Well, I wouldn't be very good with muscles and nerves! But I had to specialise a bit. I doubt that there wouldn't have been many people with such an intimate general knowledge of meningiomae in Australia as I gleaned 15 years ago, wrt treatments, survival and recurrence rates after each type of treatment, and all from Herston Medical library and a dial up modem!
But don't be fooled by the neurosurgeons. If there was one thing that stood out, it was that surgeons know all about surgery, but little about radiation. And radiologists know all about radiation, but little about surgery. Chemo, fortunately, doesn't work for meningiomae (although some claim bromocriptine can arrest growth). Fortunately, in that it wasn't another group of experts saying "Use me first!" Each will say "Use my technique first, then go to the other side for them to tidy up what I can't do".
Yes, neurosurgeons might be knowledgeable about their specialisation, but unaware of latest techniques. The Brisbane butchers were very keen to "have a go" at her tumour, a 12 hour operation involving the removal of the ear and surrounding bone, plus an approach through the roof of the mouth. 7 - 10 day recovery in hospital afterwards.We asked one surgeon how many he'd done in that area - he said nine. We asked what the post operative outcomes were. He looked horrified that we expected him to know that and said he never followed up his cases. We looked equally horrified, and then he remembered a case of a 35 y/o woman who was living a reasonably independent life. Whatever that meant.
Because we didn't rush into it (i.e. leaving it for 17 years, against the strong advise of the Brisbane butchers), keyhole techniques which had already existed in the US had come to Australia so she ended up with a 6 hour op., (retaining the use of her ear), and was discharged from hospital ten hours later to fly back to Brissy. Which required a team of one surgeon and one anaethetist. A specialist surgeon, but not a team of surgeons, as opposed to the old method requiring an ENT surgeon to cut out the ear and make the hole in the palate and two neurosurgeons for the dual approach excision.
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