Spotlight > Patient Success Stories
Patient Success Stories
Suzanne Sun »
Odette Pringle »
Josephine Edu »
Leigh Hamilton »
Steve Miles »
Rene K. »
Beverly Naclerio »
Suzanne Sun - She’ll never forget Dr. Kelly
On the evening of March 25, 2009, Suzanne Sun had a 30-minute lapse in memory.While memory loss isn’t an uncommon occurrence, it was a scary event for the 47-year-old Fox Studios account executive.
“Physically I felt okay, but I couldn’t make sense of anything,” Sun said. “I was disoriented and essentially lost in my own house.”
So a friend of Sun’s drove her to Saint John’s Health Center in Santa Monica where she was learned the memory loss was most likely caused by a seizure and that seizure was caused by a calcified mass in her brain. The attending neurologists recommended she see Daniel Kelly, MD, the Director of the Brain Tumor Center at the John Wayne Cancer Institute at Saint John’s Health Center.
“Suzanne had a 4 cm intraventricular meningioma and her only real treatment option was surgery,” Dr. Kelly said. “Although benign (not cancerous) this tumor presented quite a challenge to remove safely since it was in the center of her brain in one of the fluid filled chambers called the lateral ventricle. I explained to Suzanne and David there were only a few options to remove the tumor safely and effectively but they all involved traversing normal brain tissue.”
“I didn’t realize the enormity of it until later that day, although I am pretty sure Dr. Kelly could see the fear in my eyes,” Sun said. But Sun felt at ease with Dr. Kelly from the beginning. “He was thorough in detailing all aspects about what to expect with surgery, how they would get to the tumor, how they would shrink it down and remove it, what nerve areas in the brain could possibly be affected and recovery,” Sun said. “The care by Dr. Kelly was exceptional.”
After their initial meeting, Dr. Kelly ordered two additional studies. “To find the safest trajectory to the tumor, Suzanne had a functional MRI and something called MRI fiber tractography which allows us to localize key fiber bundles for motor function, sensation, and vision in relation to where the tumor is located. These critical structures were then superimposed on her pre-operative navigation MRI (like GPS for the brain). With this data, it was clear that the best route was to go through the right parietal lobe from the top of the head through almost 5 cm of brain to reach the tumor in the right lateral ventricle.”
Dr. Kelly performed a small keyhole craniotomy over her right parietal lobe measuring about 2 X 3 cm. The use of intra-operative navigation along with the tractography data and ultrasound helped guide Dr. Kelly safely to the tumor in her ventricle. Although the tumor was extremely firm and rubbery, 99% of the tumor was able to be removed using the surgical microscope and endoscope for visualizing the tumor. Only a tiny cauterized tumor remnant enveloping a large important blood vessel was left behind. Since the tumor is benign and very slow growing, Sun likely will not have to worry about it for the next decade, if ever. Her recent MRI 3 months after surgery shows no visible tumor.
Overall, Sun was extremely happy with the care she received from Dr. Kelly and Saint John’s. “Not having been a patient at Saint John’s prior to my initial seizure, the entire staff at Saint John’s treated me with the utmost professional and personal care,” Sun said. “My husband, who was involved with many of the decisions and interactions, was very, very impressed with the hospital staff, the environment and the professionalism.”
Despite having some minor sight problems post surgery, Sun is now back to normal and is feeling good both physically and cognitively. She was even able to go back to work at Fox Studios a few days earlier than she intended. Now the surgery is only a memory but not one she will easily forget.
“The strong and respectful relationships between Dr. Kelly and the other doctors involved was very helpful to my success; the staff at Saint John’s believes in Dr. Kelly, and that showed through out our time there,” Sun said. “When you have to deal with this for the first time, there are such a myriad of thoughts and emotions that you experience, and having confidence in a place like Saint John’s and a doctor like Dan is critical. I’ve read that there are 100 billion neurons in your brain, and I’m happy to say I believe he put them all back in the right place!”
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Odette Pringle - Worth the Trip
When Odette Pringle, 47, from Denver, Colo., found out she had a benign brain tumor called a craniopharyngioma in November of 2008, she didn’t hesitate to fly the over 800 miles to Southern California to meet with Daniel Kelly, MD, Director of the Director of the Brain Tumor Center at the John Wayne Cancer Institute at Saint John’s Health Center, to see what could be done.Pringle first started having headaches and blurred vision in mid-September of 2007. She blamed the vision problems on the LASIK eye surgery she had earlier that year and thought the headaches were due to allergies. She went to her general practitioner with her allergy concerns and was told to up her water intake and take Claritin.
