Author Topic: My experience with trans-lab surgery.  (Read 9549 times)

PranaRN

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My experience with trans-lab surgery.
« on: August 16, 2016, 03:19:51 pm »
On 8 Feb 2016 I had my Acoustic Neuroma removed by Translabrinth approach.  The surgery lasted about 8 hours, plus a long time in the recovery room.  I was very fortunate to have family members there, which helped, since I don’t remember much about the time I was in the ICU.  I was there for 3 days and then to a regular room, but still on the neuro floor. I was released on 13 Feb with some exercises (which sometimes seemed a little silly…but truly do help) and follow-up appointments.
On 15 Feb I was readmitted for a cerebral spinal fluid (CSF) leak.  The hospital didn’t have a bed on the neuro unit, so I went to a general medicine floor.  I hope I never have to do that again!  I got there with a tremendous headache and I was freezing.  As I lay in the bed with clothes still on covered with my down coat, I had to ask if I could have a blanket…I think it must have sounded like I asked for a million dollars.  The nurse came in to start the IV and I had to suggest he put me in a gown first, so it would be easier for both of us.  I must interject here, I am a RN and know this intake should have been totally different.  The nurse also broke a vial of medication, which is glass on the floor, where we walk around in socks-it was never cleaned up.  I had to get a lumbar puncture to check the pressures in my spinal fluid.  I was told not to go to the rest room by myself, so I called my nurse at one time, he said he didn’t have time for this.  I would have to get back to my bed myself.  WHAT??  In the morning, I was transferred to the neuro unit where I think the angels were singing…
A wonderful staff, but a long process for me.  I was in the hospital for 4 more weeks.  I had to lay on my back for majority of it.  If you’ve never tried to use a bedpan, it’s not as easy as they say it is!  They put me in a bed and told me to lay flat and gave me pain medication.  I never love the idea of medication, but this helped the pain greatly!!  I had a lumbar puncture (LP) drain put in since the leak would not just seal up.  This is the same type of drain they put in the first night, but this one stays in and they can take fluid off at a controlled rate.  The pain I felt when it went in was beyond anything I’ve ever felt, but they were running it against a nerve, which makes the pain shoot down to the toes.  Plus when they hit the area, I could feel the CSF draining and felt like my head was caving in!  I told them after that if I ever needed another one in this lifetime, I will have anesthesia.  NEVER AGAIN!!
The drain wasn’t helping the leak stop, so I went back to surgery on 27 Feb.  More fat was taken from my abdomen to fill the area, but at least they used the same incision as the first time.  They put another drain in, while I was still under anesthesia.  I was told to go ahead and get up to go to the bathroom after a day.  I was leaking again.  Flat again.  It didn’t work.
I went back for surgery again on 5 Mar, more shaving of my hair, more fat taken-new incision, and a plate put in.  This worked.  I was home by 13 Mar.  It was a long stay, but I’m that one.  We always run into that one patient that has the problems.  I was that patient.
I do have some suggestions for anyone who may need them:
-Have support at the hospital with you!  It helps to have a second pair of ears when the doctors are there and someone to help you when the staff is busy
-Set your house up before hand to have walkways clear and free of things on the floor.  I made sure I had a straight shot to the bathroom.  
-Have some easy snack food or have someone bring you some for when you get home.  You’re body will be tired and you’re not likely to want to cook.
-I made sure I had someone come by and check on me and phone numbers available if I needed them (I live alone).
-Have someone set up to come take your trash out or help care for animals.  Bending over sucks at first and lifting is not something you want to do right away.
-Don’t be afraid to ask questions!  At times, doctors are one track with their thinking, it happens to all of us.  Write your questions down, and ask them!!  I had a friend who “didn’t want to take away from the other patients.”  They are here to help us and sometimes need to be reminded we aren’t doctors! 
-I had numerous residents, PA’s, NP’s, and fellows coming in and checking on me.  It hurt and by the third week, I said enough!  I didn’t allow anyone but the surgeons and their PA to touch me.  I just couldn’t take it anymore.  I realize my experience was kind of exptreme, but you have to speak up for yourself.
-Be nice to the nursing staff!!  They will make your experience awesome, if you let them.  They are used to dealing with us patients on a daily basis and the doctors.  You can ask them questions and they will generally always find out the answer or pass it on to whoever needs to know what is going on.
-Basically…use your resources!!!
The after-affects:
My facial nerve was saved.
I had already list much of my balance, so it hasn't been horrible.  Coming off the pain meds was horrible-but I was also on them for longer than most. I have lost some of my taste. I lost a LOT of hair- three months after surgery  (they say it's due to my being so sick and all the anesthesia).  I'm sure I'll think of more, but I hope this helps someone!!

