Author Topic: 2nd Time Around  (Read 4960 times)

theshrine

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2nd Time Around
« on: August 10, 2008, 10:37:46 am »
Hello fellow ANA members,

I am writing this to give encouragement to those who are recent AN club members and to ask for some advice for my own situation.

First the encouragement.  I am a 64 year old male.  I had an AN operation (1.6 x .8 cm) in 1987 at Oregon Health Science University (OHSU) in Portland Oregon.  The AN was found when investigating the root cause for loss of hearing in my right ear.  Life after the AN was/is very normal - except for the nearly total loss of hearing in my right ear, some tinnitus, and perhaps being a bit more susceptible to motion sickness.  I was able to return to work after 5 weeks (I’m an electrical engineer), finish raising my two kids, and was able to get on with my life the way it as before AN.  The main constant reminder is I have to tell people sitting on my right that I can’t hear them. I won’t get into the advantages of sometimes not being able to hear one’s spouse  ;D.  Choosing a seat to maximize my hearing at a restaurant or conference has more-less become automatic.  I have been very fortunate to have good health otherwise.

Advice Needed.  It now appears my AN is back.  My symptom is the swarm of locust in my right ear (tinnitus) has increased dramatically over the last 6 months.  My MRI in April was inconclusive – can’t tell if it’s scare tissue or tumor.    Unfortunately I cannot locate previous MRIs to compare.  Hospitals only archive film for 7-8 years. I probably tossed my films out 5 years ago when we moved thinking after 17 years the AN was ancient history.  OHSU was able to send me my ’87 medical records (which includes a detailed written description of my procedure).

I am currently living/working in Houston, TX.  Despite a huge medical community here, to my surprise there aren’t any hospitals in the area that I would feel comfortable with.  I would like to locate a specialist to advise me.  Any help here would be appreciated.  My preference is the west coast because of friends and family in the area.  Passing on any first hand experiences with either House in LA or Stanford would be appreciated.

More personal stuff.  In the past 21 years there have been significant medical advances and the AN information available – thanks to the Internet – is nothing short of phenomenal.    I was on the operating table for 12 hours and in the hospital for 7 days – this was normal.  In ’87 I was 43 years old - jogged and played racket ball on a regular basis.  Today there is less invasive micro-surgery - they don’t have to push your brain around as much or punch such a big hole in your skull.  I chose OHSU over a local hospital because they are a teaching hospital and did 4 to 6 AN procedures a year in ‘87.  But now, thanks to this web, site I know that I should seek more specialized help.

Lynn

sgerrard

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Re: 2nd Time Around
« Reply #1 on: August 10, 2008, 05:27:31 pm »
Hi Lynn,

Welcome to the forum. I am sorry to hear that your reason for being here is a possible regrowth 20 years after AN surgery. Another member, Carrie (CMP), just went through something similar in the last couple of months. Hopefully yours will turn out to be scar tissue.

If it is not, it is most likely small, since it was not obvious on your last MRI. That would suggest that watching and waiting, and radiation treatment, are both possible alternatives to another surgery. It would be worth looking into while you wait for the next MRI.

There are members here who have had good surgeries in Texas; they may pick up on this shortly. There are also many who have been to House; it is one of the top notch places in the country to go. I went to Stanford for Cyberknife treatment, and was very pleased with the results, and others have done the same.

So, you can expect lots of sympathy for your situation, should it turn out to be a regrowth, and lots of information and support from other members here.

Hoping for the best,

Steve
8 mm left AN June 2007,  CK at Stanford Sept 2007.
Hearing lasted a while, but left side is deaf now.
Right side is weak too. Life is quiet.

Brendalu

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Re: 2nd Time Around
« Reply #2 on: August 10, 2008, 06:51:17 pm »
Welcome Lynn,
I took live in the Houston area (far South).  I won't recommend my hospital or doctors.  I didn't utilize the resources on this forum three years ago.  I wish I had!  I have learned a lot and have gotten a wealth of information from this fantastic group of people.  I had trans lab surgery, so I am right side deaf, with poor balance and migraines and vertigo.  I have also been diagnosed with NF2.  I am in the ait and watch stage with that.  I am weighing my options and reading and learning more and more.  I'm sure you will too.
If you need any information or help, please feel free to message me or email me.
Brenda
Brenda Oberholtzer
AN surgery 7/28/05
Peyman Pakzaban, NS
Chester Strunk, ENT

Pooter

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Re: 2nd Time Around
« Reply #3 on: August 10, 2008, 09:43:07 pm »
Lynn - I hope it's just scar tissue as well.  If not, I'm curious why you don't feel that there's adequate care for AN's in the Houston area.  I just had my surgery in Houston with Drs Vrabek and Trask at Baylor and I would recommend them both to you to explore.  Together, I've been told they do about 50 per year which is as many as the top tier Drs in other areas.  Overall, I think I fared good.  I had some bumps in the road, but I'm definitely happy with where I am and the future.  I wish nothing but the best for you.  In any way we can help, we are sure to do what we can.  Btw, Boppie (from this forum) has had surgery with Drs Vrabek and Trask a few years ago as well.

