|Note pressure of the|
titanium frame on head.
You get used to it.
Selfie by JT Marlin.
Having already lost most of my hearing in the left ear, I decided to wait before doing anything about the neuroma.
|Nurse feeds me water through|
titanium cage. This and later
photos by Alice Tepper Marlin.
The neuroma had grown to 8 mm. The vestibular ear canal controls balance. As a doctor told me: "When you hear the sound of hoofs outside the window in the USA, do you assume a zebra or a horse?" The horse is this case would be the neuroma. In other words, anything to do with my balance should be assumed to relate to the neuroma.
So yesterday morning I had the procedure. I am informed it successfully killed the neuroma (although the process of its dying may take weeks or months), so unless you want to know more, that is the end of the story.
A neuroma or schwannoma (also known as a "Schwann cell tumor" or a "neurinoma,"or "neurolemoma") is a benign nerve sheath tumor composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral nerves. The tumor cells can be thought of as feeding on a nerve, but they stay outside the nerve. The tumor causes trouble by pushing the nerve aside and/or up against a bony structure. Schwannomas are relatively slow-growing and are almost always benign, so they don't spread.
|Dr. Wang sets up the Perfexion machine.|
The "Gamma Knife" radiation procedure avoids having to cut through the skull or physically cut out the tumor. Instead, it bombards the neuroma with gamma rays from dozens of different directions. After enough of this the neuroma cries "Uncle" and goes into a funk that ends with its death.
"The neuroma is a weakling among tumors and is ready to give up the ghost with a little bombardment," is how I remember Dr. Michael Sisti summing up the situation. The downside is less worrisome than the hole-in-the-scalp and mini-scissors strategy for the surgery.
The Gamma Knife is an advanced radiation treatment for adults and children with small to medium-sized brain tumors and diseases such as abnormal blood vessel formations called arteriovenous malformations, epilepsy, and trigeminal neuralgia (a nerve condition that causes chronic pain) and other neurological conditions.
That takes care of what I know of the medical science. You can stop here or review what happened during the 9-10 hours that were occupied by the surgery.
The Surgery Narrative
For those contemplating or just curious about the Gamma Knife procedure, here's how my day went yesterday:
4:30 a.m. Shower and dress in clothing with no metal anywhere (even metallic snaps are verboten). I wore a polo shirt and jogging pants.
|Getting ready to open|
6:30 a.m. I am checked in. Alice gets a visitor's pass, I get two bracelets, one indicating my name and doctor and various numeric IDs, and the other listing allergies. I also get a hospital bathrobe. We are introduced to half a dozen people who have different responsibilities during the procedure.
|Dr. Wang watches the Perfexion machine,|
with data at his left.
8:00 a.m. A clear-plastic thing that looks like a transparent hair dryer and was mysteriously called a "halo" was put on me. Dr. Tony Wang used it to take measurements of my skull. This information was presumably fed into the computer to help it decide where to target the gamma rays.
|Nurse puts on ice to|
reduce swelling at
12:00 noon. After Dr. Sisti and Dr. Wang conferred on a strategy, I was brought in to the "Perfexion" Gamma Knife machine and by this time it was programmed with measurements and the irradiation plan. It was almost an anti-climax. No noise, just an occasional hello from Dr. Wang and Alice. And then I was out of there.
|Data from Perfexion machine.|
1:00 p.m. Dr. Sisti says they got all of it but it might take six months before the neuroma was completely dead. Meanwhile, he said, "play tennis".
1:30 p.m. Headed home with a bandage on my head.
I am grateful to Drs. Sisti and Wang, to all the attendants, to Alice for accompanying me, to all those who said they prayed for me, and to the divine being(s) who respond to prayer. And now... back to work.
Update, May 1, 2017
Today I brought in the MRI taken after six months. Dr. Sisti was happy with the outcome and said that, unusually, the Gamma Knife had cut a hole in the neuroma so that it now had a doughnut-like shape. I am to come back after another brain scan in July 2018, and then he expects to be able to say with some finality that the neuroma is dead.