Note: This post shows the most recent update first.Hello all, thanks and congrats for having such an active community. I started this post as a series of questions and later developed into my recovery journal to share my experiences, just in case if it helps others.
Part 5: Last update December 6, 2019Completed one year anniversary of RS procedure in October 2019. Updates are:
1. There is improvement in the movement on paralyzed cheek and it is stretching almost 60%.
2. Lips from the right side of face have not responded. No movement at all.
3. Still cannot cry from right eye (no tears).
4. Still cannot move forehead on the affected side.
5. HB scale reached 3 from 4 (self-assessed). I am able to close and blink affected eye like unlike before.
6. No growth so far in tumor post RS procedure. I am due for visit in Jan-21 again.
On the other hand:
a. I have purchased TENS advice for electronic stimulation (YouTube and Google have better physios than I tried here) so will be starting self-therapy after waiting a year to let things take their time to settle.
b. Life is good except a regret that I lost all bodybuilding gains
(this is not about AN) so back to being a skinny guy.
Lastly, I guess this thread fully depicts my story so I won't be updating this thread anymore (unless something changes drastically).
if anyone has a question, please feel free to PM me. Good bye all.
Part 4: Update July 11, 2019I am almost eight and a half months post RS procedure. Despite of all optimism and efforts to keep myself motivated I lost hope to some degree. Things changed last week (I guess on or around 7th of July) when a close look in the mirror revealed very slight movement on my right cheek. Yes, I was able to move in a controlled manner but it was very limited movement.
What have I been doing since last update?
1. Stopped doing self-exercises or self-massages about 2 months ago (e.g. disappointment phase).
2. Could not find a good therapist so didn't go for useless PTs who only suggested eletronic stimulation for 30 minutes straight.
3. Felt that my surgeon had lied to me about nerve 'not being severed' until I noticed movement which, literally, just happened itself.
My status as of today?
1. Affected eye still does not close to the full, I reckon its the same as it has been since surgery. Using artificial tears but infrequently.
2. Affected eye movement is still problematic but my guesstimate is less than before.
3. Very minor movement on cheek of paralyzed part but part of face itself is still (and mostly) paralyzed.
4. My visit to neuro is due now and will seek his advise for starting electronic stimulation including a prescription of B12 which helps recovery.
End of part 4Part 3: Update May 6, 2019Quick story updates:
I completed exactly the sixth month on April 26th, 2019. Things have not improved as my surgeon has been telling me.
1. Facial palsy
* Friends and relative mention major improvements in appearance of face. If I keep my mouth shut, no one can tell I have facial palsy (it is a different matter when I say, 'what's up bro?').
* Rest of the palsy is exactly the same as day 1. Smile is half-faced, right eye-lid closes only 80% or so and does not function normally in sun-light which is major pain in the buttocks.
I am considering gold (something) treatment for my eye so it closes due to weight and I am able to walk in sun normally.
2. Started vitamin B complex supplementation for 45 days, I think it helped the appearance as my friends/relatives cite. Again, I do not have any scientific findings to support my assertion.
3. I am due for another MRI in next 30 days.
End of Part 3Part 2: Update March 22, 2019Visited my surgeon on 26-Feb-19 being the first post-surgery MRI and consultation. 0.8 cm of tumor was there attached with nerve versus the original tumor size stated above (2.7 cm x 2.5 cm). This was not unexpected and surgeon recommended the pathway of "wait and see" that if tumor shows signs of regrowth then we will go for Gamma Knife procedure.
With regards to my face, although eye lid movement has improved very little and my right eye gets wet at times, however, it is in no way closer to natural or normal functionality. For example, in sunlight I have to use my fingers to partially pull down right eyelid or use a tape as it remains wide open regardless of Middle Eastern sunny day which hurts my vision. I am still using ointment before sleeping for protection as eyelid also does not fully close. I don't want to go for the eyelid procedure that implants gold to help eyelid closure (perhaps I am afraid that my insurance will not cover it).
Facial palsy is still there with no signs of improvement at all. My neuro-surgeon said that after 3 months of RS procedure, I should have had some chances of improvement which are not there so I should me mentally prepared to end up with permanent facial palsy but, at the same time, he said let's see until 9th or 10th month of surgery and hope that things improve. If not then he said, I can go and consider electronic stimulation and if that does not help within 2 to 3 months electro-stimulation I can go for facial reanimation which is again, not a straight forward procedure.