Welcome aboard!

Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

"I must be having fun all wrong!"  - Roger Creager

Brendalu

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Re: 2nd Time Around
« Reply #4 on: August 11, 2008, 04:51:42 am »
Lynn,
Houston has many really great hospitals that deal with brain surgeries daily.  Check out the stats for Methodist, St Lukes, Baylor, Memorial Hermann, just to name a few.  We also have some of the top docs in the country.  It takes some time and in this day of drive thru surgery, you have to stand your ground with your insurance.....I have found that the hospitals and the personnel want to do the right thing but have to follow insurance protocal and that isn't always what is best for any of us.  I have heard nothing but fantastic things about Pooter and Boppie's docs. 
Brenda
Brenda Oberholtzer
AN surgery 7/28/05
Peyman Pakzaban, NS
Chester Strunk, ENT

jerseygirl

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Re: 2nd Time Around
« Reply #5 on: August 11, 2008, 09:21:46 am »
Hi Lynn,

Sorry to hear that your AN might have come back but only time will tell for sure. Hopefully, your scar tissue will turn out to be only that, not the tumor. The real scar tissue, I was told, does not grow. Tumor, on the other hand, does. Another great thing is that most ANs grow very slowly and the growth is even slower or  nonexistent in males over 60, so you might not have to do anything about it again, just monitor it with periodic MRI. Should you need treatment, chances are that it might be in a few years and options will be even better than they are now as medicine gets rewritten every 5 years or so.

 I had surgery for a huge AN in 1988. Scar tisue with no mass effect was found 7 years later. 3 years after that this "scar tissue" grew and became a small tumor. I watched and waited for 9 more years and finally decided on the surgery again which I had last year in June. I also found that times have really changed! The surgeries became infinitely better (speaking from experience), there are different forms of radiation available for small to medium size tumors and information as well as support can now be easily found on the Internet.

During the years of my wait and watch, I visited a lot of doctors and found that sometimes the most brilliant surgeons do not have the skill of patiently going over the options and sorting among them. In addition, they do not like to do it because insurance does not reimburse them  more for long appointments. I also discovered that my options are severely narrowed as opposed to the newbies with the same size tumor despte the fact that I live in an area where great neurosurgeons are not in short supply. I do not know anything about Stanford in terms of following and monitoring but House in LA follows a lot of patients even from a distance , and probably does the most recurrences than anybody in US. They do overwhelmingly surgeries, though, and just last year they purchased a GK machine and started doing this form of radiation.

Good luck and please keep us posted!


                                         Eve
Right side AN (6x3x3 cm) removed in 1988 by Drs. Benjamin & Cohen at NYU (16 hrs); nerves involved III - XII.
Regrowth at the brainstem 2.5 cm removed by Dr.Shahinian in 4 hrs at SBI (hopefully, this time forever); nerves involved IV - X with VIII missing. No facial or swallowing issues.

Jim Scott

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Re: 2nd Time Around
« Reply #6 on: August 11, 2008, 09:32:50 am »
Hi, Lynn:

I won't attempt to offer any advice at this point as you don't know for sure whether your AN has re-grown, which I sincerely hope is not the case.  Other Texans can and will advise you on doctors and hospitals in your area.  What I will do is simply welcome you to the site and forum and wish you much success in whatever path you need to take should the AN actually be there, again.  I'll just add that you were very fortunate in your surgery and recovery success, considering the paucity of knowledge regarding Acoustic Neuromas in 1987 and the often unpleasant consequences of the surgery used to remove them.  I hope and will pray that should you require treatment now, it will be equally successful.

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

Kaybo

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Re: 2nd Time Around
« Reply #7 on: August 11, 2008, 09:43:02 am »
Lynn~
Hello!  I had my surgery in Houston at Baylor with Dr. Herman Jenkins 12 years ago (Methodist hospital).  Dr. Jenkins is now in the Denver area, but I was pleased with his care.  However, I have told my hubby that if my tumor did reappear, we'd be on the first plane to House!  From what I have gathered here, they do free phone consultations first.  I don't want my tumor to come back, by any means, but for those who have had to do it again, it seems like it is much "easier" (for lack of better word) now - probably for the simple fact of modern medical advances.  Good Luck with everything - I sure hope that it is just scar tissue on the MRI!!

K

PS - What part of Houston are you in??
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

theshrine

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Re: 2nd Time Around
« Reply #8 on: August 13, 2008, 07:49:45 pm »
Hello all,

An update.
Thanks to the folks who responded to my post. 
I sent an email to House in LA on Monday.  Today I got a phone call from Dr. Antonio De La Cruz.  After a brief chat he told me distinguishing between scar tissue and tumor can be done reliably with the right MRI.  I faxed him my MRI report along with some other info.  A couple of hours later he called me again and gave me very specific instructions for a new MRI.  I passed the info. on to my personal doctor so he could set up the MRI appointment.

