ABR test on Monday...MRI denied by insurance company

[AlliKC]

I saw an ENT this morning. He reviewed my hearing tests and recommended an ABR-he never mentioned a possible AN-just said he wanted to see what was going on.  When I asked about an AN he said that's really unlikely and he's more concerned about Meinere's Disease.  The only thing that is not consistent with MD is I have high frequency hearing loss. I don't have vertigo either.  I really don't know what that means but...

So he said he does want the ABR to rule out an AN. Then we will retest my hearing to see if there are any changes in the next few months.  I was okay with that as this seems consistent with standard procedure and I have heard if you "fail" the ABR an MRI is a must.

It was my HUSBAND that had an issue and he insisted on the MRI on the grounds that I am a compulsive worrier and it will be too much for me to wait a week let alone 6 months to know for sure. I don't think I am that bad but he knows me best 

Well, we double-checked with the insurance company--DENIED.  I figured this would happen--there are a lot of people with asymmetrical hearing loss that have negative MRI's-they want the ABR first.

My concern about the ABR is I have since read it can have false positives and negatives.

When I went to see the Audiologist to make the appt. for the ABR, she was annoyed with the insurance company as she thinks my hearing loss and symptoms warrant an MRI.  She said I will likely fail the ABR test because my hearing differential is 30 decibels--I don't know, but this sounded like this was not good news for me   I thought it was just over 10 but it's 30--how bad it that???

Anyways, she got me in first thing on Monday so I will know more then....

I am just not really good with this kind of stuff-the longest I have ever had to wait for medical results were my 2 pregnancy tests and those only took a minute--but what longgggg minutes those were BUT a positive result was welcome

[phantagrae]

I'm sorry, but what is an ABR?

[Jim Scott]

I'm sorry, but what is an ABR?

Auditory Brainstem Response.  http://ent.about.com/od/diagnosingentdisorders/f/abr.htm

Jim

[AlliKC]

I had the ABR test this morning-the audiologist was really shocked at how well it came out.  My left ear was fine, the right there was a delay on the 1st nerve but no delays or anything wrong with the 5th or 8th nerve...

She said she is sending the info to the ENT but that my results do not concern her too much for any serious issues.

It does not look like I will need to have an MRI. 

I will go back in 3 weeks to test hearing aids and then I will have another hearing test in about a year and then yearly for a couple of years.

Does this sound okay or should I be more concerned??

[Tumbleweed]

Congrats on a good outcome with your ABR.

Further questions for you to consider before you conclude you likely don't have an AN:
1. Do you feel dizzy much of the time (disequilibrium; you said you don't have vertigo)?
2. Does your ear with the hearing loss -- I assume it's your right ear, based on your ABR results -- ever have a feeling of fullness, like it's stuffed up with wet cotton deep in the canal?
3. Do you ever hear your pulse beating in your right ear?

If you answer 'no' to all these questions, you probably don't have an AN (based also on the other factors and the ABR test results you've reported). While an MRI is the only surefire test for ruling out an AN, it seems like it's not warranted at this time (if you answered 'no' to the other questions I posed).

It's also highly unlikely you have Meniere's disease, as that would present as progressive loss of low frequencies, not high.

Best wishes,
TW

[Tumbleweed]

Just to be clear:
Answering 'yes' to any of the questions I posted immediately above does not necessarily mean you have an AN. Answering 'no' to all of them likely means you don't have an AN (taking your ABR test results into account also).

Best wishes,
TW

[AlliKC]

Congrats on a good outcome with your ABR.

Further questions for you to consider before you conclude you likely don't have an AN:
1. Do you feel dizzy much of the time (disequilibrium; you said you don't have vertigo)?
2. Does your ear with the hearing loss -- I assume it's your right ear, based on your ABR results -- ever have a feeling of fullness, like it's stuffed up with wet cotton deep in the canal?
3. Do you ever hear your pulse beating in your right ear?

If you answer 'no' to all these questions, you probably don't have an AN (based also on the other factors and the ABR test results you've reported). While an MRI is the only surefire test for ruling out an AN, it seems like it's not warranted at this time (if you answered 'no' to the other questions I posed).

It's also highly unlikely you have Meniere's disease, as that would present as progressive loss of low frequencies, not high.

Best wishes,
TW

Thanks for the help.  No, I don't have vertigo, not even close.  I have never felt like I was spinning nor have I ever not ben able to walk or been disoriented, etc. 

I have felt dizzy, not often, but sometimes.  Nothing that would have made me think there was something wrong. I also have mild allergies and I often think that causes dizziness sometimes.

