At 38, Preston Bottomy had a successful career as Walmart’s VP for e-commerce and maintained an active Manhattan social life. He was healthy and fit, with a daily workout regimen, so he was surprised one night as he sat down to dinner with friends when he had the sensation of the whole room spinning. He excused himself and headed home to recover.
Over the course of the next several months, Preston had several of these episodes, which concerned him more and more. “The world would start spinning as I was on the treadmill,” he says. “I had to stop and get off. It’s quite scary!” At work, he would sometimes have to pause during meetings to let the spinning pass.
His primary care doctor recommended a neurologist, who diagnosed his dizziness as vertigo. As Preston says, he realized it was time to connect the dots.
“I wish he had come to me seven years ago,” says Dr. Stieg. “We could have treated him more easily then.”
Seven years earlier, after an accident on a beach, Preston had had an MRI of his brain, and doctors discovered a tumor near his ear. It wasn’t causing any symptoms and didn’t seem dangerous, and Preston remembers, “The neurologist I’d gone to then said I just needed to monitor it — not to worry about it.” Now his neurologist posited that the tumor could be the culprit behind the vertigo, and she advised him to visit Dr. Philip Stieg of Weill Cornell Medicine Neurological Surgery to have it evaluated.
Dr. Stieg was convinced that the tumor — a vestibular schwannoma, more commonly called an acoustic neuroma — was causing the vertigo, and he lamented the advice earlier doctors had given Preston. “I wish you had come to me seven years ago,” he said. “We could have treated you more easily then.” Dr. Stieg conferred with his colleague Dr. Samuel Selesnick, an ear, nose, and throat surgeon who partners with Dr. Stieg on acoustic neuroma care, and they agreed that the tumor could be safely removed.
Preston consulted his father, a doctor, who told him that “living in New York City, you have access to top care. You landed in a fantastic place.” Preston not only felt confidence in his surgical team’s expertise, but also in their patient-friendly approach. “I was incredibly impressed with their experience, credentials, and approachable style,” he says.
Preston now knew why he felt dizzy when doing lunges in Pilates and why the room would spin during meetings. “Having a diagnosis gave me an optimistic outlook that there was a solution,” he says.
“I like being in control of things. I didn’t want to be the victim of surgery; I wanted to recover as quickly as possible.”
To prepare for his surgery, Preston had further tests and learned more about the procedure. Both Dr. Stieg and Dr. Selesnick spoke to him in depth about the main risk of surgery for a vestibular schwannoma/acoustic neuroma: hearing loss in the affected ear. Preston recalls, “I totally understood and I was comfortable with that risk.” Four months after that dinner that gave him his first experience with vertigo, Preston was ready for surgery.
Preston’s family traveled up from Nashville to offer support on the day of the surgery. Preston says he needed all the support he could get as his anxiety overwhelmed him — he suddenly fainted while sitting down! He laughs now, saying, “I think my anxiety manifested itself physically and freaked everyone out by me passing out!” The last thing he remembers was being wheeled away into the operating room.
An acoustic neuroma forms on the vestibular portion of the acoustic nerve, but since the location is so close to the cochlear nerve it can also affect hearing.
Preston woke up in recovery feeling dazed, but his family — including his brother, a neurological ICU nurse — was by his side. He recalls that he couldn’t hear out of his left ear and his mobility was compromised. Preston recalls, “I like being in control of things. I didn’t want to be the victim of surgery; I wanted to recover as quickly as possible.” Dr. Stieg and Dr. Selesnick stressed the importance of getting back on his feet and told him that once he could walk, he could go home. Determined, Preston urged himself to get up and start moving. As he and his father walked the hospital’s halls, he remembers, “the nurses kept telling me to go to bed! But I needed to walk, and the more I walked the better I started to feel.” Two days after the surgery, he was well enough to go home.
Dr. Stieg directed him to take it easy for a few weeks, but Preston was eager to recover. He started with short walks around his apartment building, then graduated to the street. “It was definitely more slow-moving than I was used to,” he remembers, but less than a week after he returned home he started taking work calls at home. He returned to work just eight days after the surgery. He laughs, saying, “I was so bored; there was only so much binge watching I could do!”
A month after the surgery, Preston’s hearing slowly started to return. When Dr. Selesnick tested him, he showed only minor hearing loss in that ear, not much different from any adult’s day-to-day hearing. As for his active life, once the 6-week mark passed Preston went to Pilates class and told his instructor what had happened. He did experience some dizziness and worried he wouldn’t be able to follow through, but he claims now that “my balance is better now before surgery, but I’m still working to get that back.”
Preston is delighted that the room doesn’t spin anymore. “My experience was really fantastic, and I’m really glad I opted for the treatment plan,” he says. “The care I received was top notch and I felt like I really understood what the risks and options were. I think I made the right choice. It worked out really well for me.”
More about Dr. Stieg | More about Dr. Selesnick
More about the Weill Cornell Medicine Acoustic Neuroma Program