I insisted to neuro to prescribe vitamin B12 complex to help recover but he refused so I had to consult another doctor who agreed with my idea that B12 complex will help so he prescribed me the dose for 45 days.
In general, my life has fully returned to normalcy. I can eat and drink whatever want except a problem that there is difficulty eating foods like burgers which require wide opening of mouth (right side does not support it). I go to gym, play video games and so on all is well. No weakness, no imbalances, no dizzy-ness but all I miss is expressions on the right side of face.
End of Part 2Those in a hurry can also watch a short-video I made here; below story gives more detail than I put in the video:
(Part 1, Nov-18) Acoustic neuroma surgery patient from Saudi Arabia
https://www.youtube.com/watch?v=8iXSdJzXbWY
Part 1: It begins...1. How it started?
Upon start of little hearing loss visited ENT, he removed wax and told me its all good. I was not satisfied as the I could still feel the difference in hearing from left/right ear. In coming years, I consulted multiple ENTs but all would talk about ear wax instead of exploring reasons. In all, none told me to see a neurologist. Since I could still listen/talk on phones, etc. and never had any other symptom like loss of balance or headaches or anything of this sort, I continued for about 4 years until in May-18, I felt electric like shocks on my right canine during breakfasts. Apart from breakfast, my whole day would go perfectly normal; I mean I would eat all and everything I wanted, smile, play, do workout in gym without shock or shock-like feeling.
After first shock, I visited a dentist who also cleared me but then I decided to put Dr. Google to use. Search results led to a conclusion that I could have Trigeminal Neuralgia hence I visited a neurologist who suggested an MRI only to find that it was this tumor called Acoustic Neuroma. Neurologist suggested immediate consultation with a neurosurgeon for treatment options and cautioned me not to delay any further.
Also worthwhile to mention, my breakfast shocks stopped from happening in about 2 weeks of visiting neurologist -- so the only problems I had was mild level of hearing loss in right ear and an MRI report showing tumor.
2. Tumor size:
2.7 cm x 2.5 cm
3. Comments from final MRI taken 1 day before surgery:
- Mass extending into the right internal auditory canal
- Mild mass effect on the adjacent right middle cerebellar peduncle without any obvious vasogenic edema
- The gradient echo sequences demonstrate small foci of blooming consistent with intralesional hemorrhage.
- Post-contract sequences demonstrate a strong and heterogeneous enhancement
4. Pre-surgery lifestyle:
I have been an active person and gym goer (natural bodybuilder). I never had balancing issues or any difficultly / trouble lifting heavy weights during exercises. All facial and eye movements were absolutely perfect. I could move my lips, cheeks, mouth, eyelids, eyebrows, etc. in any direction I wanted with perfect symmetry.
5. Advice by surgeons:
I consulted 5 different neurosurgeon to explore all treatment options but all of them were unanimous that I must go for surgery using retrosigmoid approach because of size of tumor and my general health condition. Surgeons mentioned they would remove about 60% to 90% of tumor not all to protect facial nerves.
6. Surgery details:
My surgery lasted about 8 hours then spent about 30 hours in ICU followed by recovery in hospital room. Surgeons told me that they managed to remove 90% of tumor and left rest of it as it is because of being entangled with nerve. According to them, facial nerve was preserved and surgery was a success.
7. After surgery (and condition as of writing this post):
- Sore throat which was due to insertion of breathing pipe but now it is OK.
- Difficulty in swallowing, I remained on liquid then semi-liquid (puree kind of) diet for about 2 weeks
- No movement on right side of my face (facial palsy) including inability to raise right eyebrow or fully close right eyelid and right side of tongue was like dead
- No hearing in right ear
Surgeons classified my facial palsy at Grade 3 of House-Brackmann (HB) scale but my own conclusion is that it is neither 3 nor 4 but rather something in between based on eyelid closure.
8. Recovery time as per surgeons:
Surgeons told me that:
- Sore throat and swallowing issues would go away in 1 or 2 weeks -- which turned out to be true.
- Eye-lid will return to normal function in about 6 weeks -- waiting but for now, I am using tape, eye-drops and ointment (they referred to me an eye specialist on 4th day of surgery as IPD.
- Facial palsy would improve in 4 to 6 months but may take 1 year. From 4th day, they also sent a Physical Therapist who, daily, used to asked me do this-and-that, suggested exercises but nothing more.
- Have patience, recovery will take long-time.
End of Part 1Thanks again for reading my post. Please ignore typos and grammatical errors, if any.