v357139

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Re: My experience with trans-lab surgery.
« Reply #1 on: August 16, 2016, 06:48:07 pm »
Prana,
Congratulations on making it through.  I am sorry you had to endure so much.  But I am very glad it looks like the worst is behind you.  You made it through and now you can move forward.  I hope your recovery is now much less eventful than it was.  And you make a great point about asking the questions you need to, and having someone there to advocate for you.  Thank you for sharing that very good lesson.
Rich
Dx 2.6 cm Nov 2012, 35% hearing loss.  Grew to 3.5 cm Oct 2013.  Pre-op total hearing loss, left side tongue numb.  Translab Nov 2013 House Clinic.  Post-op no permanent facial or other issues.  Tongue much improved.  Great result!!

mcrue

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Re: My experience with trans-lab surgery.
« Reply #2 on: August 16, 2016, 09:48:22 pm »
PranaRN,

I'm so sorry to hear about your disappointing and what certainly sounds like a miserable multi-week recovery following your microsurgery. Unfortunately, major brain surgery has so many potential serious complications and variables which are dependent on so many different factors.

Thank you for sharing your true story with everyone. Brain surgery is frightening enough, not to mention several CSF leaks to deal with post-OP..... and also the whole bedpans-and-catheters for over a month.

Obviously, you've been through hell, and living on your own is not ideal following such a major life event. You sound like a strong person.  Hopefully at the end of the day it will be a total success, and you never have to go through it again. Your story is certainly very touching and we all wish you the very best for the future.

Warm regards.
« Last Edit: August 16, 2016, 09:50:47 pm by mcrue »
5/19/2015 - 40% sudden hearing loss + tinnitus right ear

6/26/2015 - AN diagnosed by MRI - 14mm x 7mm + 3mm extension

8/26/2015 - WIDEX "ZEN" hearing aid for my catastrophic tinnitus

12/15/2015: 18mm x 9mm + 9mm extension (5mm AGGRESSIVE GROWTH in 5 months)

3/03/2016:   Gamma Knife - Dr. Sheehan

UpstateNY

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Re: My experience with trans-lab surgery.
« Reply #3 on: August 17, 2016, 10:12:34 pm »
PranaRN,

I am sorry you had such a difficult recovery, but it appears this is now behind you and your facial nerve was saved.  Those are some great suggestions you have provided as well.

Would you mind sharing what the size of your AN was and which facility performed the surgery?  Although such lengthy complications are not typical, it may provide useful info for others considering surgery.

I hope your recovery continues to be positive.
« Last Edit: August 17, 2016, 10:15:20 pm by UpstateNY »
Apr 2015: Diagnosed with 8mm AN at age 49
Oct 2015: MRI showed growth to 12mm
Feb 2016: Completely removed via Transcochlear approach at House Clinic; no facial/eye issues, balance improved
Aug 2016: MRI shows no regrowth/residual tumor

My story:  http://www.anausa.org/smf/index.php?topic=22581.0

PranaRN

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Re: My experience with trans-lab surgery.
« Reply #4 on: August 18, 2016, 09:47:25 am »
Thank you everyone.  I am so blessed to be here and have my facial nerve saved!! 

I don't remember the size of my AN, but they said it was small.  Unfortunately, it was growing into my cochlea and getting very close to my facial nerve.  This is why I opted for surgery.  My hearing was mostly gone already. 

I had the original surgery at Providence Park Hospital in Novi.  When I was readmitted, I went to William Beaumont Hospital in Royal Oak, due to proximity to my family. 

Someone asked if I would do this again, I believe I would.  I learned so much during my down time and know it all happened for a reason.  I believe God was watching over me and certainly has a plan. 

