Author Topic: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona  (Read 52668 times)

sgerrard

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #150 on: October 26, 2008, 07:56:21 pm »
Mary,

I hope your appointment goes well, and you find some new information about your dizziness issue. Hopefully it is something that will improve with time, or exercises, or if necessary, some other form of treatment. I know it is not easy for you some days.

Best wishes, and Happy Birthday tomorrow,

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

MaryBKAriz

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #151 on: October 30, 2008, 01:54:14 pm »
It has been a "whirlwind" the last few days which should have me feeling discouraged. While my dizziness is a little more today my outlook is better.

Saturday my wonderful sister-in-law cam for a visit. She is a guest that is NO maintenance and giving. Sunday, my husband gave me a surprise birthday party for my 60th birthday the next day. While, of course someone leaked the surprise, it was such a beautiful gift to have so many people I love attend. What a FABULOUS gift! Monday was my birthday and the family totally spoiled me all day. Tuesday we were out all morning visiting the ad agency my daughter works at and having a lunch out. Wednesday morning my dear sis-in-law left. :'(

Yesterday afternoon I had a follow-up appointment with my AN specialist. I didn't know why I was asked to schedule it, because I am not quite 5 post CK months yet. Perhaps because of my balance issues. Whatever the reason, I was so glad to talk to him. My husband and I went in with researched approaches to fight imbalance. My dizziness often does keep me constrained. I am using a cane all day most days and most of the time the rest of the days.

He is not scheduling an MRI yet because it isn't 6 months. But he is scheduling vestibular testing again to see if it is worse than pre-ck. He is MOST understanding of my difficulties. I feel so lucky to have a physician that not only hears, but listens. I am waiting to hear about the scheduling for that. Afterwards we will re-meet and decide a course of action. Right now I do believe we will go the injection(s) of gentamicin into the balance organs to kill the vestibular sensory signal to my vestibular nerve on my AN side route. He did NOT think I needed the major surgery that the surgeon suggested. While it is viable option, at that point he might as well do the AN surgery at the same time. That is just what I was trying to avoid with CK. This is an in-office procedure. He goes in through the ear drum to inject it and it may take more than one injection. It will probably make me worse for a little while but eventually it will even out like it does with surgery. Weird thing to say, but I am excited that we have this viable option on the table.

Late yesterday afternoon we went to the Phoenix chapter AN meeting. The subject - balance. How perfect for me! The most wonderful aspect of the meeting is being able to meet with "Pauline" of this site. She is remarkable and in person she GLOWS! What an inspiration. Of course meeting with the others also is good. The lady sitting next to me was post surgery by less than a month and felt terrific. Her facial nerve was bruised, so she had was dealing with that but it seems like that is temporary and I was amazed at how great she was doing in all ways.

The doctor that spoke gave some very interesting descriptions of imbalance and issues concerning it. He is the one who read my first vestibular test results and will be doing the next ones also. There was a PT doctor also who specializes in vestibular issues. She was so good that I hope to see her no matter what I do and how far away she is. Afterwards, when talking to her I think we can arrange an alternate schedule so I won't have to drive or be driven way into Phoenix twice a week.

After we left the meeting we went out and ate and discussed all that we learned. I guess I just feel so much better having a path to pursue. I went to bed early and crashed!

Again...everyone.....you are all THE best!

Take care,

Mary  8)
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

MaryBKAriz

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #152 on: November 19, 2008, 01:58:15 pm »
Yesterday I had a second vestibular testing (see my Pre-CK description in this thread of what all happens in this 1 1/2 hour testing) and then we went back to see my AN Dr. I had my first testing pre-CK. It had showed 76% loss on balance on that side . Needless to say it was bad before CK. Since I had symptoms piling up and worsening, I decided I was not comfortable with watch and wait. I am not sure if my decision to do a ONE day zapping CK caused it to get worse or if the trajectory would have taken me there anyway, but I am now testing at 100% loss on that side. I am so glad I have a doctor who is a specialist not only in ANs but vestibular issues, also. He explained not all imbalance and dizziness is testable. I believe it is the vertical that isn't able to be tested. Even though I have done and am doing exercises, it is not improving - but vacillating - he believes this problem will not go away by current methods, because I am trying to adjust to a constantly fluctuating situation. So the ways for me to address it are:

