Sally has been through the most dangerous and

amazing medical experience over the last

couple of weeks

She received phenomenal care at Mission Hospital in

Mission Viejo, California

April 20, 2010

Sally was diagnosed with a large brain tumor that the doctors say has been growing for a minimum of five years. This picture at left with President George Herbert Walker Bush was taken in 2005. At that time she was not noticeably experiencing the effects of the tumor.

Sally’s cognitive abilities had been declining over the last several years.

Since then, Sally has been progressively getting worse, experiencing significant short term memory loss, missing meetings and flights, getting lost in traffic, etc.

Two weeks ago, Sally had fallen while walking to lunch with a colleague from work.

She was taken to her primary care doctor who ordered a series of tests including a Magnetic Resonance Imaging (MRI) scan of her brain.

At left is a single frame from her MRI. The whitish area in the upper left is a Meningioma brain tumor the size of an orange. For reference, the tumor is over Sally’s Right eye.

These tumors grow from the meninges, the layers of tissue covering the brain and spinal cord. As they grow, meningiomas compress adjacent brain tissue. Symptoms are often related to this compression of brain tissue, which can also affect cranial nerves and blood vessels. In some cases, meningioma growth can also extend into the bones of the head and face, which may produce visible changes. Most meningiomas are considered nonmalignant or low grade tumors. However, unlike nonmalignant tumors elsewhere in the body, some of these brain tumors can cause disability and may sometimes be life threatening. In many cases, meningiomas grow slowly. Other meningiomas grow more rapidly or have sudden growth spurts. There is no way to predict the rate of growth of a meningioma or to know for certain how long a specific tumor was growing before diagnosis. Meningiomas are graded from low to high.

Sally was first admitted into another hospital, but was transferred by ambulance to Mission Hospital which had the newest and most modern imaging technology available in health care today.

Sally was admitted into Intensive Care (left) as the significant shift in her brain due to the huge size of the tumor was especially dangerous.

Sally was seeing in black and white (unable to see colors), had developed severe memory loss and was losing the ability to balance herself.

Critical Care Nurse, Michelle Chapman, was a “miracle worker” for Sally and family members. She worked eight consecutive days (12 hour shifts), which is the only time in her ten years at Mission Hospital she had worked that many days in a row.

At Mission Hospital, Critical Care Nurses stay with their patients everywhere in the hospital, including imaging and the operating room.

Sally spent four days in Intensive Care prior to her surgery. The doctors conducted endless tests to get ready for the tumor resection.

Mission Hospital has thought about the smallest details. Above Sally’s bed in Intensive Care was this wonderful panel that lights up and looks exactly like a “skylight.” This simulated view adds a peaceful calm while spending many days in a hospital.

The grand children and great nieces in our families made fun and colorful cards and drawings for Sally that were prominently displayed in her room.

Kristina (in the picture at left) made her Aunt Sally this framed memory piece to help her recall some of the wonderful moments

they had shared together

A JetBlue balloon was part of the room’s decorations to make

Sally feel at home.

Family began assembling from around the country. Judy took

over feeding duties.

Incredible technology exists

throughout the facility. Sally was

subjected to at least three MRI’s

and seven CAT Scans at various

stages of her stay.

Her vascular neurosurgeon, Dr. Ched Nwagwu, performed the first surgical procedure on Sally to get her ready for the removal of the tumor.

In addition to being an incredibly skilled surgeon, he is a classically trained pianist who has performed with symphonies.

This angio procedure allowed the neurosurgeon to cauterize the primary blood vessels feeding the brain tumor. He successfully cut off 85% of the blood supply to the tumor. This allowed the tumor to start to die and soften for removal.

During a nuclear heart stress test to determine the condition of her

heart’s ability to withstand surgery, a blockage was discovered in one

of Sally’s coronary arteries. The doctors drew various levels of

possible blockages on the board in her room.

This cardiac surgeon, Dr. Margaret Rasouli decided to perform an angiography procedure to look inside each of Sally’s coronary arteries to see the degree of blockage seen during the heart stress test.

Coronary angiography is performed to detect obstruction in the coronary arteries of the heart. During the procedure a catheter (thin flexible tube) is inserted into an artery in yourarm or groin and then threaded carefully into the heart. The blood vessels of the heart are then studied by injection of contrast media through the catheter. A rapid succession of X-rays (fluoroscopy) is taken to view blood flow.

When this cardiologist performed the angiography procedure, it turned out the nuclear stress test had resulted in a “false positive”reading. Sally’s arteries were clear and she was approved for brain surgery.