By mid-November 2007, Pringles symptoms hadn’t diminished, and she took it upon herself to see an optometrist.
“He discovered during my exam that I had no temporal vision,” Pringle said. “He advised that I urgently contact my GP and tell her I needed to have an MRI.”
Pringle got an MRI scheduled for the next day, and she was soon after notified about the scans results.
“When I found out about the tumor, I contacted my sister, who is a radiation therapist at the VA in Los Angeles. A friend of hers is a personal friend of Dr. Kelly,” Pringle said. “She found him for me. Thank God!”
Pringle and her husband talked to Dr. Kelly and his assistant Maribel Leyva about her options.
“They couldn’t have been more thorough in explaining the good and bad of my situation and what needed to be done,” Pringle said.
After the conversation, Pringle decided to fly from her home in Denver to Santa Monica and meet with Dr. Kelly in person and look into what treatment options were available to her.
“Craniopharyngiomas are relatively uncommon benign tumors that arise near the pituitary gland and optic nerves. As they enlarge, they typically cause visual loss, pituitary hormonal failure and headaches,” Dr. Kelly said. “Hers was a fairly typical presentation of this tumor type. The first-line treatment for a symptomatic craniopharyngioma is surgical removal. Fortunately most of these tumors can now be removed through either a nostril (the endonasal approach) or through a small incision in the eyebrow (a supra-orbital eyebrow craniotomy).”
In Odette’s case, Dr. Kelly decided the best approach would be to do a left supra-orbital eyebrow craniotomy. This type of keyhole surgery differs from traditional larger craniotomies in which a long scalp incision is placed behind the hairline and a large scalp and muscle flap is elevated to access the frontal and temporal bones. “The eyebrow craniotomy is a relatively newer minimally invasive approach to many brain and skull base tumors in this area including craniopharyngiomas and meningiomas,” Dr. Kelly said. “With this approach, we make a short incision in the eyebrow and elevate a small area of the temporalis muscle (the chewing muscles). We then make a window in the bone directly above the eyebrow measuring about 1.5 x 2.5 cm. Through this small half moon-shaped keyhole we can access a large area around the frontal lobes including the optic nerves and pituitary gland.” A major advantage of this approach is that it requires little to no brain retraction. The minimal scalp, muscle, bone and brain manipulation translate into a rapid and less painful recovery with a lower risk of complications and generally excellent cosmetic result.
As is often the case with craniopharyngiomas, Odette’s tumor was extremely adherent and stuck to part of her optic nerves. “With such tumors as Odette’s, it is safest to leave a small remnant of tumor rather than risk worsened vision by trying to remove the entire tumor” says Dr. Kelly. Her post-operative MRI shows that he was able to remove 80 percent of Pringle’s tumor. The remaining 20 percent was treated with focused radiation known as stereotactic radiotherapy (SRT). Now more than 6 months after surgery, Pringle’s vision is much improved and the small residual tumor is getting even smaller after radiotherapy.
In the end, Pringle found the journey to Dr. Kelly worth it, and she was incredibly glad she decided to fly out to be treated at Saint John’s.
“I had a great experience at Saint John’s,” Pringle said. “The staff of the doctors, their assistants, the nurses and the rest of the staff on all accounts went above and beyond the call of duty to help in making my stay very comfortable.”
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Josephine Edu - A Brain Tumor Through the Eye of the Beholder
Josephine Edu is a registered nurse, the mother of an autistic teen and twin boys, and the survivor of a brain tumor. Forty-three years old and pregnant with her twins at the time of her diagnosis, Edu had suffered from headaches and nosebleeds for years. But when she started to lose her sight she knew something was drastically wrong. “My neck wouldn’t turn all of a sudden,” Edu remembers. “I was having nosebleeds while I was sleeping, and then I couldn’t see.” It was December of 2005.
Her primary care physician found nothing overtly wrong, but referred her to an optometrist who prescribed glasses. Her sight continued to deteriorate.
“At first I thought the glasses weren’t the right prescription,” she says now. “So I went to an ophthalmologist, but even he couldn’t find anything. I kept wondering: if there’s nothing wrong with my eyes, why can’t I see?”
