Arnold, that's the last straw!

The decision to wait some more came in mid-July.  That meant I only had a little over 4 months until I would go through another audiogram and MRI.  I thought all of this waiting would be so agonizing; that having Arnold just hanging over me would drive me crazy.  In fact, the waiting gave me time to accept that he really is there and to accept that my hearing is lost to me and would not ever return.  
For me, there was no epiphany moment where it just sank in and I got it.  It has been a slow process of living with the hearing loss and knowing that Arnold is just right there, hanging out between my ear and brain stem, pushing on those nerves, causing tons of tinnitus and distorting my hearing.  As I was able to talk about it more and make jokes about not being able to hear, somehow I slowly have been able to accept it.  
Many of you know this shirt that I have:

 

Greg bought this for me as way to relieve the tension and inject some humor.  I think it has helped quite a bit and, well, the kids love it.

I would like to interject here that most of my interaction with Dr. M's office is through e-mail with his amazing Practice Coordinator, Miss A.  She always answers my e-mails and is completely on top of everything.  She told me once I had decided to wait for the one year mark that she would be contacting me at the beginning of October to set up appointments.  On October 1 I received an e-mail from her telling me she had called my insurance to check for pre-authorization and had send the MRI request to PAMF, where I have been going for my MRIs.  Her professionalism, responsiveness and organization give me great confidence in this doctor's office.

My audiogram was on Thursday 11/8.  

The blue box is where my hearing was on my last audiogram.  As you can see, tones in my right ear took a dive.  Word recognition on this one was non-existent.   

If you have not done a hearing test lately, they certainly are different from when I was a kid and put those headphones on and listened for tones.  It is done in a sound room and they do lots of neat things like check that your ear drums are working properly and that conductivity through your bones works.  The main part of the test they plug both ears with an earphone in each ear.  The doctor closes the door to the sound room and then talks to you through the earphones, first in one ear and then the other.  This isolates the ears completely for each test.  

For this go around, she talked to me in the left ear when it came time to test in the right ear.  When the word recognition part came, she said she wanted to just try, so I said ok.  She switched over to the right ear and I listened and listened and waited for her to say something.  Then she said it was over.  My useful hearing in my right ear really is gone. 

One fun thing she did just on the right ear was to put a headset just behind my ear on the temporal bone.  She then played static in the left ear and tones in that headphone on the right side.  Because the bone could conduct it over to my left ear, I would hear the tones in my left ear!  It was so weird.

My MRI was scheduled for Friday 11/23.  Yup, the day after Thanksgiving.  As occupied as I was, it was still difficult to have to focus on confronting Arnold yet again and seeing what he had in store for me this time. 

Here is my first MRI from a year ago:

 Here is my latest scan, one year later:

You can see he has grown.  The official findings were:

Again identified within the right internal auditory canal is an enhancing expansile mass with dense associated enhancement measuring approximately 12 x 6 x 6 mm in maximal diameter, slightly enlarged as compared with prior exams.

My last MRI, 6 months ago, measured 8.3 x 4.8 x 5.8 mm.  So, according to my math, that was a 3.7mm hike in size!  That is a 44% increase?! and they think it is "slightly" enlarged?!  

Thankfully, I have copies of all my scans and software to view them.  I can even take my own measurements.  No, I am no radiologist, but given how different each reading has come back (let's see, the second one neglected the third measurement, the third one did not even bother with a decimal point accuracy...), I figured if I measured myself I would pick as close to the same points for measuring as three different radiologist would.  I found that from the first scan to the second it was slightly enlarged and the second scan to the third it also was slightly enlarged.  It has a rather steady growth pattern, which is expected for acoustic neuroma.

I was smart this time and went ahead and had scheduled an appointment with Dr. M back in October when I was setting up all these follow-up tests.  We met with him a week after my MRI.  He told us it's growing, it will continue to grow, might as well treat it now.  We talked about the different options, but then we pushed him to make a recommendation. He said given my age and that I have no useful hearing left, he recommends surgery, the translabyrinthine approach.

Now a little background on Dr. M.  He is a very well regarded neurosurgeon AND he is the director of the Gamma Knife program at UCSF (that's the radiation).  He treats with both approaches, I feel confident in his recommendation.   

I did not decide then and there in the appointment to go ahead with surgery and schedule it.  It still took a couple of weeks to come to that decision.  So, yes, I am going to have surgery and I hope to say good-bye to Arnold forever.