Madison ~
I'll just chime in here to concur with Jan that choosing a doctor/surgeon close to home is not necessarily a compromise. Upon my AN diagnosis, I was considering making the financial and personal sacrifice to go across the country to HEI because of it's overall sterling reputation and the many hosannas HEI and it's doctors received on these forums.
The first local neurosurgeon I saw seemed a bit put off by the size of my AN and was evasive when I pressed him as to how many of these surgeries he had performed. He finally, reluctantly admitted he had done 'approximately' sixty. Not good enough - and his attitude made this doctor a non-starter for me. This is when HEI stated looking like my best bet. Then, my wife called her neurosurgeon's office (she had spinal surgery the year before) and - because her neurosurgeon didn't 'do' ANs - she asked for a referral to a neurosurgeon that was familiar with acoustic neuroma surgery. In a serendipitous turn of events, the receptionist told my wife that the practice had a neurosurgeon with decades of experience performing AN surgery and was highly respected in his field. As a courtesy, we were able to obtain an immediate appointment with this surgeon. He was not intimidated by my large AN but looked at as a challenge. He was very respectful of my concerns regarding facial paralysis as a result of the surgery and presented us with a plan to debulk the AN, then radiate it to destroy it's DNA and effectively 'kill' it. The surgery went splendidly, as did the radiation (FSR) and my recovery was excellent with basically no complications. Like Jan, I have absolutely no regrets about using a 'local' neurosurgeon.
However, every AN patient is slightly different and in some cases, it may be near impossible to find a highly experienced neurosurgeon within a reasonable distance that routinely performs AN removal surgery and has a record of successful outcomes. Had that been the situation when I was considering surgery, I was quite ready to spend whatever it took (even if I had to go into debt) to use the best facility and surgeons I could find to help ensure a good surgical outcome. This is every AN patients goal, with good reason, and if that means travel, inconvenience and debt, so be it. This is not a surgery you can take for granted or entrust to the first available neurosurgeon who comes along.
So, there is no hard and fast 'rule' on this issue. We do our research and make our individual decisions as we see fit. Some will opt to stay local for their own reasons, some will feel it's a better choice to go 'out of town' for surgery (or radiation, in some cases). Naturally, traveling for treatment can be complicated (and expensive) but AN surgery is too important to let those considerations decide for us. If one can locate a very competent, AN-experienced neurosurgeon locally, all the better. Again, there is no 'right' or 'wrong' choice. It's a subjective decision.
Jim