By June 2006, Edu was almost 6 months pregnant, and almost completely blind in her left eye with deteriorating vision in her right eye. Finally, an MRI confirmed a large tumor, nearly the size of a golf ball, pressing on the optic nerves and compressing the pituitary gland, which controls the secretion of the body’s hormones. Edu now knew why she was losing her sight, but this new problem was potentially worse. The first specialist she saw couldn’t do the operation because of where the tumor was located. He referred her to Daniel F. Kelly, M.D. and Director of the Brain Tumor Center at the John Wayne Cancer Institute at Saint John’s Health Center in Santa Monica. “Mrs. Edu had something called a meningioma, a benign tumor that arises from the coverings of the brain,” explains Dr. Kelly. “While the tumor lacked the malignant properties of a cancer, this tumor was causing her to rapidly lose her vision and had the potential for her to lose her twins because of the tumor’s effect on her pituitary hormonal function.”
Meningiomas are actually the most common benign brain tumor and occur more often in women than men, typically in middle-aged or older adults. Josephine Edu was 43 when diagnosed.
On June 20, 2006, Dr. Kelly performed an eyebrow craniotomy, a unique, minimally invasive approach where the surgeon removes the tumor through an incision in the patient’s eyebrow and small half moon-shaped bony opening in the skull above the orbit. Compared to traditional large craniotomies, this type of “keyhole” craniotomy requires minimal brain retraction and muscle dissection, thus promoting a more rapid and less painful recovery. Cosmetically, the results are typically excellent.
In Edu’s case, Dr. Kelly was able to completely remove her tumor. Over the next several weeks, her vision markedly improved in both eyes, especially in the less effected right eye. Most importantly, she delivered healthy fraternal twin boys in September of 2006.
Follow-up care requires an MRI every six months for at least the next five years, a regimen that Edu is happy to follow. Her twins, Daniel, named for Dr. Kelly, and Emmanuel, named for her obstetrician, are happy, healthy, squirming boys fast approaching their second birthday. Her most recent MRI two years after surgery shows the tumor has not returned.
“My life is full,” Josephine Edu says. “We’re waiting to see what the future will bring.” A future that can thankfully be seen through the eyes of Josephine Edu.
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Leigh Hamilton
Leigh Hamilton began having trouble with her vision. She saw flashes at night, and driving had become difficult. “I remember driving through Topanga Canyon, and being in a complete state of panic,” recalls the 58-year-old owner of a Santa Monica art gallery. “It was like falling down stairs.” Hamilton obtained prescription eyeglasses, but they weren’t working. What she did see appeared to be drained of dimension and color. “I had repainted the kitchen, and all the samples seemed so dark that I wound up choosing an electric yellow,” Hamilton says. Moreover, waking in the mornings was torture. “It would take me two hours to get awake. I was slow, grouchy and mean,” she adds.
After six months of such problems, Hamilton visited an ophthalmologist, who confirmed that she had gone all but blind in her left eye, and was at risk of losing her vision altogether. Further physician consultations and an MRI had confirmed the lurking suspicion of Hamilton’s husband, who had been a premed student at college: she had a tumor.
“I hadn’t been paying attention. I just thought I was getting older,” Hamilton says of her symptoms.
Soon, Hamilton was referred to Daniel F. Kelly, M.D., Director of the Brain Tumor Center at the John Wayne Cancer Institute. Dr. Kelly's diagnosis was a tumor on Hamilton’s pituitary gland. Although the growth was a non-cancerous pituitary adenoma, it was pressing on the junction of Hamilton’s optic nerves, causing the vision loss. It was also pressing on the pituitary gland itself, threatening the shutdown of all the hormonal functions it regulates, such as metabolism, energy level, stress response and sexual function.
Hamilton would have to have surgery – not exactly a pleasant thought. “I’m afraid of all medical things…I’m just squeamish,” she says.
However, Dr. Kelly put her at ease. “He’s got a manner that’s just divine. He was gentle, firm and caring, and he made me get in there for the surgery,” Hamilton recalls.
Hamilton’s 8-year-old child described the procedure her mother underwent on February 29, 2008 as “getting a hole in your eye to feel better.” The resulting hole was only slightly lower: Hamilton underwent an endonasal transsphenoidal procedure – essentially minimally invasive removal of the tumor through her nose. Dr. Kelly used an approach with an operating microscope and an endoscope to provide a highly magnified and panoramic view of the base of the skull where the tumor was located.
