Okay, so I’m not Dr. David Banner. But I do have a story about gamma radiation exposure that you might want to pay some attention to. And oddly enough, it has a surprise happy ending.
It all started four years ago when I was getting my annual physical. The doctor concluded by saying, “Well, if you drop dead on your way out of here it will be because someone shoots you. You are remarkably healthy.” He then asked if I had any complaints to discuss. I told him that I seemed to have picked up a mild case of tinnitus in my left ear, and was there anything to do about it. He said that the current thinking about tinnitus was that I was probably hearing was the blood flowing through my ears, and I probably shouldn’t worry about it. So I didn’t.
Another year goes by and I’m back talking to the doctor. I tell him that my tinnitus had not gone away and seemed to be getting slightly worse. He responded that I was still a healthy guy, even if I was a year older, and that since I was now 59, I could expect that my body would no longer perform like I was 30. Besides, he said, lots of people tend to get diminished hearing as their bodies age. Well, I figured he was the doctor, and I really did feel in pretty good health otherwise, so I chose not to worry about it.
About six months later, I picked up an occasional facial twitch just below my left eye. It wasn’t anything too serious. It was just a tic that would annoy me for about 20 minutes and then stop. It wasn’t even discernible to anyone who was looking at me while it was happening. It was just irritating, and it only happened very occasionally. It had not happened again for several months so I forgot to mention it to my doctor at our next annual get-together. I did mention the tinnitus, as it was getting moderately louder, but he again dismissed my complaint as just getting older.
Another year went by and when I went to see the doctor, we discussed my kidneys. Previously in my life I have been afflicted with kidney stones, and I told him that I thought my stones were trying to make reappearance. So he sent me off for an ultrasound to determine what was going on with my kidneys. At that time I again mentioned that my left ear seemed to have its own messaging center, but he said that, again, it was just me listening to the blood flow in my ears. The day after my kidney ultrasound I was sitting at my desk and the doctor’s nurse called to say that the doctor needed to see me at my earliest convenience – never a good sign. So I went to the doctor’s office and had a one-on-one with him. Apparently the ultra sound showed hydronephrosis – a condition I previously knew nothing about, but it certainly didn’t sound like a good thing to have. Apparently when there is not good drainage in a kidney, the back-pressure builds up to the point that it destroys the kidney. So he sent me off for a CAT scan to determine the extent of the damage. The CAT scan revealed that there was no hydronephrosis, but there was a suspicious mass inside the kidney that needed further investigation. Good news/Bad news. So I went off to get an MRI of the kidneys. The report back from the MRI was that there were non-obstructing kidney stones and no other mass internal to the kidney. There was however, a possible mass of fat cells on top of one of the kidneys. The doctor said that the radiology reports were generally written in a conservative manner, so he would call the radiologist to find out if the radiologist thought the mass should be biopsied. I said no. Before we even start to worry about that, I said, we should get serious about investigating my left ear. He asked, “What’s wrong with your ear?”
I said that there was definitely something beyond simply getting older. That my left ear could hear nothing beyond the horde of cicadas that had seemed to have taken up residence therein, that I was getting occasional facial tics, and I was getting to the point that I was pretty certain that I could not pass a field-sobriety test while fully sober. My walking was turning into more of a stagger, and while sitting and driving was not a problem, standing was getting to be an ordeal. So he sent me off to an otolaryngologist for evaluation.
At the ear, nose, and throat doctor, he gave me some audio tests and determined that I had lost all hearing in my left ear, but he wanted to run an MRI of my head to determine the exact cause. So I was back to the MRI. A week later I went back to the ear, nose, and throat doctor and he came into the room and said, “I just want to make certain that you know the tumor is benign. I am going to stress that to you in everything I say to you.” He told me that my hearing in the left ear was gone, and was never coming back. The condition is known as either a vestibular schwannoma, or an acoustic neuroma (po-ta-to, pu-tah-to) and there are three treatments generally followed: 1) it’s a slow growing tumor that sometimes just stops growing on its own, so monitor it and do nothing, 2) surgical extraction by opening up the skull just behind the ear and practicing making tiny melon balls out of the extraneous tissue encountered, or 3) gamma knife surgery by focusing multiple sub-millimeter gamma rays at the tumor and killing it (or most of it) without actually cutting open the skull.
My first thought was that doing nothing had not worked so far, but I would explore that option in addition to the other two. My daughter called from the Dallas-Fort Worth area to tell me that since I was living by myself, she would drive to fetch me (it’s a full day’s drive each way) and would not take no for an answer. If I needed treatment, it would be with family present.
My main concern was cost. Jesus H. What does it cost to crack open a skull and perform anything therein. So I checked my health insurance and discovered that, as I am working for the University of Texas System, and I just happened to elect the right coverage last year when given the option, the entire cost of treatment, physician and hospital, in-patient or out-patient, was going to cost only a $35.00 deductible. Yes, you read that correctly. Thirty-five dollars! I calculated how this worked, and came to the conclusion that it actually saves both the UT System and its employees large sums of money doing this.
So I made the trip to Dallas-Fort Worth and had the procedure performed at The University of Texas Southwestern Medical Centers. Prior to the procedure, my stagger had deteriorated further, and I was starting to experience vertigo while standing or walking. I elected the gamma knife procedure for the simple reasons that doing nothing was clearly not working, and the six week recovery time from the open skull procedure, together with the concurrent risks of any invasive surgery – particularly in the skull, was simply not all that attractive. Gamma knife surgery also has risks associated, but I figure that if it take another thirty years for the brain cancer to develop, well that would make me 92, and that is a good run in anyone’s book.
Following the surgery, as expected there was some swelling of the tumor site, thereby causing me some increased vertigo for a couple of days, but now, two weeks later I am feeling better than I did before the procedure. I am not staggering when I walk, the cicadas in my left ear seem to be getting quieter every day, and my vision seems to actually be improving somewhat.
Lessons learned: 1) Believe what your body is telling you, 2) There are alternatives to hellaciously priced medicine, 3) Family is important, and 4) Don’t make me angry.