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Our parents would not have dared
I am a private pilot, diagnosed in 12/96 with a 2 cm acoustic neuroma. I was unsure how my AN would affect my flight physical status. My only symptoms were a slight decrease in hearing and constant ringing, which had started only the month before (11/96), so I couldn't see any impact on my flying, although I feared the FAA might view things differently. The AN was diagnosed by an ENT, who referred me to the "best AN surgeon in Houston" (where I live).
The ENT started right off with the assumption that surgery was the only option. This surgeon had absolutely nothing good to say about radiation treatments, and essentially tried to pressure me into surgery. He said he would never consider radiation treatments for himself. He gave me a 30% chance of some facial nerve damage from surgery, and a guarantee of 100% hearing loss (he would only consider the trans-lab approach).
After much research on the internet, reading many journal articles, seeing several specialists, etc., I chose to have Fractionated Stereotactic Radiosurgery at Columbia Spring Branch Medical Center in Houston. I had my treatments in early March, 1997. My doctor was Robert Behar. He trained at Stanford and follows their same protocol, but had only done about 14 patients prior to me.
I received 2100 rads in 3 fractions spread over 2 days (using a fixed head frame). I was back to work after four days (the only recovery being from the head-frame attachment points). Since then, I have not had any facial nerve problems, balance problems, eye problems, eating problems, headaches, spinal fluid leaks, extended recovery period, or any of the other possible negative side effects of invasive surgery.
I was unsure how my AN would affect my flight physical status, especially given that it was not surgically removed. I couldn't see how my symptoms could have any impact on my flying, although I feared the FAA might view things differently. I was unable to find anyone else who had applied for an FAA physical following FSR for an AN.
Other than the anxiety of knowing I have a brain tumor, a decline in hearing has been the only other impact on my life... I continued to lose hearing for 6-8 months after the treatment. My hearing has now stabilized, at about 30% of normal. This is just barely serviceable hearing. The main thing I hope to retain is some reasonable directional perception, which is fair, but not as good as a normal hearing person.
A year later, in March of 1998, I had my first MRI since the treatment. The official analysis is "no change in tumor size, but an indication of central necrosis". In other words, the tumor is darker in the center, which implies that it is dying off. My doctor says that is as good as you can expect for one year, although I am unusual in his experience to have continued hearing loss.
It was only due to my research on the Internet, and my personal insistence on consulting with other specialists that I learned about and was able to choose the treatment that I had. If I had been less assertive and lacked access to the Internet, I would have undoubtedly undergone the surgery, not knowing there was any alternative. I feel certain that someone in my parent's generation would not have dared question the "expert" opinion like I did (years ago you trusted your doctors completely).
I will obviously have to watch and monitor this for years. But the good part has been there has been nearly no impact on my quality of life or daily activities. The impact has been far more mental than physical. It has brought me closer to God, my church, my wife, my family, and my close friends. I am sure all of you that have been through this understand what I mean.
Eric Bauer <bauers AT usa.com>
(7/98) After a special review, the FAA has just reissued my 3rd class aviation medical certificate, and I am medically certified to fly for another 2 years, providing the symptoms don't change.
(2/99) I have had no noticeable change in any symptoms over the last
year. I continue to have constant ringing in the affected ear, and moderate hearing loss.
I just had a hearing test and MRI at approximately the 2 year point since my FSR treatment
for my 2.0cm AN.
The hearing test showed about the same tone response, but speech recognition in the bad
ear has improved from a low of 40% to between 60-90%(depending on the volume). I doubt
that the hearing has really improved much but think I am just getting used to interpreting
the garbled sounds that I receive there.
The MRI showed no change at all since the previous year. No smaller, no larger, no darker. Although I had hoped for some shrinkage by now, the doctor is happy with the results and says I represent about 1/3 of the cases to show no change. He believes that the chances of no growth after 2 years if I had NOT had the FSR would be very low.
I continue to do all my pre diagnosis activities and sports with no problems, including my flying. I am still very happy with my decision to avoid surgery and have FSR instead.
(2/00) I just had my annual MRI and hearing test. They were essentially identical to last year. The tumor has not changed. I am now 3 years post FSR, and have had no change in hearing or other symptoms for over 2 years.
(2/01) I just had my annual MRI and hearing test. No changes in either. I am now 4 years post FSR treatment for my 2 cm AN. The doctor is now recommending switching to 2 year frequency on the MRI's because of the good results. I continue to fly and do other sports. The only symptoms are reduced hearing and tinitus in the left ear.
(1/03) In 12/2002, I had an MRI and hearing test. Both showed to be essentially unchanged since the last tests in 2/01. I am now nearly 6 years post treatment, having had FSR for my 1.8cm AN in March, 1997. I have retained about 40% hearing in the affected ear. I continue to participate normally in sports and other activities, including flying as a private pilot. Please note also that my primary email address has changed to <bauers AT usa.com>©
Last Edited: Wednesday, August 13, 2003