Labryinthectomy - The procedure involves complete removal of the inner ear. It involves a two or three day hospital stay. The incision is made behind the ear in the crease behind the ear and takes about forty-five minutes. This always results in a total loss of hearing in that ear. The advantage is that it controls the vertigo virtually one hundred percent of the time. This fixes the problem in 96-99% of the patients

Gentimycin injection(s) - Gentamycin profusion of the ear is employed to destroy the balance function and hopefully preserve the hearing. This involves opening the middle ear by cutting a hole in the eardrum after numbing it by placing a cream on it in the office. Once this is accomplished, the Gentamycin is placed in the middle ear and allowed to profuse across the round window membrane into the inner ear. A tube is placed in the eardrum at the same time to allow subsequent infiltration of the medication into the middle ear in the office after the initial profusion. It usually takes at least three treatments lasting thirty minutes each and spaced ten days to two weeks apart. Gentamycin is an antibiotic that is toxic to the nerve endings in the inner ear. It will destroy the balance nerve endings as well as the hearing nerve endings. However, it affects the balance nerve endings preferentially and if the dose can be titrated, you can usually destroy the balance function and preserve the hearing function. This works to stop the dizzy spells about 80% of the time.

While talking to him, we mentioned my hearing is fluctuating also. He feels that even the gentomycin has a good chance to destroy what hearing I have left. So he wants me to come in on a good day to see if the audiology testing will show 60 or more % FUNCTIONAL hearing in that ear. I really doubt it and neither my husband nor I even thought to ask, what IF there was functioning hearing? Is there any other choices? I kinda don't think so and I would choose losing my hearing to gain balance over saving hearing in one ear and having these many bouts of dizziness and imbalance to contend with.

So this is the decision awaiting me. He has signed a handicap license application. Makes me feel weird. I feel sad, but I also feel it will help me feel freer. If I can address this balance issue, I hope to not need it!

I was so exhausted when I got home yesterday evening I went straight to bed. Today all my muscles and joints from my waist to feet are sore from the battle to stay upright during the testing yesterday. I had NO idea at the time the toll it was taking but I do know being in a harness kept me from falling and the computer registered in BOLD letters "A FALL" everytime I lost my balance that bad. I couldn't get away with anything!  ;D

I will update this situation when I get my arms around this more and can enlighten you more about the decision.
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

sher

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #153 on: November 19, 2008, 08:04:26 pm »
Oh Mary, I wish I could give you a hug.... Dr. Daspit told me on the phone one time that a labrinythectomy is an option if balance is an issue after CK. He is a friend of my ENT. I am having swelling now and my balance is getting worse, so I am thinking I may have to look at those options one day. I am glad that you have dr's that are experienced in the vestibular issues. My CK Doc just says... oh no that couldn't happen...he is clueless sometimes. I will say some prayers for you and I hope that you get this figured out soon.
Hugs!
Sher
1.2cm x 0.6 cm extracanicular component (7 mm) 05/08/08
MRI in AUG 08  showed 30 % growth
Having CK 9/30, 10/1 and 10/2/08
1/12/08 MRI shows swelling

MaryBKAriz

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #154 on: November 19, 2008, 08:29:01 pm »
Sher,

What an uplifting note. It does help me to have the support. THANK YOU! I am keeping you in my thoughts, also.

I am leaning towards the injections. I can always go back and do the labrynthectomy later IF needed.

Take care,

Mary 8)
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

sgerrard

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #155 on: November 19, 2008, 08:56:49 pm »
Mary,

I am sorry to hear you are still struggling with this. It is so frustrating, because the way it is supposed to work is that when you lose all your balance function on one side, your brain adjusts and relies only on the other side. I guess it means you are still getting bogus signals from your AN side. If it is going to drop from 76% percent loss to 100% loss, why can't it just go away?

I am curious too what the doc might say if you do have 60% functional hearing on that side. Maybe you could wait and see if the balance nerve finally shuts down completely on its own? I have to say the injections sound like a reasonable first step, since the outcome is no worse than the surgery, and might be better. At least they aren't still talking about "while you're at it, might as well do a whole translab."

