Another busy week
I counted up the number of post-its on my desk on Friday. 20 of them, stuck to every square inch of available space. The fraction that relate to my job? 1 of them. The rest are reminders about medical appointments, second opinions, blood test for (still unobtainable but there are hopeful signs) life insurance, wills, lawyers, house purchasing and so on. I'm fortunate to have an employer who is entirely supportive!
Last week, I met the ESRF welfare officer. I'd never come across this sort of a post before, but it is apparently common in big companies (at least in France - the university in England has nothing of the sort). She works about two days a week at the ESRF, and is a vertiable treasure trove of useful information on 'how to solve a problem'. From contacts with bank directors, to other employees who've undergone surgery by the same guy as proposed in Grenoble, she knows it all. She's offered to visit the banks with me, and helped me keep things a little more under control. I am amazed - just at the time when Kirstin and I were really starting to wonder about who could help us with all the details, someone mentioned her. An administrative angel.
I spoke to the head of neurosurgery again on Friday. Prof. Passagea is the guy we saw before - it won't be him doing the surgery, but he's well up on what is happening. He gladly gave me the names and numbers of the best people in France for neuroma removal, so I'll hopefully get in touch with some of them on Monday. I'm still not sure about staying in Grenoble for the surgery, but am feeling much better about the possibility than I did. We'll see.
I see the neurosurgeon (Prof. Gay) on Thursday, and it will probably be at this point that we decide both on the date of the operation (looking to be early December-ish) and the surgical approach. The ENT surgeon, Prof Schmerber, who I met 10 days ago, is proposing the trans-labrythine approach, which in order to provide the best possible access to the tumour itself, and secondarily the facial nerve (cranial nerve number VII, in case you were interested), goes straight through the inner ear. Unfortunately, that results in complete and irreversible hearing loss on that side. There are a few other approaches, termed the sub-occipital, retro-sigmoid, or even retro-labrythine, which provide also good access to the tumour, slightly (slightly) less visibility of the facial nerve, but can preserve some of the hearing. Typically, ENT/ORL doctors think of hearing preservation is absolute terms, rather than useful hearing preservation. We'll find out on Thursday, I hope, what approach will be taken. It is most likely not the preference of the doctor (or the patient) that dictates this, but the results of the CT scan I had last week, showing the bone structure in that part of the head, revealing the best possible position to enter from.
I haven't told you much about the tests I had last week while visiting the ENT/ORL: both an audiogram then two vestibular (balance) exams. The first was pretty informal, involving a special chair that could be spun, and the second was slightly more technical, with a computer controlled chair, certain visual patterns on an overhead projector, and a water bath of the eardrum designed to induce vertigo (and thus measure the functioning of the vestibular system on both sides). I've found the most fascinating description of this test in the acceptance speech of a 1916 Nobel prize in medicine: here it is.
In it, Robert Bárány gives a very lucid description of the work he did that led to the understanding of how the vestibular system worked, and in particular how the 'caloric test' (that of using hot or cold water to stimulate the sense of balance) was developed. Amazing.
Anyhow, the upshot is that while the nurse was confused by the results - that she seem to be able to stimulate my left ('good') side and induce vertigo artifically, she was puzzled by the lack of response from the right. Read the lecture - you'll see that this is not unexpected when the semi-circular canals (or the nerve leading from them) has some sort of pathology.
So, we'll have to wait till Thursday and see what the plans are then. A bientot!
Last week, I met the ESRF welfare officer. I'd never come across this sort of a post before, but it is apparently common in big companies (at least in France - the university in England has nothing of the sort). She works about two days a week at the ESRF, and is a vertiable treasure trove of useful information on 'how to solve a problem'. From contacts with bank directors, to other employees who've undergone surgery by the same guy as proposed in Grenoble, she knows it all. She's offered to visit the banks with me, and helped me keep things a little more under control. I am amazed - just at the time when Kirstin and I were really starting to wonder about who could help us with all the details, someone mentioned her. An administrative angel.
I spoke to the head of neurosurgery again on Friday. Prof. Passagea is the guy we saw before - it won't be him doing the surgery, but he's well up on what is happening. He gladly gave me the names and numbers of the best people in France for neuroma removal, so I'll hopefully get in touch with some of them on Monday. I'm still not sure about staying in Grenoble for the surgery, but am feeling much better about the possibility than I did. We'll see.
I see the neurosurgeon (Prof. Gay) on Thursday, and it will probably be at this point that we decide both on the date of the operation (looking to be early December-ish) and the surgical approach. The ENT surgeon, Prof Schmerber, who I met 10 days ago, is proposing the trans-labrythine approach, which in order to provide the best possible access to the tumour itself, and secondarily the facial nerve (cranial nerve number VII, in case you were interested), goes straight through the inner ear. Unfortunately, that results in complete and irreversible hearing loss on that side. There are a few other approaches, termed the sub-occipital, retro-sigmoid, or even retro-labrythine, which provide also good access to the tumour, slightly (slightly) less visibility of the facial nerve, but can preserve some of the hearing. Typically, ENT/ORL doctors think of hearing preservation is absolute terms, rather than useful hearing preservation. We'll find out on Thursday, I hope, what approach will be taken. It is most likely not the preference of the doctor (or the patient) that dictates this, but the results of the CT scan I had last week, showing the bone structure in that part of the head, revealing the best possible position to enter from.
I haven't told you much about the tests I had last week while visiting the ENT/ORL: both an audiogram then two vestibular (balance) exams. The first was pretty informal, involving a special chair that could be spun, and the second was slightly more technical, with a computer controlled chair, certain visual patterns on an overhead projector, and a water bath of the eardrum designed to induce vertigo (and thus measure the functioning of the vestibular system on both sides). I've found the most fascinating description of this test in the acceptance speech of a 1916 Nobel prize in medicine: here it is.
In it, Robert Bárány gives a very lucid description of the work he did that led to the understanding of how the vestibular system worked, and in particular how the 'caloric test' (that of using hot or cold water to stimulate the sense of balance) was developed. Amazing.
Anyhow, the upshot is that while the nurse was confused by the results - that she seem to be able to stimulate my left ('good') side and induce vertigo artifically, she was puzzled by the lack of response from the right. Read the lecture - you'll see that this is not unexpected when the semi-circular canals (or the nerve leading from them) has some sort of pathology.
So, we'll have to wait till Thursday and see what the plans are then. A bientot!
posted by Kirstin Jeffrey Johnson | 12:41 pm
0 Comments:
Post a Comment
<< Home