length of surgery

[becknell]

We met with a neurosurgeon in Charlotte, N.C. on Wednesday. We felt fairly good about this, but I did have some concerns I wanted to get feedback on. My husband has a 3 CM An. When we asked about the length of the surgery, the Dr. said maybe four hours. I quizzed him on this, saying I'd read about considerly longer surgeries for this size of tumor, often in the 8- to 12-hour range or perhaps even more. His response to this was that he and his neurotologist had gottern “so good� at this that they were able to do this surgery in that time, although he did acknowledge that there are unknowns that won't be known until they begin the surgery, which could affect things, and mostly notably, he said, was the stickiness of the tumor. We asked about a second opinin and he wholeheartedly recommended another doctor in Raleigh, N.C., he offered his opinion on the docs at Duke University and he seemed fairly up front about most things. But the four-hour surgery seemed short to me — we are new at this, though.. He did say he's done 350 or so of these surgeries in 14 years, about 25 a year. I wondered: Is that enough to be “so good� you can do it in four hours? Thoughts? (P.S. We do plan to seek a second opinion and possibly a third.)

Jennifer

[tumor mom]

Hi Jennifer,

You didn't mention what type of surgery your husband was having.  Is it translab or retrosigmoid.  We were quoted 4-6 hours at the House Clinic for translab but those doctors perform at least 100  AN surgeries a year.   My daughter had translab out there but when we met with them they said they were going to take it slow because it was almost 5 cm and they wanted to be very careful around the facial nerve.  Her translab surgery took almost 11 hours but she came out with no problems at all.  She is now 10 weeks post op and just tired, which we were told would be expected because of the long surgery.  She had a little facial paralysis two weeks after surgery but that has pretty much subsided.

The doctors in Houston were going to do the retrosigmoid  approach and they all quoted 12-15 hours of surgery some even longer than that.  We visited with two sugical teams in Houston and another neurosurgeon who said he would do it by himself.  All came highly recommended.  We ended up out at House because they could do the translab approach, and we felt if we could save her time under anaesthesia that would be a plus.  Also that approach they can see the facial nerve early on.  I was also apprehensive to use surgeons that did this surgery twice a month compared to the doctors that do it at least twice a week.  We felt very comfortable after we spoke with the doctors out there and decided on them.

Right now is the hardest part. trying to make a decision.  Definitely visit with as many teams as you can and if at all possible see if you can speak with one of their patients.  We were lucky using this board and contacting patients from the House Clinic and the doctors we used. That also helped to make our decision.  We weren't able to find anyone complaining about our doctor so that helped build some confidence.

I hope this helps you a bit.  Good Luck and your welcome to contact me if you need to

Donna

[becknell]

he needs to have the retro-sig approach, the doctor said, because of the position and size of the tumor, that's the best access. he said he wouldn't be able to get good enough access with the translab.

[tumor mom]

I would definitely question that time frame - I haven't heard of anyone with the retrosigmoid approach having such a short surgery.  That would be amazing.  All we can keep telling you is do your research and don't jump into any surgery to quickly - usually these tumors grow slowly and you have time to make your decision.  There was some discussion on the previous pages about retrosigmoid - maybe that will be helpful. 

Again - good luck with your other appointments.  I know it is tiring and gut wrenching to go through all these appointments and try to organize all the information - we also found it very depressing to keep going in and be told how long the surgery is and all the nerves you need to worry about.  I must say it seems like years have gone by since we made our decision in early March to go to House - it really was the first step to recovery for my daughter.

Keep us posted.

Donna

[stein78]

My 2.5cm AN was removed via retrosigmoid and it took just over 6 hours.  My doctors have treated almost 1000 cases.  Best of luck to you and your husband.

-Jason

[littlemissrory]

Hi.  I had the retrosigmoid approach for an 8mm AN in May 2004.  My surgery lasted 4 hours and that included prep time.  My tumor was considerably smaller than your husbands.  To be quite honest I don't remember ever being given, or asking for a guesstimate of time.  My surgeon probably told me and I forgot.  I LOVE my surgeons!  I feel great.  I lost no hearing, my facial nerve is fine and they save the balance nerve as well.  This year I did more than I anticipated without problems and I expected the world out of this.  I skied, hiked, and would be whitewater kayaking if I hadn't needed shoulder surgery.  I would say meet your second and third opinions, see what they say and who you feel comfortable with.  I had mine at Swedish in Seattle and would not have gone anywhere else.  You have to have full trust in the surgeons.  Good luck.

