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| Meningioma: Success Stories |
Dave G., Duncanville, TX
This letter is to tell you about Dr. Hrayr K. Shahinian, Director of the Skull Base Institute of Los Angeles, CA, who removed my olfactory groove meningioma and preserved my olfaction.
At the time of my surgery, I was a 64-year old construction manager; today I'm working as hard as ever, with excellent senses of taste and smell.
Several years ago, during a checkup following my quadruple-bypass heart surgery, tremors in my right hand prompted my primary care physician (PCP) to refer me to a Dallas neurologist.
The neurologist ordered an MRI to determine whether a brain condition was contributing to the tremors. The MRI film clearly showed a 3cm "white cotton ball" meningioma. He concluded the tumor was not causing my tremors, but he was quite concerned about the potential for seizures. The neurologist referred me to a neurosurgeon to schedule removal of the tumor.
The neurosurgeon described the surgery I was facing: an open craniotomy, with brain retraction, stretching/cutting of the olfactory nerves and the subsequent loss of smell and taste. He said that during tumor resection, he would scrape the underlying bone to make sure the tumor wouldn't grow back, and that the olfactory nerves would be severed during resection. He recommended that I have the tumor removed within six (6) months.
We were very disappointed that my olfaction would need to be sacrificed. So I asked our PCP for a 2nd opinion referral.
If Dr. Shahinian hadn't ultimately done the surgery, this second opinion doctor, a surgical professor, would have been my choice of neurosurgeons. At least he wasn't planning to do an open craniotomy and move my brain. His approach was to make a 1 ½- to-2-inch elliptical opening in my forehead, using primarily a microscope with minor use of the endoscope. Initially he said there was a chance he could preserve a measure of olfaction, depending on the tumor's position and surgical realities. But on a 2nd visit, he was less confident. Consequently, my wife and I were not convinced that he could preserve an acceptable measure of olfaction. He took pride in his surgical dexterity, which he implied gave him the edge over other surgeons.
Thus began several months of research to understand more about the risks of my surgery and to decide whom I wanted to perform my surgery.
An Internet search led me to a doctor at a prominent hospital and university. Their website showed the customary open craniotomy photos and description, again holding little promise of preserving olfaction. For $100.00, the doctor offered to read my MRI and give his opinion. I declined.
Another prominent doctor also recommended either an open craniotomy or Gamma Knife to target the tumor. Obviously, I wasn't interested in the open craniotomy and felt that the Gamma Knife was too risky. I believed that either approach would have jeopardized my olfactory sense.
In addition to wanting to preserve olfaction, I didn't want to risk the debilitating side effects of brain manipulation that I had read stories about. One patient experienced a bad taste in his mouth after surgery. According to that patient, having no sense of taste at all would have been preferable.
A stranger on the Internet suggested that I check out Dr. Shahinian and his minimally invasive endoscopic surgical approach. I called Dr. Shahinian, and the very next day, he called me back and asked to see my MRI film. After reading the film, Dr. Shahinian told me he was confident that he could preserve my olfaction thanks to his advanced endoscopic procedure. He followed up the phone call with a letter to confirm what he had told me.
After I received Dr. Shahinian's letter, I called one of the doctors I had seen. "That's just Hollywood," he said. "They'll tell you that to get your money. They can't be sure of preserving olfaction."
I shared Dr. Shahinian's letter with my 2nd neurologist who encouraged me to check Dr. Shahinian's track record. This neurologist then went on to discount Dr. Shahinian's contention that he could save my olfaction. I did check on Dr. Shahinian's credentials by contacting a doctor at the Cedars-Sinai Medical Center Department of Surgery, who stated in an e-mail to me, "Dr. Shahinian is an impeccably trained skull base surgeon with superb technical skills. His program has been very successful and patients come to him from around the world. He has a particular interest and skills in minimally invasive surgical techniques, and he uses these approaches routinely with excellent results."
Our final decision to have Dr. Shahinian perform my surgery in Los Angeles came after an e-mail from Nicole, the Patient Liaison at Skull Base Institute. She likened Dr. Shahinian's expertise in minimally invasive endoscopic surgery to the advances in gall bladder surgery. She said that gall bladder surgery used to require a large abdominal incision, but now only a small incision is necessary.
My wife (a registered nurse) and I concluded that we should choose the surgeon who was most confident in his ability to preserve my olfaction without manipulating the brain. We reasoned that a surgeon who felt there that there was a high probability of preserving olfaction was preferable to any surgeon who felt there was little or no possibility. This, of course, led us to the conclusion that Dr. Hrayr K. Shahinian was the best choice. The results validate that choice.
I was so confident that Dr. Shahinian could preserve my olfaction that, before we left Texas to go to Los Angeles, my wife and I bought Dr. Shahinian a Texas-shaped wooden clock bearing a Texas flag and the following inscription:
"THANK YOU! Dr. Shahinian and the C-S/SBI Team from Texas Dave G. for your surgical excellence in endoscopic resection of olfactory groove meningioma."
I presented the clock to Dr. Shahinian the day he removed my stitches. I'm told that the clock is still on display in his office. On the reverse side of the clock is another inscription I wrote the night before my surgery, once again expressing full confidence that Dr. Shahinian could do what his track record and his letter said he could do: "preserve olfaction!"
Dr. Shahinian has the best bedside manner of any physician or surgeon I've ever known, and I've had several major surgeries. He's pleasant, has a winsome smile, and listened to our questions until my wife and I were completely satisfied. He has a high level of confidence, but we never saw the cockiness or arrogance that are common in other superstar professionals. He made me feel as if I were the only patient. And the Cedars-Sinai personnel and SBI Staff were unsurpassed in my medical and hospital experiences. Not one was a disappointment to me; they tried their best to make us feel welcome and important. They succeeded on all fronts!
Since Dr. Shahinian removed my tumor, I have referred two other patients to him. I'm glad to say that both had their surgery with Dr. Shahinian, and both are doing well post-op.
Dr. Hrayr K. Shahinian is a phenomenal doctor and person. I believe that his passion is to use his gifts, skills, dedication and compassion to preserve and improve the lives of people with skull base tumors. He is among those who make historical improvements in the practice of medical surgery. I told him that I saw his level of expertise as similar to the contrast between a fine furniture craftsman and a house framer; both are noble trades, but the framer usually doesn't have the dexterity, skill and temperament to make fine furniture.
I believe in Dr. Shahinian and wish that those who continue to insist on open craniotomies would learn how to use Dr. Shahinian's techniques and equipment! Their patients deserve the best surgical care, not the "we've always done it this way" approach.
"Texas" Dave G.
Duncanville, TX
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