Extremely sophisticated surgical technology is employed by the

neurosurgeon for the brain tumor resection.

The family gathers in the waiting room during the five hour operation. Here Susan, Donna Sue and Rhea - Sally’s Mom eagerly await the surgeon’s report.

Also waiting are Kristina, Briana with Tatiana and Susie, who are trying to focus

on homework

Kristina and Tati play at a child’s learning center in the family waiting room.

WARNING

If you would prefer NOT to see the actual surgical photos of Sally’s brain and the tumor (next slide), please skip

the next two slides.

After the Meningioma tumor is removed, a huge hole is left in Sally’s brain. Several CAT scans and an MRI

confirm the brain had moved back into its original shape and size by the following morning.

Immediately after surgery and recovery, Sally was moved back into Intensive Care and left on a ventilator in a sleep state, planned for two additional days.

The preferred sleeping medication fed through an IV drip was “Propofol,” the same drug that killed Michael Jackson.

Although Sally slept through the night and was constantly monitored by her Critical Care nurses, just 17 hours after emerging from surgery, while still on Propofol, she opened her eyes and started moving her arms. Her nurse, Michelle, called in the neurosurgeon to see for himself. Sally clearly indicated, using hand signals, she wanted the breathing tube removed from her throat. It was removed and she began talking immediately (and hasn’t stopped since).

Each day, the doctors and nurses track important metrics

and set goals for recovery.

Sally wanted to look as good as she could for family members after she woke up from surgery. Michelle wrapped her

up in towels and blankets

Michelle brought shampoo and conditioner from home and meticulously washed

Sally’s hair

Dr. Anthony Kim was the primary neurosurgeon who performed the complex surgery to remove the tumor. He visited Sally every day to monitor her condition. He attended Yale, Harvard and USC and also sang Opera earlier in his life.

Dr. Guu was Sally’s internal medicine physician during her stay.

Dr. Cummings was her Neurologist. He will continue her on seizure medication.

In addition to a phenomenal team of doctors and nurses and amazing, state-of-the-art technology, the constant flow of family, friends and neighbors kept her spirit alive. Judy, Ken, Bri and Tati.

Abby, Donna Sue, Rhea and Jamie

Andy and Susan

This introverted cleaning lady came out of her shell after meeting Sally. The most touching moment in the hospital was when she brought Sally a hand-knitted hat to wear over her incision.

Aby was one of the night critical care nurses.

Ken and Tatiana

Head of Critical Care Nursing at Mission Hospital (on right) and a colleague.

Wonderful Coto de Caza neighbors Tricia and Andi

Within two days, Sally was able to stand up out of bed with the help of a walker and physical therapists.

Dr. Marquez (below) focused on her Pulmonary condition.

Physical therapy continued every day

Kristina, Trisha and Susie were frequent visitors to the hospital.

Peter, Tati and Briana

Sally’s Mom and Sister were constantly cheering her up and monitoring her progress.

Jen and Isabel

Ken and Olivia

Roger visited while Sally tried on scarves and new pajamas

Beautiful flowers started arriving from all over the country

The room began smelling like a garden.

Some were delivered to the house

Gifts poured in as well

Bella tries to teach Sally how use an Ipod

Even after Sally was relocated to the step down floor from intensive care, she had multiple visits from Michelle and Dr. Nwagwu who let Heather know how Sally was to be cared for

Two other nurses (Karen at right) during Sally’s stay on the step down floor

Phone CallsPeople called from all over the world to wish Sally well. These included calls from some

of the recent participants on the “Legends of Aerospace Tour.”

General Steve Ritchie - Last Air Force Pilot ACE since the Korean War

Bob Gilliland First Test Pilot of SR-71 Blackbird. Holds record for most time at Mach 2 and Mach 3

Finally the bandages had

to come off which revealed the 37 staples

needed to close her incision.

Sally had to see for herself and intently studied her incision in the mirror.

Sally undergoing physical therapy, practicing going up and down stairs.

Notice the wireless heart monitor which is continuously feeding data to the nurses station at all times during her hospital stay.

The Charge Nurse got Sally all bundled up in the “Snugie” that Jennie and the kids had purchased for her ride home.

Sally is wheeled outside to be picked up for her ride home.

Quite literally, flowers were still being delivered as we were departing the hospital.

And the best news of all, within 5 days of surgery, Sally was home playing with the grandbaby. Thank you all for your prayers, calls, emails, cards, flowers and love. Keep her in your thoughts as she continues her miraculous recovery.