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agonizing decsion.......

Posted: Sun Sep 14, 2003 7:20 am
by admin
Hi, I am the odd one here with the huge nerve cell tumor(schwannoma) compressing my brachial plexus under my right collarbone. Dr.Nath agreed to look at my case and now he says that he can remove the tumor.(they are trying to fit me in sept 19th or 23rd...eeek!!)

The prob is that I may end up worse after surg. with a permanent BP stretch. As of now, the tiny tissue sample from the tumor shows it to be a begnin schwannoma, and while it is VERY large, and I do have alot of pain, I do have fairly good function still of my shoulder, arm, and hand compared to most I see on here. I have about 50% of the shoulder muscle atrophying and that has caused my shoulderblade to sink inward, making sleeping difficult, can't be on my back or sides. However, I have not yet had any PT, so I don't know if that sit can get any better w/ time.

Part of me wonders if I should not risk being worse off, and possibly losing use of RT arm, hand or shoulder(am righthanded). The way Dr. Nath explained, after the tumor is removed, I will have relief from the compression, which will be good, but I am not sure how much of the pain and probs are due to that, or from the injury and trauma of the biopsy stupid other doc did 2 months ago.(that is when pain and probs increased 100%)

The problem he said, is that when he removes the huge tumor, the nerves(s) will be left loose, and very stretched, so I am assuming I will then have to deal with all the symptoms pain and probs of that type of injury and trauma to BP. Which I am NOT looking forward to.(plus then I will be not able to sleep on tummy for quite a while til healed, and I haven't figured how to sleep standing....how do you u all do it??? I am not able to have any even slight pressure on shoulderblade) He says he thinks there is 80-90% chance it will return to pretty normal and after 6 months we should know. If not, there is a 2nd surgery he would do, with maybe a 70% chance of sucess.

That seems very scary to me. I have already had my life alterd so drastically(not for the better) and been on this medical merry-go-round for almost 3 months now, and I feel like my life has already been put on hold for so long, and also those close who depend on me GREATLY(my kids(youngest 18), my 2yr old grandson that I babysit full time, my mother who has some health issues, husband with some health issues, plus I live on a horse farm run by my daughter).

I want, need, to be "me" again, or at least find out what the new "me" is going to be so I can get past this and deal with how I will live my new life. I HATE the thought of lots of surg and recovery periods...esp w/ the pain, sleep probs, drug issues and side effects, and fighting to be normal and stay upbeat.

However....Docs tell me that this tumor is quite rare and unusual and very suspecious b/c of it's huge size and location. They say that often these supposed schwannomas like mine turn out to be hodgkins after all(which is what they thought in the begining....or lymphoma), so they really really need to get the whole tumor out and section and biopsy it. Even worse is that even begnin schwannomas can on rare occassion turn malignant, and when they do, it is very poor prognosis...(hodgkins is at least mostly curable if found and treated) Usually the begnin ones grow very very slowly...and mine seems to be fast and agressive.

We also are not sure if it is growing bigger right now, as it seems to be, or if that is scar tissue etc. Radiation and chemo will does not help if it is just begnin schwannoma. And of course, the longer I wait, the more it MAY be damaging the BP and chance for recovery.

AUGH!!! Do I risk ending up worse, (he thinks if worse case happened, I would have some bicep etc, but no shoulder..but the shoulder is what bothers me the most now, hate for that to be worse!!!)...however the odds are high for good recovery and being better off than now, and finding out what tumor is?

Or do I leave alone, and have pretty high function level and fairly manageable pain and sleep, but risk cancer growing(altho at present it says begnin), and never getting any better, and possible being worse anyway if tumor grows bigger?

Help!!

Re: agonizing decsion.......

Posted: Sun Sep 14, 2003 2:43 pm
by Joy in FL
It sounds like the doctor has given you some very good information. He has told you about all the bad that could happen. While I know it sounds flip and not very helpful..only you can decide if the surgery is right for you to have. You will be the one that has to live with the outcome. Personally, the odds he is quoting sound pretty good.

I also have to say that when I read your sentence "The prob is that I may end up worse after surg. with a permanent BP stretch." I thought to myself...don't you already have a permanent BP stretch? I mean this tumor could very easily continue to grow and thus continue to stretch the brachial plexus nerves... thus meaning as long as that tumor is there you have a permanent bp stretch. At least that was my first thought when I read your post.