I hope you recover from the testing quickly, and figure out a good course of action. Take care.

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

MaryBKAriz

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #156 on: November 20, 2008, 09:03:57 am »
Steve,

Hi! Hope you are still doing well up in your beautiful part of our world.

When I was told by the technician that she is not getting a reading on that side, I started getting confused at that point. The doctor confirmed it was 100% loss. So from everything I had read, once it is gone you adjust and it takes up to a couple of weeks and you go on. So I said to the doctor, "I'm so confused". He then explained in detail which some I understood, other parts I didn't because of no medical background, the complexity of this balance issue and the fact my emotional state was in "oh no! what now? mode". ;D

What Weldon and I got out of it was that the testing can go just so far in measuring the vestibular system. He believes strongly that the vestibular nerve is still functioning in those areas that aren't abl;e to be testedd. He believes this because of my symptoms. This I gather is rare. But I was unusually dizzy BEFORE CK. In addition I have a big toe also on my right side that has a joint replacement and is not fully functional. The technician mentioned my eye problems are also complicating things. By the time I left I felt like SUCH a mess that I just wanted someone to put a sign on me if I fell. "I've fallen and I can't get up."....the sign saying "please step over!" :D

I see the humor of the crazy Clockwork Orange meets amusement park testing. You start believing you are in a bizarre dream. I am just today feeling like I am somewhat sorting through what happened. I am strongly leaning towards to injections, even if I had perfect hearing in that ear (which I most definitely do not). I am a night owl personality type and it is strange to be so tired by the early evening that I go to bed. I am an out and about socializing type person, also so it is cramping my style! Luckily, I am an optimist and a creative thinker so I know I will find my way out of this through the procedure and tweaking of my life style then adding some new adventures.

Take care,

Mary 8)
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

ppearl214

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #157 on: November 21, 2008, 06:25:59 am »
*runs in.... runs up to Pirate Wench Mary, gives her BIG OLE' HUGGLE........... ok, smoochie too  :-*.... and runs back out*


(hang in there Mary!)
xoxoxoox
"Gentlemen, I wash my hands of this weirdness", Capt Jack Sparrow - Davy Jones Locker, "Pirates of the Carribbean - At World's End"

MaryBKAriz

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #158 on: December 10, 2008, 11:11:50 am »
GREAT NEWS!!!!!!!!!!  I received the results of my MRI and it shows "central area of necrosis". I felt nonchalant about the MRI results because I knew it may not show anything. That mad it even better to find out that my "Goldie" is dying. She is NOT dying gracefully, though. I still have the imbalance and at times some pretty dizziness.

I have an appointment next Wednesday with Dr. Daspit to have the TTG (transtympanic gentamicin) Treatment. Gentamicin (a medication intended to purposefully damage the inner ear to stop dizzy spells in Meniere's disease) is injected through the eardrum using a narrow needle. The drug is left in the middle ear for about 30 minutes, and then allowed to drain out. You can read more on  http://www.dizziness-and-balance.com/treatment/ttg.html.

Has anyone else in AN Land had this procedure???? Anyone else heard about it? Have any inputs????   I am back in research mode. :D

I have done soul searching about it. I know it is also used for tinnitus which is my other main issue. If this could make either or both conditions better, I would be a very happy camper. I guess I have some anxiety about doing anything. But I fear not doing anything too. So many things with this AN seem to be ambiguous. There is some chance it could make my tinnitus worse and/or not work for the vestibular issues. It is hard to take a risk but then again, it is hard to think of keeping these symptoms as they are. Any input?

On my better days I have been trying to re-direct my artistic pursuits that had stopped due to shaking hands. I bought a bunch of wooden medical canes and I am having fun making theme-oriented canes. Whether this is viable or not, I don't know. I haven't spent much so if they don't sell, I haven't lost much and had fun doing it. I have sold 3 on Ebay. I do feel sassier now that I carry a different canes depending on my mood or outfit. At least my dusty studio has some life back in it although doing portraits is a thing of the past.

Take care all and than you so much for being here!!!!!