Working through Hamilton’s nasal passage and the sphenoid air sinus, the growth was removed using specialized micro-instruments.
Waking from the surgery was a revelation for Hamilton, who remained hospitalized for 48 hours after surgery at Saint John’s Health Center. “I was seeing colors again – in fact, they came back for a vengeance. For three days, it seemed infrared, it was really beautiful,” she says.
Hamilton’s color perception has since subsided to normal, and her vision has been completely restored. She no longer needs glasses other than for reading. She has since lost about eight pounds, and some recurring neck pain – along with her fatigue – has completely vanished. “I cannot tell you how good I feel,” she says. “I feel 20 years younger…Daniel Kelly is my hero.”
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Steve Miles
Steve Miles didn’t know anything was really wrong until he went for an eye checkup at his local Costco. “Half of the vision in my left eye was missing,” Miles recalls.There had been other things out of kilter as well for Miles, a resident of Encino who’s in charge of warehousing and logistics for a national retailer. Fatigue had dogged him for the past year. He had suffered from headaches. He had had some trouble controlling his weight. But Miles never connected one condition to another. Taken as a whole, they are signs of a potential hormonal or neurological disorder.
Miles was quickly referred by his optometrist to an ophthalmologist, who referred him to a neurologist. An MRI was taken. He and his wife Sue were soon sitting in the office of Daniel F. Kelly, M.D., director of the Brain Tumor Center at the John Wayne Cancer Institute. Dr. Kelly’s diagnosis was a tumor of his pituitary gland. Although the growth was a non-cancerous pituitary adenoma, it was pressing on the junction of his optic nerves, causing him to slowly lose his peripheral vision and shut down his pituitary gland, which regulates all the body’s hormonal functions such as metabolism, energy level, stress response and sexual function.
“Dr. Kelly was great. He very matter-of-factly described everything in detail, and explained the pros and cons of having the operation.” Miles says. “The reality is, if it kept growing, I probably would have died for a variety of reasons.”
Miles would have to undergo surgery. It was a decision he made quickly, much like when he underwent surgical procedures on his knee in the 1970s and 80s – the result high school football playing days in the Sacramento Valley town of Yuba City.
“I look at something like that, and make the decision to do it,” he says. “If it’s going to make the situation better, there’s no point in holding off.”
Miles underwent an endonasal transsphenoidal procedure – essentially removal of the tumor through his nose – on March 14. Dr. Kelly used an approach with an operating microscope and an endoscope to provide a highly magnified and panoramic view into the base of the skull region harboring the tumor. Working through Miles’ nasal passage and the sphenoid air sinus, the growth was removed from his skull base using specialized micro-instruments. The surgical defect in the skull base was closed in a layered fashion using collagen, a small piece of titanium mesh and synthetic tissue glue to prevent leakage of cerebrospinal fluid.
“It was very creative. I was kind of expecting the old shave of the head and the baseball cut,” Miles says. “It didn’t seem like this would be as painful as the old way.”
Miles was alert not long after waking from the approximately three-hour procedure. He watched the UCLA basketball game with his family and had a meal. He was released from the hospital two days later, suffering little more than mild nasal congestion but with a notable improvement in his vision.
That’s when the real challenge for Miles occurred. He had promised to take two weeks of home rest. “Within a couple of days I was kind of stir crazy,” he says.
Four months after the surgery, things are much improved for Miles. He’s regained much of the vision in his left eye. Hormone therapy has helped him regain his energy and helped him lose weight. The headaches are in the past. His recent brain MRI shows the tumor is no longer there and his hormonal tests indicate his pituitary gland function is improved. “The advancement of science in recent years has made this whole process just really amazing,” he says. “And when you consider I could have very easily kissed off getting my eyes checked, I’m very lucky that I even had this surgery.”
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Rene K.
It had been a tough time for Rene K. Trigeminal neuralgia had caused almost constant burning pain on the right side of her face for more than two years. The anticonvulsant medications she had been taking to control the condition had been taking their toll. “I went to work every day, but the quality of life I had wasn’t very good. There were terrible side effects from the medication,” says Rene, 63, a resident of Torrance who recently retired as the longtime office manager for a group of Westwood neurologists. “I was listless, tired, and dizzy.” Rene often went to bed early to compensate for the side-effects from the medication. Moreover, the effectiveness the anticonvulsants had in controlling her pain was slowly wearing off, and was also interfering with her electrolyte balance.