I have had that "fullness" feeling in my ear.  But honestly, now I cannot remember if it was just the right ear or both ears.  I have hearing loss in both ears, the right is just worse than the left, by a little over 30 decibels.  This is what caused the audiologist to be concerned as there is no family history of hearing loss or any other explanation for the loss or the asymmetrical hearing loss.

I do notice I have ear aches, sometimes mild pain but it's on both sides, not just the right. It's also not severe or something that would alarm me too much.

I am really not worried too much now that the ABR came back with no concerns.  I think many of my symptoms are consistent with hearing loss (a little ringing of the ears is to be expected).  I think the dizziness is from allergies or just being tired.

I had decided not to think about it anymore but today I received a letter from my insurance company authorizing an MRI 

I think I will call my ENT and ask him if he thinks it's really necessary.  I am learning more towards a no. I am going to be monitored by an ENT and my audiologist consistently so I feel really comfortable with this.

[Tumbleweed]

If your insurance will pay all of the expense for the authorized MRI (i.e., you have no unmet deductible and no co-pay), I would get the MRI. You very likely don't have an AN, but a free test would cost you nothing and definitively rule out a tumor.

Best wishes,
TW

[AlliKC]

Well, I decided to play it safe and had an MRI today-the MRI itself was no issue.  I'm glad they gave me ear plugs or if I was not already hard of hearing, I surely would have been!

I have my CD and have been looking at it for an hour.  From what I can tell-I think I have about 20 possible tumors 

I am assured that if I have anything there, it is tiny, tiny, tiny.  And there's only one little spot that shows up that gives me any concern.  But if I were a betting woman, I'd bet I do not have an AN.

My husband said they are probably going to come back and tell me I have a nail in my head or something

I should know for sure on Monday, I hope my ENT calls me sooner! I am not overly concerned but until I get the all clear, every symptom in my body freaks me out

[alabamajane]

Little late to ask now,, but just out of  sheer curiosity ,, did you have an MRI with the contrast ,,they would have brought you out of tube and injected you with a solution and run more test?? Just wondering ,, that is what makes the tumor "glow" on the x-ray,, just for clarification for others,,, thanks Jane .... ANd hoping you still get good results on Monday

[AlliKC]

Little late to ask now,, but just out of  sheer curiosity ,, did you have an MRI with the contrast ,,they would have brought you out of tube and injected you with a solution and run more test?? Just wondering ,, that is what makes the tumor "glow" on the x-ray,, just for clarification for others,,, thanks Jane .... ANd hoping you still get good results on Monday

Yes, I had the contrast.  When I look at the MRI, I see a few glowing spots but most of them are on both sides, in the same place.  There is only one glowing spot (on the right side where my hearing loss is) that concerns me because it's not on the other side and it only shows up in the last few photos.  It's tiny though and does not look like any of the MRI images of an AN on MRI that I have seen on google. And the other ones I saw where more towards the middle, this almost looks like it's outside my head!

I will likely spend all weekend looking at this MRI--it's probably not a good idea for me to have this CD  

I'll be sure to post on Monday after I get the all clear. 

[Tumbleweed]

Alli, don't be concerned. Most of the "glowing spots," as you put it are undoubtedly cross-sections of blood vessels. And you're right, an AN would not be located so close to the inside of your skull. But your doctor will tell you what's going on. For now, take a deep breath and put it out of your mind.

Best wishes,
TW

[AlliKC]

No acoustic neuroma!  My MRI was fine, nothing out of the ordinary and definitely no tumors, not even a little one 

I don't even know how to thank all of the regular posters here for the information you have shared and for your calming words.  I would really have made myself ill from worry if I had not been able to read the information here and realize that even if I had been diagnosed with an AN--I would be okay.

I went into my doctors visits and testing with knowledge, what to expect, what to ask for and what my choices were. It made the entire process easier for me, my husband AND the medical professionals trying to help me.

I was so reassured that I actually forgot to get my test results earlier and did not call the doctor to get news.

I am happy, relieved and grateful.  I am still worried about my hearing loss and what that means for me in the future. But I will order my hearing aids in 2 weeks and move on from there.

Thank you again for your help-you really talked me down from the ledge.  The only way I feel I can show my gratitude is by making a donation designated to the maintenance of these boards.  I want this resource to be here to help calm and reassure others in fear and panic-whether they have an AN or not.

Best of luck to all of you 

[Tumbleweed]

Alli, congratulations on your excellent MRI results. This is the best possible outcome for you, and I'm sure everyone here shares my sentiment of being glad you have dodged the bullet.

And thanks for giving back by making a donation toward the maintenance of this forum. Many new people come here each month, afraid and looking for answers, support and comfort.

Good luck with maintaining your hearing, and best wishes for a healthy and happy life.

TW