an update regarding my son (treatment recommendation, questions re house and usc

[areles]

the consensus is in:  both dr. miller at house and dr. friedman at usc agree (for various reasons) that translab is the best option for my son due to his youth and the size of the tumor.  my prior research indicated this would be exactly the case (and i'd already mentally rejected radiation, retro, and middle fossa on my own, just based on my own non-medical interpretations of nik's case vs their risks), so i can't say i'm surprised, and i'm not at all questioning the recommendation.  out of a sea of awful choices, it seems like the most-correct awful choice in his specific case.

but here's my question:

dr. miller, who was awesome on the phone, but who is new, does not work with dr. schwartz, and the latter is the neurosurgeon i want on the case.  i'm not entirely sure how to handle this, so if anyone has any tips, please advise. 

with respect to dr. friedman, although i intend to consult with him live, i have to admit i was a little put off by the fact that he spent more time 'selling' me on usc (specifically usc vs. house - was there bad blood in his departure?) - and in fact, that was not only his opening, but his closing - than explaining the reasoning behind his recommendations.  in fact, i had to prod him when he said 'so i think microsurgery is the way to go,' asking which specific type he was recommending.  only then did he get into it.  between that and phrases like, 'we do the highest volume with the least complications' and 'i spent 15 years at house, and they're good, but we have something special here at usc,' it felt like he was trying to 'win the business'.  and not simply 'win' it, but 'win' it from house specifically.    it was off-putting.

bear in mind i hadn't even MENTIONED i was consulting with house (much less that i had already spoken with them). so it just left me a bit unnerved.  but his reputation precedes him and i'm not going to discount a renowned physician based on a single phone call, so i still intend to consult. 

but the usc team is already in place, so i'm more questioning how to go about getting a different consult from house if i'm in the end not quite sure about dr miller.  i could very well end up preferring her anyway, and suspect i will, but i'd like to talk to others, and am not sure how to do that now that she's already the one who reviewed my son's case.

thoughts?  (thank you in advance.)

[CHD63]

Hi areles .....

I am sorry you were "put off" by Dr. Friedman as he is an excellent surgeon/physician.  For me, he is the most caring doctor I have ever had.  That being said, I guess my first question is "Why does Dr. Miller not work with Dr. Schwartz?"  Since this is your son, you have a right to the best medical care, with the most experience, you can find.

4 1/2 years ago, when Dr. Friedman was still at House, he and Dr. Schwartz did my translab surgery.  Both of them are excellent at what they do so that makes the decision that much harder.  Admittedly I do not know that much about Dr. Miller ..... her credentials look impressive but she does not have the years of experience Dr. Friedman has.

Ultimately it comes down to what feels right for you.  Go with your gut feelings or you could possibly regret it.

Many thoughts and prayers.

Clarice

[mcrue]

Hi Areles,


For what it's worth, I had similar feelings.  In my opinion from being on this forum for 6 months and dealing with an Acoustic Neuroma, Dr. Schwartz at House Clinic in LA is the surgeon I would most likely select if it came to that. For radiation, I would pick Dr Chang at Stanford for Cyber Knife, or Dr. Lunsford in Pennsylvania for Gamma Knife if there are no local options that you're comfortable with. Everyone has their own bias and opinion, so take my opinion for what's it worth.


Dr Schwartz is so unbiased he actually told me to have radiation while knowing he could have "cashed the check" and had me come in to have microsurgery at House. The man is 100% integrity.

I would trust him with my own mother.


Warm regards.

