©

Lederman or Shpiegelmann?
Ya'akov's story

After reading the interpretation of the MRI done in Tel Aviv on November 1, 1998, which told me that I had a recurring AN, my very first reaction was:  "No way I'm gonna let a surgeon pry into my head for a second time. And maybe I shouldn't have agreed to the first time either?" 

Having ruled out microsurgery -- it took me a full year to recuperate from the removal of a 2.5 cm. AN on my left side -- I now had the "luxury" of two more options, GK (Gamma Knife) and FSR (fractionated stereotactic radiation).

Due to my contacts with Dr. Gil Lederman and, more intensively - with some of his patients (Keenan Davis in California, Jerry Kemper in South Africa, Dina Q. Goldin in Boston, and Rony Kess-El in Haifa, Israel), and thanks to the various ANA listserve e-mail groups, I was very much inclined toward going to SIUH (Staten Island University Hospital) where Dr. Lederman practices. In addition, there's no doubt in my mind that Lederman's prominent presence on the internet also contributed toward that inclination. Finally, Lederman's and other FSR centers' data look simply great.

Two and a half years ago, before deciding on microsurgery, we did check out the local radiosurgical option, the facility at the Sheba Medical Center at Tel HaShomer, adjacent to Tel Aviv. The results they achieved here with radiosurgery on AN's were at that time not as good elsewhere, i./e in the States. Still, I find it strange that I did not pursue this more intensively. For some reason, at that first time around with a freshly diagnosed AN, we ruled out the option of radiation. Undoubtedly, my surgeon's opinion was indeed the same as elsewhere: you're young, healthy, toute la vie devant toi, why do something shady as radiation? Fact is that at that time and under those particular circumstances, I happily accepted and adopted the view that microsurgery was the right thing to do.

Having "been there," I think is important to understand that when a person is confronted with having an AN, the thought of having a time bomb ticking in his or her head permanently, is often difficult to accept.  Many will opt to have it removed, over and done with, as it were. GK, FSR, Proton beam or other method may all make the bomb stop ticking, but do nothing to remove the bomb itself.

But over time, attitudes change. Having put my surgeon on the trail of radiosurgery, he didn't hesitate even a second before writing a recommendation that this time, the only option around was stereotactic radiation. FSR at SIUH was most recommended.

"No way Jose," my HMO shot back upon receiving my request to go to SIUH in NY for treatment. "You're welcome to do radiosurgery in Israel - if you choose to do it abroad, you'll have to foot the full bill yourself."

Okay, so let's meet the guy who does radiosurgery here in Israel. His name is Roberto Shpiegelman, a neuro-surgeon by training, in his late forties, ambitious, suave, and very convincing. He also is the only radiosurgeon in Israel. According to sources in the hospital, his data are completerly reliable, and comparable to those reported in the USA - those we have all been reading about in the various issues of NEJM.

We had a long meeting with him and he showed us his data. Great results w/acoustic neuromas, my chief concern being the preservation of the facial nerves. He did dozens of post operative (recurring AN) patients and all have complete functional facial control. And yes, the HMO will cover the entire procedure.  And then, there's always a rather irrelevant detail that tips the balance:  In my case, I found out that the mother of our favorite baby sitter (who also used to be a neighbour for ten years) is Dr. Shpiegelman's chief technician. She called a few days ago, telling me that she'd be around when I come in for treatment.

Ya'akov Almor <mrktdrct AT netvision.net.il>
Dec. 1998

I.N.S.I.D.E. (Israel News Services & In-Depth Exclusives)
21, Yigal Alon Street #12
Herzliya 46324 Israel
tel. (972-9) 9565176
fax: (972-9) 9509958

Update

(12/99) Good News - did my MRI - showed complete "freeze" of tumor. i.e. no change form the MRI made just before the "zap" of last year.  Shpiegelman was very upbeat about it.

©

Back to Yaakov's entry in the Patient Directory

Last Edited: Friday, November 01, 2002