How long can you put off surgery?

[steve33]

I don't seem to be getting any worse, but I have a situation where I cannot get an MRI due to a metallic object in my face. I haven't seen a doctor in years because I don't want a CT scan, and I need surgery to remove the metal before I can get another MRI. I'm 33 years old, and once in a while get vertigo, and I barely if ever notice that I even have tinnitus. Any way this can go away on it's own, or can I delay it? I cannot imagine having surgery in my head is going to allow me to go back to work anytime soon. My insurance has no preexisting conditions restrictions, but I doubt work would be very tolerant of me taking a lot of time off as I am low on the totem pole and have tons of student loans I have to pay off.

[MAlegant]

Hi Steve,
If you haven't had an MRI how did they diagnose your AN?  How long to put it off depends on the size and location of the tumor so you'll need to figure that out first.  It will NOT go away on its own, though it may not grow very much or very fast.  Fill us in on more of your story. (I was back at work part-time in 6 weeks, full-time in 8 weeks.)
Best,
Marci

[Jim Scott]

Steve:

Welcome. I'm sorry you're in this predicament and I'll try to address your questions as best I can, with the understanding that I'm not a doctor.  I'm sure others will, too.

 Having surgery to remove the metal in your face is going to become necessary at some point because the only definitive way to determine whether you have an acoustic neuroma is with an MRI scan.  If you do have an acoustic neuroma, it is unlikely to 'go away on it's own'.  It may remain dormant for some time - years, in some cases - but it won't simply disappear.  Of course, many things could be causing your vertigo and mild tinnitus but you'll never know for sure without the MRI.  Ignoring your symptoms is a bad idea.  You could be setting yourself up for real problems down the road in terms of treatment and recovery time.  If your (possible) AN is small enough, it may be treatable with radiation, which is non-invasive and wouldn't require weeks of recuperation.  Endoscopic surgery is also becoming available.  In any case, you'll need to deal with this at some point so, why wait?  Have the face metal removed and then, have an MRI scan to determine the source of your vertigo and tinnitus.  It might be something related to your ears, and not an acoustic neuroma.  An MRI scan would make the absence of a tumor clear but if the MRI showed a tumor you wouldn't be wasting your time on ear-related procedures when you really needed AN removal surgery.  I urge you not to procrastinate on addressing this problem and I wish you all the best as you deal with it.  Let us know what you decide to do.  Thanks.

Jim

[Sue]

Yeah, Steve, you are going to need to address the metal object (wow, am I really curious about that!) so that you can find out the status of your AN.  And Marci and Jim are right.  AN's, much to our dismay, do not just go away on their own.  You will need to find out how big your AN is, and then you can go from there.  Perhaps you will find that Gamma Knife or CyberKnife (treatment with radiation) would be more agreeable to you and your work schedule.  It's hard to predict what your outcome would be with either surgery or radiotherapy, because results do vary.  It certainly is not to your advantage to ignore an Accoustic Neuroma/Vestibular Schwannoma, if that is indeed what your doctors have told you you have.  

Best of luck to you,

Sue in Vancouver USA

[Pooter]

I hate to pile on, but the MRI scan with contrast is the gold standard for seeing what's going on (or not) with your tumor.  I understand needing to be working, not taking time off, etc.. But, this is your LIFE that we're talking about.  Not to be blunt, but if you let this go on forever then it won't matter about the job anyhow.

Most companies would understand the need to address the metal object in your face and then an MRI afterward.  What options you have for treatment after the scan will be much clearer.  Besides, if you get a scan now you could determine that you have an Acoustic Neuroma and able to radiate (less invasive than surgery), but if you wait then you could get a scan and radiation then is no longer an option and only surgery is.

For what it's worth, I think you should take care of the metal, have the scan with contrast as soon as humnly possible.  Surely, your work would understand your need to be sure there's nothing life threatening to deal with.

Do you have an Acoustic Neuroma for sure, or are they wanting to test to rule it out?  If you have already been diagnosed as having one, then how was it diagnosed without a MRI or CAT Scan?  Tell us more about the story and maybe there are things we're not thinking about...

Regards,

Brian

[wendysig]

Hi Steve,
Welcome to this forum.  As you can see you'll get very straightforward advice here.  Most of us are not doctors, but with the exception of having some type of metal in your face, we've all been where you are now.  Whatever your problem is, the first step is finding out exactly what the problem is.  While it certainly may be possible to put treatment off, depending on what is found, you need to address the problem of getting an accurate diagnosis, otherwise, as everyone has said, you may be setting yourself up for even more  problems.  You are talking about saving your own life here and nothing is more important than that.  Please keep us posted on what you are doing.

Best wishes,
Wendy

[fbarbera]

Agree with these guys, Steve.  There is no benefit to delay in these circumstances.  Putting things off can only result in more problems down the line.  Better to address it quickly.  Best wishes, Francesco

[Joef]

I don't seem to be getting any worse, but I have a situation where I cannot get an MRI due to a metallic object in my face. I haven't seen a doctor in years because I don't want a CT scan, and I need surgery to remove the metal before I can get another MRI. I'm 33 years old, and once in a while get vertigo, and I barely if ever notice that I even have tinnitus. Any way this can go away on it's own, or can I delay it? I cannot imagine having surgery in my head is going to allow me to go back to work anytime soon. My insurance has no preexisting conditions restrictions, but I doubt work would be very tolerant of me taking a lot of time off as I am low on the totem pole and have tons of student loans I have to pay off.

you have not seen a doctor in years ? with metal in your face ? .. get that taken care of first !!! ... tinnitus and vertigo can be many many things...