Again, thank you!! 

mcrue

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Re: My experience with trans-lab surgery.
« Reply #5 on: August 18, 2016, 10:12:37 am »
Michigan Ear Institute performs most of their surgeries at Providence Park Novi. Did you get treated by one of their physicians?

Dr. Hong was the one who diagnosed me with my AN last summer.
5/19/2015 - 40% sudden hearing loss + tinnitus right ear

6/26/2015 - AN diagnosed by MRI - 14mm x 7mm + 3mm extension

8/26/2015 - WIDEX "ZEN" hearing aid for my catastrophic tinnitus

12/15/2015: 18mm x 9mm + 9mm extension (5mm AGGRESSIVE GROWTH in 5 months)

3/03/2016:   Gamma Knife - Dr. Sheehan

PranaRN

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Re: My experience with trans-lab surgery.
« Reply #6 on: August 18, 2016, 06:15:14 pm »
I was actually diagnosed by my PCP.  Dr. Jacob was my neurosurgeon and Dr. Bojrab was my ENT surgeon from MEI. 

Mcrue, did you have surgery, or what is your status?? 

mcrue

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Re: My experience with trans-lab surgery.
« Reply #7 on: August 18, 2016, 08:12:46 pm »
PranaRN,

That's terrific that your facial nerve was saved. I forwarded your story to several of my friends and family, and let's just say the general consensus was that they all agreed it was pretty gruesome. We all really feel for you and your plight.

I visit Providence Hospital in Novi all the time for my appointments, as it's a quick ten minutes from my house. I'm glad you had the courage to share your valuable story on the forum. It's refreshing to escape the often "pollyanna mentality" that sometimes permeates the microsurgery forum.

As I said many times, AN surgery is major brain surgery and the possible complications, side effects  and recovery issues should never be minimized. Your story is a perfect example of that. Not all surgeries are home-runs, and not all recoveries are disasters, but at the end of the day it is brain surgery none-the-less.

My tumor was under 3.5 inches, so thank God I was a very good candidate for radiation according to several world-renowned specialists in the field. After much research, I ultimately went to Dr. Jason Sheehan at the University of Virginia during the first week of March 2016 to have Gamma Knife. I feel it was one of the best decisions I ever made.

I was fortunate to have made the trip to Virginia, and fortunate to have the funds to fly out to prestigious UVA.

As they use to say on my favorite childhood television show the  A-TEAM: "I just love it when a plan comes together."

Better luck with your ongoing recovery.
5/19/2015 - 40% sudden hearing loss + tinnitus right ear

6/26/2015 - AN diagnosed by MRI - 14mm x 7mm + 3mm extension

8/26/2015 - WIDEX "ZEN" hearing aid for my catastrophic tinnitus

12/15/2015: 18mm x 9mm + 9mm extension (5mm AGGRESSIVE GROWTH in 5 months)

3/03/2016:   Gamma Knife - Dr. Sheehan

UpstateNY

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Re: My experience with trans-lab surgery.
« Reply #8 on: August 18, 2016, 11:43:52 pm »
PranaRN, I was in a similar situation to you.  My AN was close to my cochlea, so chose to get it removed.  My hearing was completely gone at that point though.

Although you had a lengthy recovery, I couldn't agree more that things happen for a reason.  Your recovery could have been much longer if you chose a different mode of treatment.  Some people downplay the risks of radiation because it is a simpler procedure, but the recovery time and long term side effects could be much worse.
« Last Edit: August 18, 2016, 11:58:10 pm by UpstateNY »
Apr 2015: Diagnosed with 8mm AN at age 49
Oct 2015: MRI showed growth to 12mm
Feb 2016: Completely removed via Transcochlear approach at House Clinic; no facial/eye issues, balance improved
Aug 2016: MRI shows no regrowth/residual tumor

My story:  http://www.anausa.org/smf/index.php?topic=22581.0

mcrue

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Re: My experience with trans-lab surgery.
« Reply #9 on: August 20, 2016, 08:58:18 am »
Your recovery could have been much longer if you chose a different mode of treatment.  Some people downplay the risks of radiation because it is a simpler procedure, but the recovery time and long term side effects could be much worse.

