"My hearing did return to normal after this episode, after I also received an intratympanic steroid injection. Instead of ruling out a tumor, though, the MRI showed a ~1 cm size mass in the inner auditory canal and I was diagnosed with an acoustic neuroma.
Together with my wife, I then saw several specialists in both New York and Los Angeles. After our visit with
Dr. Friedman, it was immediately clear to both of us that we would stay with him. Not only did he seem to have a practically unmatched amount of experience and achieve excellent outcomes in his patients, he was also willing to accommodate our desire to understand as much as possible about the condition and treatment options, which was very important to us as professional scientists.
Because of the tumor's relatively small size and the fact that it was still completely contained in the canal, we first chose a watch-and-wait approach with MRIs every six months. Although the tumor appeared to remain stable in size over the next two-and-a-half years, I experienced several episodes of transient hearing loss.
Things changed dramatically in January 2018 when I developed a terrifying new symptom: while taking a hot shower, the right side of my face froze into a grotesque grimace with the eye closed and mouth pulled up. It probably only lasted for a minute, but it felt like the longest minute of my life and it happened again a few minutes later.
I was with my wife in New York at the time, who immediately sent a frantic email to Dr. Friedman. Despite it being a Saturday morning, he called us right away and arranged a prednisone script. From then on, I avoided long hot showers (something I always used to enjoy), but my eye would still start twitching even from a lukewarm brief shower. At my next MRI two weeks later, it became clear that the tumor had grown by about 2 mm overall compared to the initial assessment. Moreover, my serviceable hearing had deteriorated to only ~12% word recognition.
Although it was clear that the time had come to get the tumor out, I struggled with this realization. I am a professor at a major university where I conduct basic medical research, which means the world to me. I was very concerned that surgery would leave me unable to continue this work. Although we had originally discussed the middle fossa surgical approach for me, my poor hearing now made the translabyrinthine approach the more appropriate choice and we made tentative plans to have the surgery about two months later.
However, this plan had to be dramatically accelerated when I had a severe vertigo attack only a week later. It woke me up in the middle of the night and, for the next ~36 hours, I was completely incapacitated, lying still in a dark room trying (unsuccessfully) not to be sick. This attack left me essentially deaf in the right ear. Most frighteningly, my face was no longer symmetric and I could not raise the right eyebrow all the way or whistle. The only priority now became saving my facial nerve. When we sent pictures of my face to Dr. Friedman, he responded by saying that I needed treatment as soon as possible. Later the same day, Kris Siwek called us to say that, because of a cancellation, there was an available opening exactly one week later and we jumped at the chance.
During the surgery, my wife received regular updates from the OR nurse and Dr. Friedman came out at one point and told her that my tumor appeared to be a meningioma. Upon waking up, the first thing I remember is checking whether I could still move my face and whistle. It was such a relief to realize that it still worked. Happily, I hardly had any vertigo, probably because the nerve had already been functionally dead before the surgery.
It has now been close to two months since my surgery and I feel that I am mostly back to normal, although I still tire more easily and sometimes just need to sit and take a break. Of course, I am also still adjusting to having only one-sided hearing now. Because my tumor ended up being a meningioma, I will continue to need follow up MRIs and there is a small chance that I may have to deal with this thing again at some point in my life. Still, I am extremely grateful that the surgery went so well and is behind me now.
I cannot say enough good things about the staff and the setup at Jacobs Medical Center. I really feel that if one needs to have surgery, there cannot be a more comfortable place for it. All the rooms, even in the ICU, were private and included a sleeper couch that my wife confirmed to be rather comfortable. All the fellows, residents, nurses and assistants without exception were amazing, so competent and kind. Even the food was not bad! Of course, the most important component in all of this are the surgeons. I can say with complete candor that Dr. Friedman and Dr. Schwartz are my heroes and I will forever remain grateful to them."
– André Hoelz
April 2018