Mary  8)




Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

Kaybo

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #159 on: December 10, 2008, 12:56:21 pm »
Mary~
What wonderful news!  Glad to hear that Goldie is on her way OUT!!  I don't know anything about the other procedure but I will keep my fingers crossed with you!  How can we see your canes?  Sounds like a really cool thing to do!

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!

cindyj

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #160 on: December 10, 2008, 02:36:40 pm »
Hey Mary!

So glad to hear the good MRI results!  Know that is such a relief.  And great that you are giving the TTG a try - truly hope it works for you and your dizziness.  Do you know how long it takes to start working? 

What a great idea about the canes!  You'll have to give us some pictures...

Will be anxious to know how things go next week,

Cindy
rt side 1.5 cm - Translab on 11/07/08 Dr. Friedman & Dr. Schwartz of House Ear Institute,
feeling great!

"Life consists not in holding good cards, but in playing well those you do hold."  Josh Billings

carter

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #161 on: December 10, 2008, 05:29:59 pm »
mary - hang in there - we are rooting for you!

i have been dealing with my AN for only 2 months ... the one string of posts that most inspired me is your exploit ....   the manner in which you went foreward.   sorry that you are having a bad time ... but you have inspired me.

carter
Diagnosed in fall of 2008 with 1.6 * 2.9cm AN on left side. 

Scheduled CK at Oklahoma Cyber Knife in December, 2008 and decided not to proceede on 2nd date that CK was scheduled.  I fired them.

CK performed at St John's Hospital (Tulsa)Jan 2009

MaryBKAriz

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #162 on: December 10, 2008, 07:49:52 pm »
Thank you, Carter - and I hope your journey is a good one. I am feeling quite positive about where I am heading. It is a great feeling.

Cindy, I am not sure they now precisiely but in a few weeks I should know and may need a second or even a third injection, depending. Hopefully only one!  :D

Hi Kay, Yep Goldie is a goner. She is losing her mean spirited battle.

I will try to post a couple of cane photos soon. It is fun, in case anyone decides to do it. I have thought if it doesn't work as a VERY small little enterprise for me, perhaps I can get them to some nursing homes or something like that. Ay least I am having FUN and doing something a little creative. I sold a yellow and black Bumble Bee Cane, a Red and White Candy Cane, a US Navy Cane and a Harley Davidson cane. There are other people out there besides me that want spunkier canes.

Take care,

Mary
Diagnosed March 24, 2008, 1.1cm, right side, "Goldie" - small but mighty!! :-(
Hearing, lottsa balance problems and a few facial twitches before CK
CK June 2, 2008, BNI in PHX, Drs Daspit/Kresl, side effects,steroids helped. Getting "sea legs".
Apr 2012 - Still glad I chose CK

sgerrard

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #163 on: December 10, 2008, 11:55:52 pm »
Hi Mary,

Great news! It sounds like the little booger is a goner, so at least there will be no new symptoms. I also really like your new cane enterprise. If you can't lick 'em, join 'em!

There is a new member Catlover, from Sweden, who is having an injection prior to surgery, to kill off the balance nerve. Apparently in Sweden they do this routinely now, so it is not unheard of. I think they have a better handle on how much, how often, and how long now, so I don't think it is very scary. You could wait and see what Catlover has to say about it.

I now have a lovely image in mind of an entire nursing home filled with grumpy old men all waving colorful matching canes around and complaining about the mashed peas. Maybe you should go for school colors, for all the aging football fans. They can have duels with them!  ;D

Steve

8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

sher

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Re: Ck - The Great Cyberknife adventure here at BNI in Phoenix Arizona
« Reply #164 on: December 11, 2008, 12:34:41 am »
Mary,
What a fun idea for canes. I was just looking at one in a CVS store the other day and thinking how boring looking they were.
Do you have any on ebay that we could look at now? I just might buy one.
I pray that your injection works for you.. I have some of your issues, but not as severe. I can only imagine what you are going through. I am doing a HAPPY DANCE for your Goldie dying.  yoo hoo!!!!! I hope mine does the same.
Hang in
Sher
1.2cm x 0.6 cm extracanicular component (7 mm) 05/08/08
MRI in AUG 08  showed 30 % growth
Having CK 9/30, 10/1 and 10/2/08
1/12/08 MRI shows swelling