Rory

[okiesandy]

Has your husband sent his MRI's to House?  I sent mine to Dr. Brackman and go a call on Sunday. MY AN was a little smaller than I was told by my doctor in Oklahoma City. I was quoted 6 to 6 1/2 hours here and 3 to 3 1/3 at House. I was also sent some information that talked about different approaches in that information it was stated that there is no tumer that is too big for Translab.

I was very impressed with Dr. Brackman's conversation and have made the decision to go there for the surgery. At this time I am in a holding pattern because of suspected auto-immune problem with other ear. We talked about insurance and feel very positive that this can be handled.  My doc. has only done 20 to 30 in ten years. Others in the clinic have done up to 175 in 12 to 20 years. I am beginning to wonder if there is anyway to check just how many these doctors really do.  I get conflicting information from former patients on the numbers they were quoted.

Please send those MRI's to house they give free website consultations and people come from all over the world to go there. They will work with insurance and complications are less. That is bottom line with insurance most of the time. Even my own doc. who has a bit of a God like syndrome said he has to admit he would think about going to Brackman if he had this. No small praise coming from him. He has at least 5 other doctors in his clinic that do this. You don't have a thing to lose by sending the MRI's and believe me when I say you will never regret it.

I am so stressed over the Autoimmune good ear hearing problem and Dr. Brackman put my mind to rest about immediate surgery and the need to treat my intermittent hearing lose in by good ear more agressively.

[wanderer]

mine was 2cmX2cmX2cm I was told 4 hours by translab,   it took a little over 5 hours.   

[karcher]

May I ask whom in Charlotte you spoke with?  I live in Charlotte and was diagnosed 1.2cm
in May.  I have consulted with both a microsurgeon and a radio surgeon here, and am planning
on visiting House in early July.  The microsurgeon here recommended middle fossa - to be honest
I don't remember the exact time quote, although I think it was 4-6 hours.

[okiesandy]

I understand about your husband.  Mine had cancer last year and just wanted it out.  I finially kind of put it to him about how I felt and how devistated I would be if I stood by and did nothing to help him get the best treatment. Of course macho man didn't really listen until his son talked to him and said he would also be more comfortable if he would consult with the doctor I suggensted after some research here.  When he met the new man the was instantly won over and admits a 1 1/2 yr. later that he was scared and didn't know there could be such a difference in doctors. 

He had his surgery and is fine. Not a walk in the park for sure. Now he brags about his wonderful doctor and how he just knew all of the time he was making a mistake with the first one. I did all of the research and cried all of the tears and had a lot of anger toward him because he wouldn't  (I thought) listen to me.

Now I am in this AN boat and am having auto-immune problems to go with it in the good ear. The operation for the AN was number 1 one on my list two weeks ago and now it is auto-immune disease. I was so angry about the AN and what it was doing to me I couln't see the bigger picture. Now the AN and loss of hearing in one ear is nothing compared to losing it in both ears and really not knowing why puts it in prospective. Dr. Brackmann is a man's man kind of guy. He is consulting with my doctor here (or at least trying to). I have gotten a very different prospective since he has made suggestions.  He has called me twice and has never put any pressure on me. In fact far less than may doctor here.  One thing we did talk about was recovery time and out come. House recovery time is a lot less than I was told her and the out come a lot better. I have not just taken Dr. B's word for it I researched and talked with others that had it done, House and other places and House comes out on top everytime. Please be patient with your husband. He will go thourgh many moods and unfortnately at times you will feel like the enemy. Try and have him look at your angle.  Sometimes I am not so nice to my spouse, family and friends. Damn it! They don't undersand just what I am going though and there they are making choices for me. I is only anger at the tumor and the interuption of his live and believe me he is scared. Keep you your research and call Dr. Brackman youself if you need to talk to him. He is easy to reach or if you would like his e-mail I can give it to you. Just email me sandypaschall@aol.com and I will get you what you need.

[Kim]

4 cm; 11 hours; total removal; no nerve damage.

That timeframe you were given seems quite short.  I would also wonder about that attitude ("we've done so many we've gotten so good...")  To me, careful and thorough are the priorities

Good luck!