I found Dr. De La Cruz a very refreshing breath of fresh air.  No going through assistants, answering a bunch of frivolous question, or filling out a pile of paperwork.  I told him my situation and he personally responded telling me what I needed to do to take the next step. I love it!!!


Lynn

jerseygirl

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Re: 2nd Time Around
« Reply #9 on: August 13, 2008, 08:08:18 pm »
Hi,

Could you please post what kind of MRI do you need for distinguishing between scar tissue and a tumor?  I had scar tissue for quite awhile and was never told this. It would be nice to avid the guessing game.

         Eve
Right side AN (6x3x3 cm) removed in 1988 by Drs. Benjamin & Cohen at NYU (16 hrs); nerves involved III - XII.
Regrowth at the brainstem 2.5 cm removed by Dr.Shahinian in 4 hrs at SBI (hopefully, this time forever); nerves involved IV - X with VIII missing. No facial or swallowing issues.

wendysig

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Re: 2nd Time Around
« Reply #10 on: August 14, 2008, 09:10:00 am »
Hi Lynn,

I sincerely hope you AN has not regrown.  Even though there are more and better treatment options, I would not wish this experience on anyone, let alone for a a second time.  I hope your mystery mass turns out to just be scar tissue and your tinnitus quiets down.  I'm keeping my fingers crossed for you and hope you will keep us posted.

Good luck,
Wendy
1.3 cm at time of diagnosis -  April 9, 2008
2 cm at time of surgery
SSD right side translabyrinthine July 25, 2008
Mt. Sinai Hospital, New York, NY
Extremely grateful for the wonderful Dr. Choe & Dr. Chen
BAHA surgery 1/5/09
Doing great!

Captain Deb

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Re: 2nd Time Around
« Reply #11 on: August 14, 2008, 05:19:47 pm »
Yes, we would ALL like to know about this "scar tissue differentiation" method of MRI imaging as many of us who have our MRI's read and taken in different areas othere than where we had our surgeries are given inconclusive results.

I'm really glad HEI gave you some direction on getting a proper diagnosis, shrine! Best of luck.

Capt Deb
"You only have two choices, having fun or freaking out"-Jimmy Buffett
50-ish with a 1x.7x.8cm.AN
Mid-fossa HEI, Jan 03 Friedman & Hitselberger
Chronic post-op headaches
Captain & Designated Driver of the PBW

theshrine

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Re: 2nd Time Around
« Reply #12 on: August 14, 2008, 07:26:43 pm »
The radiologist wrote a report on my May MRI.   I had my Houston medical clinic fax it directly to Dr. De La Cruz.  I have not seen it to date but as soon as I get a copy I will post it – hopefully tomorrow.   Dr. De La Cruz said that the radiologist recommended follow up MRI and that he, Dr. De La Cruz, agreed with the setting for the follow up MRI with an addition(s).  He said to make sure that I had a scan of auditory canal – thin sections (< 3mm) with contrast and fat suppression.  Even though I am not aware that they filled the void in my 1987 acoustic neuroma operation with fat, he said it was common practice even back then. Insert Fat-Head joke here.  ;D.

My personal Houston physician never mentioned a follow up MRI.  All his nurse told me is the May MRI was inclusive.  This underscores the fact that you need to continually ask, probe, question, and try to keep on top of things yourself.  Sometimes there are serious consequences if you trust others to do the right thing on your behalf even though they are paid well to do so.   

Lynn

theshrine

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Re: 2nd Time Around - GOOD NEWS
« Reply #13 on: September 06, 2008, 09:13:54 am »
Sorry for the delay in posting - I’ve been working out of town the last couple of weeks and haven’t had web access.

Had some trouble finding a facility in Houston that could perform the type of MRI needed.  After a couple of false starts I did get the MRI CD mailed off.  Dr. De La Cruz (House Clinic) called me last week and he said there was definitely no tumor re-growth.  Happy day!!!  When I asked him about the increase in tinnitus he said that this was not uncommon with aging.

So I am going to start doing some research and see what my options might be.  Just knowing that the ringing is not the tumor saying ‘ hello I’m back’ is such a relief.  Any information passed along would be appreciated.

 :) :) :) :D :D :D ;D ;D ;D

leapyrtwins

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Re: 2nd Time Around
« Reply #14 on: September 06, 2008, 02:19:32 pm »
Lynn -

I missed your first post, since I was on vacation at the time, but I'm relieved to hear that your MRI doesn't show regrowth.  A HUGE congratulations to you!   ;D

I was luckily enough to have my first annual MRI with fat suppression and was told that the newer MRI machines are able to suppress things like fat and scar tissue.  I didn't realize it's not always easy to find a newer machine.  Thank God you were able to locate one in your area.  Thank God also for Dr. De La Cruz @ House.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways