On an ordinary day in February 2009, John M. Tew, MD, got one of the true surprises of his career. He was seeing patients in his Mayfield Clinic office on the University of Cincinnati medical campus when an unexpected guest arrived. Jerry, a retired law enforcement officer from rural Kentucky, walked into Dr. Tew’s office to say thank you.
“I was stunned,” Dr. Tew said. “I had not expected to see Jerry walking so soon. He has truly made a miraculous and courageous recovery.”
Jerry, stricken with a complex tumor at the cerebrospinal junction – the point where the skull meets the spine — had undergone surgery and radiation five months earlier. The tumor, lodged inside his spinal cord, was small, about the size of the last joint of a man’s index finger. But it was associated with a large cyst that extended into the cervical spinal cord and up into the brainstem.
“It was a tumor that was inoperable,” Dr. Tew said. “At the same time, he was getting progressively more paralyzed, and his pain was getting progressively worse.”
Surgery was Jerry’s only hope, even though it could leave him paralyzed and unable to breathe.
“What made the surgery so delicate and dangerous was the tumor’s location,” Dr. Tew explained. “It was on the motor tracts of the spinal cord and adjacent to the brain stem, where the nerve supply to the diaphragm is located.”
Fortunately for Jerry, the skilled surgeon and a medical innovation were there to help him through. A new neurosurgical laser had just become available, and Dr. Tew, who had helped pioneer the use of the first lasers in the 1970s and 1980s, would use it to vaporize the tumor while preserving much of the healthy tissue around Jerry’s spinal cord.
The new laser, manufactured by OmniGuide, Inc., consists of a flexible, CO2 laser-compatible fiber coupled to a pen-like surgical instrument. It allows neurosurgeons to operate near critical structures, such as the spinal cord and brainstem.
With the new laser, Dr. Tew was able to maneuver deftly inside Jerry’s spinal cord and burn away the tumor, a pilocytic astrosytoma.
Jerry, who worked for 44 years in law enforcement, is one of those people who likes to stay busy — “a man who could never sit down for five minutes,” according to his wife, Connie. One day in July 2006, while out mowing the lawn, he felt a sharp pain behind his neck. Thinking he had pinched a nerve, Jerry called his chiropractor and had a rubdown. The pain subsided, and Jerry went home and painted a room in his house.
The pain was back in force the next day, however, and Jerry called his doctor, who sent him to the hospital for an electrocardiogram, x-rays and an MRI. When the doctor returned with his results, Jerry received unexpected and dismaying news. “Connie and I went there thinking I had a pinched nerve,” he recalled. “But it was a tumor.”
Jerry was referred to Dr. Brad Skidmore in Mayfield’s Crestview Hills, Ky., office, and Dr. Skidmore in turn referred him to his “mentor,” Dr. Tew, an internationally known expert in tumors of the skull base.
Because of the tumor’s location, Dr. Tew recommended radiotherapy to reduce the size of the tumor and control its growth. Dr. Tew told Jerry that he could get a second opinion if he chose. But Jerry – calling on his law enforcement instincts – had already investigated Dr. Tew’s credentials. “I told him I didn’t need a second opinion,” he said. “I had already talked to five of his patients.”
Jerry underwent 28 radiation treatments at the Precision Radiotherapy Center in West Chester, Ohio. The treatment appointments lasted 30 minutes each, and the precisely targeted beams of radiation were delivered during periods of 10 to 12 minutes.
The radiation caused severe nausea. Jerry suffered but drew inspiration from the sight of a young boy who was also undergoing radiation treatments. “Every time he came out to the center they gave him a big chocolate bar,” Jerry said. “He was such a little trooper. I thought, if he can do it, by golly I can do it.”
The worst pain came when fluid built up inside Jerry’s spinal cord. “My head hurt and the left side of my body hurt,” Jerry said. “I could lie fairly comfortably on the floor or on a bed, but if I got up, the pain was like throwing water into an electric box.”
Dr. Tew inserted a shunt, which drained away the fluid and relieved the pain. But the tumor kept growing, and Jerry reached the point where surgery was inevitable.
After the September 2008 operation at Cincinnati’s University Hospital, Jerry had breathing difficulties, as Dr. Tew had feared, and was placed on a respirator for several days. But he improved steadily. He spent a week in the hospital’s neuroscience intensive care unit, under the care of the unit’s Medical Director, Dr. Lori Shutter, then two weeks at Cincinnati’s Drake Center, which provides transitional and long-term care. He spent another two months in nursing facilities, then went home. He continues to suffer some paralysis on his left side, but his pain is gone and he is improving continuously with the help of physical therapy, occupational therapy and – his favorite – pool therapy.
“It’s been slow, but things are coming around,” Jerry said. “I go to rehabilitation at the hospital three days a week, and when I don’t go in to the hospital, I do it at home.”
In short, Jerry is one highly motivated patient, one who would love nothing more than to get back to working as a polygraph examiner. Dr. Tew, for one, is betting that he will be successful in that aim.
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Hope Story Disclaimer – This story describes an individual patient’s experience. Because every person is unique, individual patients may respond to treatment in different ways. Outcomes are influenced by many factors and may vary from patient to patient