Patient Story - Brain Tumor
Sometimes the answers aren’t in the computer
If you found this story as the result of an Internet search, you have something in common with Alex Kralicek. A self-proclaimed information fanatic, Alex will scour the Web on any and every topic that piques her interest. “I have a serious Google problem,” she confesses.
In the fall of 2007, Alex searched a phrase she never dreamed would apply to her: brain tumor. And in this case, she needed far more help than her computer could offer.
Dizzy spells lead to an unrelated — and very troubling — discovery
A busy young wife and mother of two, Alex also juggles a full-time career as a recruiting manager, matching prospective employees with their ideal jobs. For years, she has balanced something else as well: stubborn and annoying dizzy spells. A handful of different doctors had offered different diagnoses, but no solution.
In October 2007, during a visit with her new family-practice physician, Alex suggested they try and resolve the problem for good. Her doctor promptly ordered an MRI. The day after her scan, Alex was surprised to hear the doctor’s voice on the other end of the phone. No, he had not determined the cause of her dizziness, but he insisted she come to his office the following day. “Please tell me,” Alex pressed. “Do I have a brain tumor?”
She was stunned by her physician’s response. Alex did indeed have a tumor in her brain.
A multitude of questions — and a neurosurgeon with answers
Alex’s response was understandable: “I freaked out,” she recalls. “What was as upsetting as anything else was I didn’t know anything about my brain tumor, the type or the treatment. I wanted every possible fact — and I wanted them now.”
Because of the tumor’s location and the cells’ appearance in the MRI images, Alex’s physician had good reason to believe that the growth was not cancerous. He then sought to provide an answer to every question his inquisitive young patient would certainly ask. He referred Alex to Dr. Marc Mayberg, a neurosurgeon and the co-director of the Swedish Neuroscience Institute — and an expert in benign brain tumors.
Alex meets with a team of brain doctors
Alex scheduled her appointment with Dr. Mayberg for the following week. When she entered his office, she was surprised to find him with two colleagues — a neuroendocrinologist, who studies the interactions between hormones and the brain, and another neurosurgeon.
“Whenever possible, we bring in our team of experts to discuss a case directly with the patient,” explains Dr. Mayberg. “It’s helpful for the patients, because they see everyone who might help care for them in a single appointment. And it’s great for the physicians, because we discuss treatment options together with the patient.
“In Alex’s case, the tumor was deep inside her head, just above her optic nerves, so we were concerned about her vision,” continues Dr. Mayberg. “And this is a very critical part of the brain, as it controls memory, vision, appetite, hormonal secretion, sleeping and waking. But she was showing no symptoms, so we agreed the best course of action was to do nothing now and watch her very carefully, with an MRI every six months.”
The wait-and-see approach works — for a year
As challenging as it was, Alex eventually became accustomed to the idea that she had an uninvited growth in her head. She went about her busy life, and all was well until a year later. Then the young mother became unusually tired and felt an inexplicable, overall malaise. She went in for her six-month MRI and as she suspected, her tumor had grown. “We knew that it would begin to cause some serious and potentially irreversible problems if we didn’t act quickly,” states Dr. Mayberg.
The brain specialists recommend surgery
The neurosurgeon reconvened his team of experts to discuss treatment for Alex. After considering all their options, they agreed to remove as much of the tumor as possible with surgery, and then treat any remaining portion with radiosurgery, using the CyberKnife.
“We planned to perform a craniotomy,” explains Dr. Mayberg, “where we remove a small portion of the skull to access the brain. Many people have a very outdated image of this procedure. They imagine that we shave a patient’s entire head and make an incision that goes from ear to ear.
“The truth is, like most other surgeries, with current technology a craniotomy has become minimally invasive. And a key advantage of this procedure is that it allows us to put the tumor under a microscope, which is the only way to diagnose it with 100% certainty. As it turned out, Alex’s tumor was extremely rare — one we hadn’t even considered in our earlier discussions.”
Alex casts her vote for Swedish and Dr. Mayberg
Alex will always remember her surgery date: Election Day 2008. She arrived very early in the morning and was greeted by a familiar face. The woman who checked her in was actually someone Alex, in her role with the job-placement agency, had recruited. “We were off to a good start!” smiles Alex.
Just a few hours later, Alex was in the operating suite while Dr. Mayberg was preparing to remove her tumor. “We made a two-inch incision in her temple and did not shave her hair,” reports the neurosurgeon. “Then we worked in and around her brain to access the deep central part. With the help of an extremely accurate, millimeter-precise GPS-like navigation system, we knew exactly where we were in relation to the brain’s critical structures. We then used a high-technology device that vibrates at ultrasonic speed. It disintegrated the tumor, and we were able to remove it entirely.”
A sight for grateful eyes: a giant frog balloon
Alex recuperated in the hospital for several days after the three-hour-plus procedure. Her vision was still perfect, which was an enormous relief to everyone. “The first thing I saw when I woke up was a giant frog balloon staring back at me, so I knew I’d be fine.
“I still felt a little wobbly during my first few days at home,” says Alex. “But then I started feeling better, and it wasn’t long before I was ready to get back out there in the world. I actually returned to work full-time just three weeks after the surgery. I feel great, and I can do everything I want to.”
Those unrelated dizzy spells? “They were finally diagnosed as benign positional vertigo,” responds Alex. “If I don’t stand up too quickly — and that’s not always easy with a two-year-old — I’m okay.”
Good news the old-fashioned way
“Alex’s prognosis is excellent,” reports Dr. Mayberg. “We have no reason to think that her tumor will recur, and every reason to expect that she’ll live a long and normal life.”
Even a computer aficionado like Alex must admit that sometimes, the best news of all doesn’t come from the Internet.
Ben and Catherine Ivy Center for Advanced Brain Tumor Treatment550 17th Avenue
Seattle, WA 98122
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Affiliated clinic: Cranial, Spine and Joint Clinic at Providence Everett
Diagnosed with a Brain tumor?
The Ivy Center has a multidisciplinary team of physicians, nurses and social workers who specialize in treating people with benign and malignant brain tumors.
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Swedish is constantly working to ensure patients with debilitating neurological disorders have access to the best treatment options, the latest technology, and state-of-the-art facilities.
At the Ivy Center, patients and their families have access to a wide range of support services provided by the Integrative Clinical Social Worker.