Five questions. Seven years. One life saved.

For Justin Krommes, a 43-year-old from Mountain Top, life is a familiar rhythm of work, family and community service. The Army veteran has spent over 18 years on the board of directors for his local Little League. “My hobbies generally revolve around my kids and sports,” he says.

But in June 2024, a routine appointment set in motion a chain of events that was anything but ordinary. Mr. Krommes was at Geisinger to see an ear, nose and throat (ENT) specialist about a perforated eardrum he’d been waiting months to address.

After examining his ear, ENT specialist Kevin Stavrides, MD, paused.

“I have a couple other questions that are not related to your ear,” he said. He asked Mr. Krommes if his wedding ring size had changed. If he’d noticed his eyebrows seemed swollen. If his voice had always been so deep.

The questions were unexpected. Mr. Krommes was there for his ear — the rest was just…him. But Dr. Stavrides was noticing things that raised a red flag in his mind. “It took one doctor to take an extra 5 minutes to ask me an extra 5 questions,” Mr. Krommes recalls. “He took that extra time from his day to go further, and that basically saved my life.”

A life-altering diagnosis

Those questions led to extensive bloodwork. The results for his growth hormone level were startling: nearly 900, almost triple the normal level for a man his age. An MRI soon confirmed the cause was a 15-millimeter tumor on his pituitary gland.

Mr. Krommes had acromegaly, a rare disorder where the pituitary gland produces excess growth hormone. While sometimes known as “gigantism,” Mr. Krommes’ post-puberty onset meant he wasn’t exceptionally tall — just a big person. The condition is often missed in men, because their size and related health issues are misattributed to lifestyle choices.

The diagnosis came with a devastating prognosis. The continued, unchecked growth of his bones and internal organs, particularly his heart, meant he likely had only 5 to 7 years to live.

“When you’re told you have 5 to 7 years to live, it changes your perspective,” Mr. Krommes says. “The likelihood of me ever making it to 50 was very, very small.”

For Dr. Stavrides, the discovery was gratifying but also sobering. It reinforced everything he believes about patient care — that sometimes the most important diagnosis isn't the one you're looking for.

"Mr. Krommes came to see me for what is ultimately a minor problem, but I was able to identify a serious problem that had been missed by other providers for many years and facilitate surgery perhaps years earlier," Dr. Stavrides says.

It was a reminder that medicine isn't just about treating symptoms — it's about seeing the patient standing before you. In Mr. Krommes’ case, that attention to detail made the difference between a slow, silent decline and a chance at a full life.

He was presented with 2 options. The first radiation came with a grim forecast. “I would have been sick for approximately 18 to 24 months,” Mr. Krommes says, and there was a chance he would still need an operation afterward. The second option was to proceed directly with surgery and use radiation later only if needed. For Mr. Krommes, the choice was simple. He chose surgery.

The first surgery

In October 2024, neurosurgeon Rafael Martinez-Perez, MD, PhD, and Dr. Stavrides partnered for the complex, high-risk procedure. The tumor was precariously wedged between Mr. Krommes’ carotid artery and his optic nerve.

What was planned as a 4-hour surgery stretched to 9. Mr. Krommes’ bones, abnormally thickened by years of excess growth hormone, made the approach incredibly difficult. The flap between the nasal cavity and the pituitary gland, normally paper-thin, was nearly a quarter-inch thick.

When he woke up in the ICU, he felt a deep, unfamiliar cold. “I'm a 6-foot, 300-plus-pound man. I'm never cold,” Mr. Krommes says. It was the first sign of a massive hormonal shift taking place in his body.

From Dr. Stavrides' perspective, Mr. Krommes’ surgery was a success. "He ended up being a candidate for transsphenoidal pituitary surgery, which I helped Dr. Martinez-Perez perform," Dr. Stavrides says. "His case went incredibly well, and his acromegaly and facial features are improving."

In the weeks that followed, Mr. Krommes’ physical changes were dramatic. His wedding ring fit again. His head, hands and legs all shrank. His endocrinologist explained that his body was going through a hormonal recalibration as profound as that of a pregnancy.

The collaborative approach between ENT and neurosurgery had given Mr. Krommes more than just successful treatment — it had given him hope. But just as he was adjusting to this new reality, a new, more frightening challenge emerged.

A life given back

Three months post-op, in January 2025, Mr. Krommes began having debilitating migraines. The pain was constant and all-consuming.

“I was useless to my family. I was absolutely miserable because I was in constant pain,” he recalls. “There were times I would sneeze, and I'd have to sit in a dark room for 2 days. It was very, very bad.”

Geisinger neurologist Kenny Schwartz, MD, prescribed medications and nerve-blocking shots, but they brought no relief. So Dr. Schwartz referred Mr. Krommes back to Dr. Martinez-Perez, where another MRI revealed a new problem: an acquired Chiari malformation. The lower parts of his brain had begun to extend through the base of his skull, an issue likely caused when his brain settled differently after the tumor was removed.

Faced with living in constant, severe pain or undergoing a second major brain surgery in less than a year, Mr. Krommes chose the surgery. The procedure, a cranial decompression performed by Dr. Martinez-Perez, took place in September 2025.

The results were immediate and life-changing. Since then, he’s had only one mild migraine.

“The first surgery saved my life,” Mr. Krommes says. “The second surgery gave me my life back.”

Today, life is different. He gets cold easily and always keeps a sweater handy — a running joke with his wife, whom he credits as his rock. “Without my wife, I would not have made it through any of this,” he says. “She was always pushing me health-wise to make sure I’m doing this appointment, that appointment.”

He’s also cherishing every moment, from a father-daughter dance to simply being present with his kids. And he’s eager to get his perforated eardrum — the issue that started it all — repaired later this year.

He credits the doctors at Geisinger for looking at him as a person, not just a patient number. "If Dr. Stavrides had just fixed my ear, I would have been able to hear just fine for the next 5 years,” he says. “But then my life wouldn't have been saved."

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