Rene underwent an MRI in July 2007. Doctors discovered a sizable meningioma, a benign brain tumor growing along the skull base in front of the brain stem and severely compressing the trigeminal nerve which is responsible for facial sensation. This growth which was distorting and thinning the nerve finally explained Rene’s relentless and refractory facial pain. Given that she had clearly failed to respond to the typical medications used for patients with trigeminal neuralgia and the large size of the tumor, surgery was discussed as the next option, which Rene decided to pursue. She was referred to Daniel F. Kelly, M.D., Director of the Brain Tumor Center at the John Wayne Cancer Institute.
“I worked for a very good group of neurologists. The quality of the work they did was excellent, and I admired them,” she says. “When I came upon Dr. Kelly, he was just as good as they were. He explained everything in detail, and is obviously practicing medicine at a high level and with a great deal of integrity.”
Dr. Kelly performed a right retro-sigmoid keyhole craniotomy on Aug. 20, 2007 at Saint John’s Health Center. The nine hour procedure started with a silver dollar-sized bony opening made behind Rene’s right ear. Dr. Kelly then created a narrow surgical corridor between Rene’s cerebellum and skull base, passing along vital cranial nerves and arteries of her brain stem. Under microscopic visualization, Dr. Kelly was able to remove over 95% of the tumor leaving her trigeminal nerve free of tumor and distortion.
Rene’s family, including her husband, son and sister, were present. “My sister was very impressed with the fact that during the surgery, someone came out to them and informed them of the progress being made,” says Rene, who was hospitalized for four days after the surgery.
Her facial pain was gone the day after surgery. Now, nearly a year after her surgery, regular MRIs show that the tumor has not grown back and she is completely off pain medications. Although Rene experienced partial numbness on the right side of her face and jaw after surgery, she has steadily been regaining feeling. “I generally feel a lot better than before the surgery,” she says. The procedure left a small scar behind her ear which is completely covered by hair.
Rene retired from her job in November. She spends a significant amount of time with her family, and has fended off several calls from her former employer to come out of retirement. “I’m relaxing, but I keep myself busy,” she says.
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Beverly Naclerio
Beverly Naclerio had been successfully battling cervical cancer for a year-and-a-half when she began to have trouble with her balance and memory.“I had lost my equilibrium, but I had also lost my way,” says Naclerio, a 74-year-old resident of Culver City and retired city employee. “I’d walk through my own complex and not know where I was going.”
Naclerio’s doctors had concerns that her cervical cancer had metastasized to her brain causing her memory and balance problems as well as visual loss. An MRI confirmed that diagnosis. Naclerio had an egg-sized tumor – a metastatic carcinoma – in the region of her right occipital lobe causing severe distortion of the adjacent brain. Further testing confirmed that the tumor had severely affected her vision with almost complete loss of her left field of vision in both eyes.
Naclerio was referred to Daniel F. Kelly, M.D., Director of the Brain Tumor Center at the John Wayne Cancer Institute. Naclerio was to undergo a craniotomy in order to remove the tumor. At first she was apprehensive: “’My god,’ I thought, ‘this guy is going to open up my brain.’” But her initial meeting with Dr. Kelly allayed her concerns.
“He gave you no doubts that you knew what he was doing. I trusted him completely,” Naclerio says.
Naclerio underwent the four-hour procedure at Saint John’s Health Center, accompanied by several good friends. “I don’t remember very much, other than ‘one, two, three, and it was over,’” she recalls.
The tumor was removed by Dr. Kelly through a small bony opening near the back of her head over the occipital lobe. Using surgical navigation (like GPS for the brain) and microscopic visualization, Dr. Kelly was able to precisely localize the tumor and completely remove it, alleviating the pressure on Neclario’s brain.
Naclerio’s balance and memory issues resolved within days of surgery and her left-sided vision has been completely restored. After the surgery, she underwent a month of radiation therapy to ensure the tumor didn’t return.
Although Naclerio is still battling cancer, she has been able to maintain much of her normal life, enjoying her involvement as a Toastmaster and working as a cabaret singer.
“I have a lot of friends. I keep myself busy,” she says.
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