Greentea ~
Bythe time it was discovered my AN was large (
4.5 cm) and surgery was the only option I had. My neurosurgeon, with decades of successful AN surgeries behind him, informed me that due to the tumors location, Retrosigmoid was the best approach. Trusting this mature doctor to the utmost, I quickly acquiesced to using that approach. He performed a 'debulking' surgery, effectively 'thinning' the tumor and reducing it's dimensions (
from 4.5 to approximately 2.5 cm) to make it more susceptible to the planned irradiation treatment that followed, ninety days later. This two-step approach was employed in an effort (
wholly successful) to avoid damage to the facial nerve.
To be frank, my neurosurgeon did not discuss options with me but presented what he thought - based on my MRI scan and strongly stated desire to avoid facial nerve damage - would be the best approach to address my AN with minimal risk of facial and other complications. I recognized this as a very rational and well-thought-out plan that he presented with much humility, considering his age, experience and sterling reputation. During his presentation this fine neurosurgeon kept using the phrase
"if you choose to hire me" which I found very affecting considering the fact that he had all the patients he could handle and was close to retirement so he certainly didn't need another AN patient to operate on. My surgery took almost nine hours to perform. Fortunately, the doctor had a much younger female neurosurgeon assisting him (
his protege) and he told us later that she was
"invaluable" to him during the long and very intense procedure.
I relate this to make the point that in some cases (such as mine), choosing a procedure is not a viable option. However, choosing the doctor, is. In my case, this neurosurgeon was a member of a neurosurgery practice that my wife had used for spinal surgery a year earlier. Her neurosurgeon did not operate on acoustic neuroma patients - but his partner did...quite successfully. When I was admitted to the hospital for the operation (
3 weeks after my diagnosis) a nurse told us that I had
"the best doctor in the state for acoustic neuroma surgery". That was reassuring, to say the least. By the way, before agreeing to consult with him I asked my neurosurgeon about the number of AN surgeries he had performed. He said, over the past 30 years, many hundreds. In response to my question about headaches stemming from the Retrosigmoid procedure he also stated, quite emphatically, that his AN surgery patients
"didn't get headaches". This proved to be true in my case. No headaches before or after the surgery. I experienced no CSF leaks or other post-op issues. I was discharged from the hospital five days after I had been admitted. I recovered rapidly, resuming driving (
with my doctors permission) within a fortnight of my surgery.
Obviously, my case is a success story that I'm happy to relate to newly diagnosed AN patients - like you - seeking information, background and advice. As you noted, AN surgery results are individualized and no doctor can credibly guarantee the outcome. My doctor didn't. He simply assured me that he would do ebverything he could to effectively reduce the tumor's size and thickness and do so with no or minimal damage to my facial and other cranial nerves. He was true to his word and, as I've stated, the surgery and later radiation (FSR) were successful.
As to my post-op experience; I suffered near-debilitating fatigue the first two weeks that I was home from the hospital and did little but nap and watch TV. I slowly gained strength and began a walking regimen (at a local park, accompanied by my wife) that slowly but surely helped my balance - and stamina - increase and improve, although not quite to pre-AN levels. I had recently retired (
at age 63) so I had no work-related issues to deal with and cannot offer any insight on that point. AN surgery recovery takes approximately six weeks, although that is a very general time frame. I needed all of that and, realistically, probably a total of 8-12 weeks before I felt
fully recovered. However, I noticed that a year after my surgery I thought I had improved even more. Today, over six years later, I'm doing great! My balance is not what is was prior to my AN manifesting itself but I consider it quite 'serviceable'. I can walk up and down stairs without using a handrail and I ride mall escalators without the need to grasp the handrail, so I guess I'm doing O.K., even if I won't be doing any tightrope walking anytime soon.
I would suggest you have as many doctor consultations as you feel are necessary but don't seek 'perfection' in a doctor (
they're only human) and always understand that no doctor can guarantee your surgical outcome but that past performance (
successful surgeries) is worth asking about. Post-op recovery varies with the individual and whether complications arise. I was 63 and in otherwise good health (
no heart, lung, back or joint issues, normal BP, BMI of 21.5 etc) so I guess that was a positive factor. I also had complete confidence in my doctor and fully expected to not have any problems and recuperate quickly, which is exactly how things worked out. I also had a lot of folks praying for me, which, in my opinion, is no small thing.
Specific questions here will usually receive specific answers although we aren't physicians and can only offer what we've learned from our own and others AN experience. I trust the AN discussion forums will continue to be a source of help and encouragement for you in the weeks and months to come.
Jim 
