Dr. Manuel Ferriera

We met with Dr. Ferriera today, and he is going to be my neurosurgeon. We have scheduled the surgery at University of Washington Medical Center for May 1st, and I will go in for a pre-surgery angiogram on April 29th, which may turn into an overnight stay, depending on the results.

Dr. Ferriera specializes in skull base surgeries. He does about 300-350 per year, about 20 of which are either chordomas or chondrosarcomas. His rate of post-surgery complications is about 5%, which is quite good. His team does more skull base operations than any other center in the country, so they have lots of experience with all the details that are necessary for skull base surgeries that might not be necessary for other types of neurosurgeries.

I’ve heard from many neurosurgeons at this point how important it is for my surgeon to have considerable experience in resecting this sort of tumor because it’s complex and delicate work. Dr. Ferriera’s experience is reassuring – he discusses the pros and cons of different strategies for addressing skull-base-specific surgical issues with the sort of confident flexibility you generally see in people who have a lot of tools in their toolbox. He speaks knowledgeably about both research and practical aspects of skull base surgery, and is comfortable discussing where the research is limited and his experience provides guidance. Basically, after today’s meeting, I feel strongly that he really knows his stuff.

He believes it should be possible to take care of my tumor removal in one surgery, assuming it’s a chondrosarcoma and depending on how it is interacting with the local nerves and other structures. He showed us on a plastic skull exactly where the tumor is located, how its position relates to my cranial nerves and structures, and how large it is (we had thought it was about the size of a golf ball). Evidently, it’s about the size of a duck egg, which is a bit larger than a chicken egg. Yikes!

He will reach the tumors via a craniotomy, and although he performs many nasal endoscopies for other things, he does not recommend going in through the nose to reach the areas where this tumor is located, and showed us why.

He will test facial nerve function throughout the surgery, as cranial nerves 3-11 are involved.

Assuming all goes well, I’ll be in the hospital for about four days after surgery. My eye will probably be worse and parts of the left side of my face will probably be numb for a while. There may be other impacts, depending on what the tumor is and what is necessary to remove. The question of whether or not radiation therapy will be necessary will still depend on the outcome of the pathology evaluation during surgery, of course. If it is necessary, the radiation oncologists who will work on the case are Jason Rockhill and Lia Halasz.

It’s a relief to finally have this settled. It’s felt like surgeon roulette the last week or so, which is fairly stressful.

I am very happy with the team that is working on my case. Dr. Ferriera has a great  Patient Care Coordinator named Laurel Connolly (no link available) who helps patients navigate billing, scheduling, and everything else necessary to make our way through this process. She will help us find the answers to questions and has already helped us with a lot of logistical questions.

So – a bit more than two weeks to go. It’s scary, but good. With some picturesque head scars and a wonky eye, I expect to look extra-piratey for a while. The Flying Spaghetti Monster would be proud. Arrrrgh.