171 Ashley Ave.
Charleston, SC 29425
843-792-1414
800-424-MUSC
|
 |
November 2008
Turning brain surgery into a chance to give thanks
It all started with a bidding war between his friends.
Teddy Schmidt knew he would have to have his head - or at least part of it - shaved before he underwent neurosurgery at MUSC. When his neighborhood buddies heard the news, they couldn't wait to break out the shaving cream.
"They outbid each other on who would get to shave my hair off," says the 14-year-old Mount Pleasant resident.
Soon word spread to Teddy's school, Trident Academy, and together with his teachers, Teddy decided to hold a school-wide hair-cutting raffle. The winner would get to shave Teddy's head in front of all the students and staff.
"They made a not-so-good situation into a celebration," says Teddy's mom Lydia. "They even had a cake."
"I couldn't stop grinning," recalls Teddy. His one-on-one teacher drew the raffle and shaved the teen's head in front of a cheering crowd. "It showed me everybody cared."
The event raised $316 for Happy Wheels, a cart that delivers books and toys to sick patients in the MUSC Children's Hospital. Teddy knew how much gifts from Happy Wheels had helped him during his frequent hospital stays.
"It made me feel better that I was doing something for someone who'd done something for me. I know kids in MUSC will feel better getting gifts," he says.
For three years, Teddy had been in and out of the hospital with uncontrolled seizures caused by a vascular malformation called cavernous angioma, or cavernoma.
"The blood vessels in his brain don't have normal supportive tissue," explains his surgeon, Dr. Steven Glazier. Over the years, the vessels had leaked small amounts of blood, which was absorbed into his body but left behind waste products including iron. This iron residue irritated his brain cells and caused seizures.
Often, says Dr. Glazier, the side effects of cavernoma are worse than the condition itself, which can be hereditary. Both Teddy's father and grandfather have cavernomas.
Despite medications, Teddy continued to have seizures. His neurologist Dr. David Griesemer and Dr. Glazier recommended surgery.
"Teddy made a very brave decision for a young man. It was a decision that he drove after understanding his condition and considering the risks both of doing nothing and of having the surgery," recalls Dr. Griesemer.
"He was dealing with uncontrolled seizures caused by a blood vessel malformation that was basically a time bomb in his head. He wanted to get back to a normal teenager's life."
In April, after a series of studies and tests, Dr. Glazier removed the vascular malformation on Teddy's left side, which is where the seizures were originating, as well as the hippocampus and amygdala. "The likelihood of a longtime cure is higher when they are also removed," he notes.
"The malformation was adjacent to the hippocampus, which helps process and store memories, so we ran several studies to prove he had good function on his right side," he says, "including a Wada test."
During a Wada test, doctors put one side of the brain to sleep. While one side is temporarily shut down, a test-giver asks the patient questions and uses flash cards to determine what specific functions the sleeping side is responsible for.
"With Teddy, the Wada told me that I had some leeway with how much tissue I removed since he had excellent memory function on the right side of his brain, but also notified me that had to be careful to avoid getting into his speech areas, since speech originates from the left side of his brain."
Teddy made a rapid recovery.
"We'd been told the rest of the school year was going to be a wash, but there he was, back in school within three weeks of surgery," says an amazed Lydia.
"He's now free of seizures, and we've started cutting back on his meds
with hopes that in 2009, we've got him off," says Dr. Griesemer. "This was a good combination of a brave, confident kid and a superb pediatric neurosurgeon."
"This surgery doesn't limit him to any activities in the long run," explains Dr. Glazier. "It actually allows him to do more because he can get through his day without the risk or fear of having a seizure."
It's a treatment option that could help more people sooner.
"We do this surgery more often on patients in their 30s and 40s, who have suffered uncontrolled seizures throughout adolescence," he continues.
Statistically, a patient who fails two seizure medicines taken to toxicity or maximum dosage is unlikely to be successfully treated with medication.
"Surgery should be considered earlier for these patients," says Dr. Griesemer. "It's no longer a final desperate effort, but a tremendously useful tool that should be considered if the first couple of medicines aren't effective and tolerable."
"We could help these patients earlier, during their childhood and teenage years, when they're most in danger of losing ground in school and being ostracized," says Dr. Glazier.
Teddy would agree. He happily reports that the headaches and seizures are gone, and that his concentration, confidence - and hair - are growing strong.
|
|
Print Version