Brain Tumor Vanquished

Ana Maria Santos, 60, rarely gets headaches, but one day she got a doozy. “I don’t like to take any pills, but I took a Tylenol and called my husband, Armando,” remembers the longtime Dixon resident. “He didn’t seem to understand how bad it was.”

Armando, who works in environmental services for David Grant Medical Center at Travis Air Force Base, was surprised when she called again. This time he took her to urgent care, and then to the Emergency Department at UC Davis Medical Center.

After imaging confirmed a brain tumor, Ana was referred to a local neurosurgeon but the consultation was delayed for several weeks. Armando asked his colleague at David Grant, neurosurgeon Jonathan Forbes, M.D., what he would do, and that’s how Ana found Edie Zusman, M.D., a neurosurgeon and medical director for the NorthBay Center for Neuroscience, who has performed more than 1,000 brain tumor surgeries. “We were able to get an appointment right away,” she recalled.

Ana had a meningioma, a tumor that forms on the membranes that cover the brain and spinal cord just inside the skull. About 90 percent of these tumors are benign, but they can grow and cause serious problems.

Dr. Zusman told Ana she didn’t think it was malignant, but she couldn’t be certain until surgery. They discussed several options and Ana decided to wait until the end of canning season, so she could work the full season—June to October—at Campbell’s Soup Co. in Dixon.

Working eight hours a day, seven days a week, she didn’t have much time to worry about the impending surgery. “I told my friends at work that I was going to have brain surgery and they were so surprised,” she recalled. “They said, ‘You don’t even look sick.’”

Indeed, there were no symptoms. Ironically, even the initial headache, which triggered the imaging tests, may have been coincidental.

Leading up to the surgery, Ana focused on cleaning her house. “I was in deep cleaning mode. I knew I wouldn’t be able to clean once I got home from the surgery, so I kept my mind focused on taking care of details.”

As the canning season drew to a close, the company held a traditional end-of-season celebration for employees. The next day, family members came in from near and far; her three children, five grandchildren, a brother, a sister, a cousin.

“I wasn’t worried,” she recalled. “I trusted Dr. Zusman. I felt comfortable with her and knew she would do well.”

To prepare for the surgery, detailed images were taken via Magnetic Resonance Imaging (MRI) and then imported into a Stealth Neuronavigation Computerized Work Station. “We design our surgical targets and trajectories on the work station,” explained Dr. Zusman. “Once the patient is positioned for surgery, we do what’s called a surface rendering. It basically reads the bone and landmarks on a patients face. That’s a registration that allows the computer images to be linked with what we’re seeing in real time, in the operating room.”

Because neurosurgeons can specifically map out their surgical plans, we have a higher degree of safety and accuracy, explained Dr. Zusman. “We can do a better job removing the entire tumor, because we’re aware of where the anatomic structures and blood vessels are,” she said.

Working under the operating microscope, Dr. Zusman used an interhemispheric approach between the folds of the brain in a narrow area next to major blood vessels. During the five-hour surgery, she and her team were able to remove the entire tumor, including the dural membrane, where it originated, achieving a surgical cure. In addition, Dr. Zusman was able to operate below the top of the scalp, in such a way that the surgical area was easy for Ana to later obscure with her long, dark hair.

That meant a lot to Ana. “I really appreciated it as I started to heal, because it took a little time for the hair to grow back. It allowed me to twist my hair up in a knot and no one could tell that I’d had brain surgery.”

In support of Armando and Ana, Dr. Forbes accepted an invitation from Dr. Zusman to observe the surgery, and he witnessed the successful and complete removal of a 4-centimeter tumor, roughly the size of an apricot.

Only five days after her surgery, Ana walked out of NorthBay Medical Center and went home. A week later, she was walking through Costco with her daughter. And she was thrilled to be back in her garden. “That’s my therapy,” she said with a smile, gazing across her beautifully manicured back yard.

At her first checkup following the surgery, Dr. Zusman was amazed. “She told me, Ana, I barely recognize you, you look so relaxed!’ She said it helped that I was very active before the surgery,” recalled Ana.

She’s quick to point out that she hasn’t lost any memory, not one bit. In fact, her husband said they must have put
a chip in, because she’s come back as sharp as ever, remembering many details of their life together.

“I’m blessed everything went so well,” said Ana, pointing out that she avoided radiation, because they removed the entire tumor. She only used pain pills for a couple of days, and after that, it was Tylenol all the way.

Now she’s looking forward to being back to work at Campbell’s this summer. She likes to stay busy. But she promises to listen to her body, and slow down when she needs to. And she’s taking time to count her blessings.

 

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