[steve33]

It's a BB, someone shot me in the face when I was a kid and I never realize it was actually in me. I guess I was a fool for not realizing that it was inside of my face. I saw a doctor about it, and he was telling me I need real deal general anasthesia to have it removed, and I'm scared to death of having surgery.


Yes, you're right, without a working MRI, I cannot know for sure. But the doctor was operating under pretty much an assumption that I have one. It's been a really long time, I had some other test, I completely forget what it's called, but he said the results didn't look good, but honestly, that might have been for something else, maybe just general hearing or the prognosis that I will lose more hearing, or if the tinnitus was going to stop. I'm not very good about keeping medical records. I would leave them in my car, and my car got stolen so I lost everything that I had.

Would a CT scan be of any benefit? I could do that though I'm not a big fan of lifetime doses of radiation in a few minutes. Then again, I'm not looking forward to having surgery just to sit inside of the MRI coffin thing. It was a nightmare inside of it.

[Pooter]

Steve,

Per the ANA Website:  "When an MRI is not available or cannot be performed, a computerized tomography scan (CT scan) with contrast is suggested for patients in whom an acoustic neuroma is suspected. The combination of CT scan and audiogram approach the reliability of MRI in making the diagnosis of acoustic neuroma. "

If you choose the route of a CT scan, then make sure they do it with contrast.  I sincerely hope that you don't have an Acoustic Neuroma, but if you do then this is THE place for information.  If your doctor is right in suspecting an AN, then it's really not the end of the world (even though it seems like it at first).  There are many options available for treatment of an AN.  None of us are doctors, everyone's journey dealing with the AN and all the wonderful presents it likes to bring with it, but we're alive.  There are other tests that can SUGGEST an AN, but a CT scan together with an audiogram can get real close to the accuracy of an MRI in determining a AN diagnosis.

Just be prepared that you MAY have to do something about your BB sooner rather than later.

Regards,
Brian

[Joef]

It's a BB, someone shot me in the face when I was a kid and I never realize it was actually in me. I guess I was a fool for not realizing that it was inside of my face. I saw a doctor about it, and he was telling me I need real deal general anasthesia to have it removed, and I'm scared to death of having surgery.

I would bet the BB' removal surgury would be a simple process.  (I bet its easier than a wisdom tooth removal !) I shooked its been there for years and never got infected !!

[Sue]

Steve,

I'm trying to be supportive of you situation and fears, but as a person who had an appendectomy when she was eight, given birth to a child,  a hysterectomy in her late 30's, and Gamma Knife procedure 3 years ago, not to mention all the other piddly things that has come down the pike - medical and dental, I urge you to address your situation.  Being under for anesthesia is the least of your worries right now.  You basically have "shrapnel" imbedded somewhere in your face.  My son recently had knee surgery for a torn ACL.  He is 36 years old and he was very, very, very nervous about having surgery. Okay, he was scared to death.  It's understandable because he's never had that experience.  After it's all over with, he is kind of wondering why he made a fuss about it.  Medical personnel are almost always kind people who don't want to hurt you unnecessarily.  You go to sleep, you wake up. It's all over with.  You have a little pain, you take a pill.  But it's over with.  Then you go on to the next thing.  And you can see if you can have an open MRI.  It's not as claustrophobic.  They also can give you a nice little relaxing pill to get you through the regular MRI, if that's all they have.  The problems are not insurmountable. 

And in my opinion, this is why God gave the whole birthing process to women.  If men had to do it, the Human Race would have never had a chance! 

As Nike says, "Just Do It!".

Sue in Vancouver USA

[sgerrard]

Would a CT scan be of any benefit? I could do that though I'm not a big fan of lifetime doses of radiation in a few minutes.

As Brian's quote says, a CT scan with contrast can do the job. Plus you would get to find out where that BB has gotten itself to. If I remember right from the radiation physicists site, a head CT scan is about the same as 1 year of background radiation (yes, we all get some of that). Not really a big deal in that department.

I hope you get over the squeamishness, and get a real diagnosis and treatment plan underway. No sense in letting this thing mess up the rest of your life.

Welcome to the forum, too.

Steve

[leapyrtwins]

I'm with Sue.  Surgery to remove the BB wouldn't be all that bad - that's what anesthesia is for.  Heck you'd sleep through the whole procedure 

But whether you choose to go that route or not, if I were you, I'd try to find out if you really have an AN or not.

Just my two cents worth.

Good luck,

Jan

[Richard in Palacios]

Steve,
The others have made the case far better than I can but I cannot resist the opportuntiy to urge you to step up and do what yoou have to do.  I am also a really lousy patient and will go to almost any extreme to avoid the medical types but there are simply things that you and I cannot control and we are so blessed to be here in this place at this time where we have so many options for medical intervention.  Please go ahead and deal with the "bb" and then investigate the possible AN.  Technology and treatment optoins have advanced so very fast in this area over even the last few years that you will be amazed at the developments and options you will have.  The best advice I can offer is to be as informed as you can and talk frankly with the potential treatment team.  Tell them what you think, feel and fear and then listen to their possible solutions.  Please let us know how you are and what you are doing as you make those decisions.  The people that participate on this site are some of the finest, honestly concerned for your health and welfare folks I've ever listened to.  In one way or another we have all been where you are and so do have some idea of what you are going through.
Richard