I appreciate the lively discussion and can certainly sense the passion in your replies regarding microsurgery; however, I'm sorry but I have to jump in here and respectfully disagree. I think we can stipulate that nobody has a crystal ball, so therefor nobody knows if the recovery would have been much longer or shorter with radiation. For all we know, it could have been much better and faster with radiation. PranaRN's harrowing story and experience with microsurgery speaks for itself.
5/19/2015 - 40% sudden hearing loss + tinnitus right ear

6/26/2015 - AN diagnosed by MRI - 14mm x 7mm + 3mm extension

8/26/2015 - WIDEX "ZEN" hearing aid for my catastrophic tinnitus

12/15/2015: 18mm x 9mm + 9mm extension (5mm AGGRESSIVE GROWTH in 5 months)

3/03/2016:   Gamma Knife - Dr. Sheehan

UpstateNY

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Re: My experience with trans-lab surgery.
« Reply #10 on: August 20, 2016, 11:10:18 am »
mcrue,

Good reply.  It is almost as if I wrote it myself. 

You are absolutely right.  Both surgery AND radiation have significant risks, and nobody can predict the outcome ahead of time.  We all hope for a perfect outcome, but sometimes that is not always the case.  Providing someone comfort that their recovery could have had more significant complications if a different path was taken is not a bad thing.  I am in the camp that believes many things in life happen for a reason, so would hope someone would do the same for me.
Apr 2015: Diagnosed with 8mm AN at age 49
Oct 2015: MRI showed growth to 12mm
Feb 2016: Completely removed via Transcochlear approach at House Clinic; no facial/eye issues, balance improved
Aug 2016: MRI shows no regrowth/residual tumor

My story:  http://www.anausa.org/smf/index.php?topic=22581.0

mcrue

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Re: My experience with trans-lab surgery.
« Reply #11 on: August 20, 2016, 02:07:18 pm »
mcrue,

Good reply.  It is almost as if I wrote it myself. 

:)

I think it's important to keep in mind that while a lot of us may have passionate views, at the end of the day we are all on the same team.
5/19/2015 - 40% sudden hearing loss + tinnitus right ear

6/26/2015 - AN diagnosed by MRI - 14mm x 7mm + 3mm extension

8/26/2015 - WIDEX "ZEN" hearing aid for my catastrophic tinnitus

12/15/2015: 18mm x 9mm + 9mm extension (5mm AGGRESSIVE GROWTH in 5 months)

3/03/2016:   Gamma Knife - Dr. Sheehan

JLR

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Re: My experience with trans-lab surgery.
« Reply #12 on: September 03, 2016, 08:05:17 pm »
Oh my goodness what an experience. Where on earth is this hospital. Hope you have continued good health. JLR

mcrue

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Re: My experience with trans-lab surgery.
« Reply #13 on: September 03, 2016, 09:49:12 pm »
Oh my goodness what an experience. Where on earth is this hospital. Hope you have continued good health. JLR

I agree JLR.   I'm glad PranaRN posted her story. It will certainly help others as they search for patient experiences with a similar sized AN and symptoms.

The name of  the hospital is Providence Hospital, located  in Novi, MI.
5/19/2015 - 40% sudden hearing loss + tinnitus right ear

6/26/2015 - AN diagnosed by MRI - 14mm x 7mm + 3mm extension

8/26/2015 - WIDEX "ZEN" hearing aid for my catastrophic tinnitus

12/15/2015: 18mm x 9mm + 9mm extension (5mm AGGRESSIVE GROWTH in 5 months)

3/03/2016:   Gamma Knife - Dr. Sheehan

mcrue

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Re: My experience with trans-lab surgery.
« Reply #14 on: September 10, 2016, 10:28:30 pm »

Providing someone comfort that their recovery could have had more significant complications if a different path was taken is not a bad thing.

It's disingenuous to suggest radiation may have offered a worse outcome.  She's likely thinking just the opposite.

As mentioned earlier, nobody has a crystal ball. Her surgery experience speaks for it self.
5/19/2015 - 40% sudden hearing loss + tinnitus right ear

6/26/2015 - AN diagnosed by MRI - 14mm x 7mm + 3mm extension

8/26/2015 - WIDEX "ZEN" hearing aid for my catastrophic tinnitus

12/15/2015: 18mm x 9mm + 9mm extension (5mm AGGRESSIVE GROWTH in 5 months)

3/03/2016:   Gamma Knife - Dr. Sheehan