Meet Josephine E.
A Brain Tumor Through the Eye of the Beholder
” My neck wouldn’t turn all of a sudden,” Josephine remembers. “I was having nosebleeds while I was sleeping, and then I couldn’t see. “
– Josephine E., Brain Tumor Patient
Supraorbital Keyhole Eyebrow Approach Patient
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, Josephine 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,” Josephine remembers. “I was having nosebleeds while I was sleeping, and then I couldn’t see.”
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?”
Losing Sight But Not Hope for the Future
By June 2006, Josephine 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. Josephine 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. Josephine 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 Josephine 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 Josephine’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. Now more than 7 years after surgery, she remains tumor free and with normal vision. Her twins, Daniel, named for Dr. Kelly, and Emmanuel, named for her obstetrician, are happy, healthy, boys just turned 7 years old.
“My life is full,” Josephine says. “We’re waiting to see what the future will bring.” A future that can thankfully be seen through the eyes of Josephine Josephine.
The condition and treatment of this patient may not be representative of all such cases as each situation and patient is unique.