Listen, if you are not sure then postpone the surgery until you are sure. Get another opinion, get several opinions. But, take it from someone who has had many surgeries (not all BP related) you are never 100% sure that you are doing the right thing. Because the "bad things" that can happen always nag you.

Good luck and let us know how things turn out for you.

Joy

Re: agonizing decsion.......

Posted: Sun Sep 14, 2003 8:46 pm
by Francine_Litz
I wish you the best of luck in making your decision. It's a hard one to make. I'm just sorry that you have to make it.

Trust and have faith in whatever decision you make - because it will be the right one for you.

-francine

Re: agonizing decsion.......

Posted: Sun Sep 14, 2003 9:56 pm
by cbe411
I would have to agree with the others that have posted here. It's a tough decision but you are the only one that can make it! Go with your gut and like was staed earlier, postpone it if it doent feel right! Keep us posted AND KEEP YOUR HEAD HIGH!
Courtney

Re: agonizing decsion.......

Posted: Mon Sep 15, 2003 3:31 am
by admin
thank you all!! you all are right, i have to try to dig deep and go with my gut. i think going down there and meeting dr.nath will help alot. nothing is a sure thing, and i have a lot of people praying for and supporting me and i just need to have faith in god, dr. nath, and myself.

ps it is my understanding from doc that while i do have a BP stretch now, it will be worse after tumor is gone, but then should hopefully heal.

Re: agonizing decsion.......

Posted: Mon Sep 15, 2003 6:13 am
by Karen Hillyer
can you go get a second or third opinion?
I live in the Uk and in our group we have one little one who has neurofbromatosis(sp?) and she grew a tumour in her brachial plexus as a baby.
She had the tumour removed and I have to say that her function is not brilliant, but of course ALL cases are different. Her surgeon was Mr Rolf Birch at the PNI unit in Stanmore England - I think his details are on the medical resources page here at UBPN - it might be worthwhile contacting him for an opnion, I don't think he's better than Dr Nath - but maybe he could share the benefit of his experience with you?
Good Luck
Karen

Re: agonizing decsion.......

Posted: Mon Sep 15, 2003 5:59 pm
by jennyb
I agree with Karen, a second or third opinion with a specialist who has seen a lot of these cases would probably be a good idea-altho it might not make yr decision any easier! Rolfe Birch is very experienced as Karen says but he's a long way from you, Dr Kline at Louisiana is probably the most experienced guy in the states for this-he's been operating on these kind of tumours for almost 40 years and his bibliography shows he's published a lot of papers about them. The Mayo clinic have also made a study of these tumours for a very long time, but in their case I wouldn't know how experienced the individual doctors are-you can reduce the chances of things going wrong by using a doctor who has performed this kind of surgery many times, preferably on adults. It's good that your surgeon has been up front about the potential outcomes of the surgery, I do think a 2nd or 3rd opinion with someone whose main interest is adult onset bpi would be a good idea.
Let us know how things go-contact details for both Dr Kline and the Mayo Clinic in Rochester are in the medical resources part of this site. All the best!

Re: agonizing decsion.......

Posted: Tue Sep 16, 2003 3:31 am
by Karen Hillyer
Thanks Jenny
How do you know so much huh?????
I'm jealous !!!
Karen

Re: agonizing decsion.......

Posted: Tue Sep 16, 2003 5:25 am
by jennyb
....I don't know stuff, I look it up....plus I think I've reached that age where you remember a lot of details but don't know what day it is....it's called getting old :0)

Re: agonizing decsion.......

Posted: Sun Mar 21, 2004 4:08 am
by admin
> can you go get a second or third opinion?
> I live in the Uk and in our group we have one little
> one who has neurofbromatosis(sp?) and she grew a
> tumour in her brachial plexus as a baby.
> She had the tumour removed and I have to say that her
> function is not brilliant, but of course ALL cases
> are different. Her surgeon was Mr Rolf Birch at the
> PNI unit in Stanmore England - I think his details
> are on the medical resources page here at UBPN - it
> might be worthwhile contacting him for an opnion, I
> don't think he's better than Dr Nath - but maybe he
> could share the benefit of his experience with you?
> Good Luck
> Karen