[areles]

it does sound like friedman/schwartz were a dream team; i've read nothing but good things about them separately, much less together, and it will be a tough decision indeed.

we got confirmation last night that our ENT is referring to house, specifically to schwartz, though i was told that they can file another referral for a second opinion in order for us to likewise consult with friedman.  i'm not inclined to judge him based on that call - it was just strikingly different than the way house approached the same consult, and i found it... well, as mentioned, off-putting.  though i'll allow that since house seems to be known as the go-to, and friedman was there for 15 years prior to usc, he might feel naturally inclined to sell usc a little harder, since - correct me if i'm wrong - usc's current reputation seems to be riding in large part on friedman being there.

so basically, all of the above makes my point moot.  i'll be reaching out to schwartz independently, and we are also likely to be 'officially' consulting with him regardless, and i do want to speak with friedman again as well.  and i really did like dr. miller at house, so we'll see how that goes.

by the way, when i said she doesn't work with schwartz, it was more of, she'd already consulted the other neurosurgeon on the case, and indicated that generally the one first consulted with is the one who is on the team.  if that makes sense - and it may not, because i'm not sure i completely understood.  but what i do know is it wasn't "i won't/don't/can't work with schwartz."  it was more like, "i'm already building your team, but, okay, i'll speak with dr. schwartz about your case as well."

at this point it seems like it's going to come down to our feelings after each consult.  kind of scary, though i suppose reassuring to be choosing between two of the best.

thank you again for your support here, and for sharing your experience with dr. friedman.

Hi areles .....

I am sorry you were "put off" by Dr. Friedman as he is an excellent surgeon/physician.  For me, he is the most caring doctor I have ever had.  That being said, I guess my first question is "Why does Dr. Miller not work with Dr. Schwartz?"  Since this is your son, you have a right to the best medical care, with the most experience, you can find.

4 1/2 years ago, when Dr. Friedman was still at House, he and Dr. Schwartz did my translab surgery.  Both of them are excellent at what they do so that makes the decision that much harder.  Admittedly I do not know that much about Dr. Miller ..... her credentials look impressive but she does not have the years of experience Dr. Friedman has.

Ultimately it comes down to what feels right for you.  Go with your gut feelings or you could possibly regret it.

Many thoughts and prayers.

Clarice

[areles]

we spoke privately, but thank you again!!!

Hi Areles,


For what it's worth, I had similar feelings.  In my opinion from being on this forum for 6 months and dealing with an Acoustic Neuroma, Dr. Schwartz at House Clinic in LA is the surgeon I would most likely select if it came to that. For radiation, I would pick Dr Chang at Stanford for Cyber Knife, or Dr. Lunsford in Pennsylvania for Gamma Knife if there are no local options that you're comfortable with. Everyone has their own bias and opinion, so take my opinion for what's it worth.


Dr Schwartz is so unbiased he actually told me to have radiation while knowing he could have "cashed the check" and had me come in to have microsurgery at House. The man is 100% integrity.

I would trust him with my own mother.


Warm regards.

[mcrue]

They are both fantastic surgeons and obviously highly intelligent.  You would be in excellent hands with either team. Let's face it it's big business. At the end of the day, like most things in life, it comes down to your personal gut instinct. Selecting treatment can be one of the more difficult aspects of the AN process.

[michellef08]

Hi areles,
I agree with previous posters that Dr. Schwartz is a genius!! I cannot say enough great things about him. When I sent my first MRI to House, I included a letter specifically requesting Dr. Schwartz and Dr. Friedman because I had heard they were a great team through this forum. I assume you could do the same - and either call or mail a request to consult with Dr. Schwartz. It may seem awkward - but you are right, this is your son's brain! You should get the treatment that feels best for you. I am sure that Dr. Miller can understand why you would want Dr. Schwartz (based on his reputation), and if she wants to work on your son's case - she will work with him. If not - I'm sure you will be in great hands with the other otolaryngologists he works with.

I am also sorry you got that impression from Dr. Friedman. He was also a great doctor, and very personable. I can see where he is coming from, that he left the mecca for AN's and now has to prove himself by winning business. It's like any other job - although they are phenomenal surgeons, they also have pressure to bring in new business. But if you don't feel comfortable with them, then that is that!

One of the only things you can control throughout the AN process is doing as much research as you can tolerate, and then make a treatment decision that feels right for you and your son. Once that is done - you can focus on getting through the surgery and recovering!