in surgical ear after 6 months recovery time.
diagnosed 3/15/14 :: 6mm x 4mm x 3mm AN in right ear.
mother diagnosed 3/2005 8mm; gamma knife 2007 at 14mm. some regrowth, pressing balance nerve, by 2012