Treatment Plan Options

So, not a half hour after my incredibly disappointing interactions with the Mayo Clinic, I got a call from the extraordinarily kind Dr. Louis Kim, the chief of neurological surgery at Harborview medical center, which is affiliated with the University of Washington. He was one of the local surgeons Grand Rounds recommended for me.

He was calling back because I had spoken with his scheduler briefly last week, and he wanted to follow up because I hadn’t scheduled an appointment yet and he wanted to have the opportunity to speak with me personally about my case. He said they had reviewed my records, and he hoped I’d come in and meet with them even if I weren’t going to choose them for the surgery because it’s a really good idea to find out as much as possible with something like this.

He said he knows basically all the neurosurgeons in the country, and that because of the location and size of this tumor, not just anyone could do it. He said he thinks of everyone they treat like family, and they base their treatment plans on how they would want the treatment to proceed if it were their spouse or kids. He said in this case, there are only a handful of neurosurgeons he’d trust to handle a tumor like mine, and one of those neurosurgeons is his co-director of skull base and minimally invasive surgery, Dr. Manuel Ferriera. He said Dr. Ferriera is so great that when his wife’s best friend had a brain tumor, that’s who he recommended, and it turned out very well.

He also said their team has handled a lot of chondrosarcomas and skull base tumors, and that in this case, they’d recommend a single surgery via craniotomy, followed 3-6 months later by proton radiation therapy. When I mentioned that Virginia Mason had recommended two surgeries because of the location of the tumor, he said Harborview has some newer, more advanced technology that will allow them to reach those hard-to-reach places with one surgery. When I asked about the timing of the radiation therapy, since Virginia Mason’s plan was to begin treatments about a month after the second surgery, he said he feels strongly that it’s important to fully heal from the surgery before beginning radiation therapy, and that takes time.

Then he said as far as scheduling surgery if we decide to go with Harborview, although with this type of tumor there isn’t as much of a rush as some others, it’s a good idea to address it within the next few weeks, and they will be happy to work around my schedule and can get things going in as soon as two weeks, if that would work for me.

The difference between Harbor View’s approach and Mayo’s approach are like night and day. Everything about my interactions with Harbor View make me feel like they care deeply about their patients, and their top priority is using the best, most current techniques to help real human beings get their lives back.

Just after I got off the phone with Dr. Kim, his scheduler, Jamie, called back and scheduled my appointment for Tuesday.

I’m also going to schedule an appointment at Virginia Mason to meet with their top-ranked (according to Grand Rounds) neurosurgeon, Dr. Farrokh Farrokhi, after the Harborview appointment, to get his point of view about the alternate treatment plans. He’ll be familiar with my case because he was one of the surgeons who reviewed it initially as part of the Virginia Mason team.

All things being equal, one surgery seems better than two. I’m certainly very interested to hear their competing explanations for how they’d handle the surgeries. Both surgeons are highly ranked by Grand Rounds, althouh Farrokhi has the statistical edge over Ferriera.

I’m anxious to meet with both teams and evaluate their proposals. More to come…