March 5, 2024
Stacey Hunter is a self-described 鈥渂usy body.鈥 As a mother of six children ranging in age from 29鈥11 years old鈥攊ncluding one with special needs鈥攕he鈥檚 always on the go. So last year, when she started feeling tired, she wasn鈥檛 exactly surprised. However, the fatigue was relentless and made it difficult for her to get through the day. Her normal routine of waking up early, working as a stylist at her in-home salon, taking care of the family, cleaning the house, and exercising was becoming increasingly challenging. Even with some extra naps and longer nights of sleep, she was always exhausted.
鈥淪everal members of our family planned to run a marathon in October, so I was training for it,鈥 Stacey said. 鈥淏ut after running three or four miles, it felt like I was going to die.鈥
She decided to bring it up with her primary care physician. After undergoing tests for things like iron deficiency, her symptoms were ultimately dismissed as being a result of aging and experiencing early menopause. That didn鈥檛 sit right with her, but her doctors said there wasn鈥檛 much more they could do.
During a trip to Utah in April, everything changed. While driving with her daughters after dropping her husband at the airport following Easter celebrations, Stacey's behavior became erratic. She seemed disoriented, searching for a handicap sticker she didn't have, causing concern among her family. Feeling something was wrong, her daughters called their dad, who thought Stacey might be having a stroke.
She returned to normal shortly afterward but had no recollection of the episode. After searching online and consulting a physician friend, who thought it might be due to low blood sugar or low protein, no clear diagnosis emerged.
A month later, Stacey experienced a second 鈥渆pisode.鈥 Then a third. She went back to the doctor, underwent more bloodwork, and received a phone call telling her she was 鈥100 percent normal,鈥 blaming the symptoms on menopause again. Frustrated and determined to find answers, Stacey insisted on an MRI.
鈥淭he MRI was at 8 am, and by 10 am, I got a phone call saying I had a massive brain tumor,鈥 she said. Her doctor recommended two options for receiving treatment: coming to University of Utah Hospital in Salt Lake City, Utah, or going to Seattle. Stacey chose Utah because it was close to her older children. By 3 pm the same day, she was on a telehealth consultation with Robert Rennert, MD, a neurosurgery specialist at 91麻豆天美直播 and assistant professor in the neurosurgery department at University of Utah, who specializes in skull base vascular and endovascular surgery.
They discussed her symptoms, the tumor, and surgery options. Then Rennert asked Stacey to see an ophthalmologist to establish a baseline for her vision prior to surgery. Although Stacey hadn鈥檛 noticed any issues with her vision, her eye doctor in Missoula was surprised that her vision was unaffected鈥 particularly given the location of Stacey鈥檚 tumor on her left optic nerve. The ophthalmologist said he could see evidence of compression of the optic nerve from the tumor because he knew it was there. But, he added, he might have missed it without having reviewed her MRI.
Vision changes are a common symptom for tumors occurring at the skull base. 鈥淪tacey had a meningioma, which is a benign growth of the lining of the brain, that was quite large,鈥 Rennert said. 鈥淚t was about three centimeters in diameter and causing significant displacement and swelling within the surrounding brain tissues. Additionally, it was compressing her left optic nerve, which can compromise vision.鈥
These benign tumors can be associated with genetic syndromes or prior radiation exposure but most commonly occur spontaneously, according to Rennert. They tend to show up between the ages of 40 and 60 and are more common in women because they often have receptors for progesterone and estrogen. Someone can have this type of tumor growing for a long time before experiencing any noticeable symptoms.
Preparing for the Procedure
About three weeks after her first appointment with Rennert, Stacey was scheduled for surgery. That didn鈥檛 leave much time to get things in order for a busy mom and stylist with a huge clientele. Nonetheless, she was soon on her way to Utah for the procedure.
Rennert discussed the risks involved in removing a tumor wrapped around her optic nerve, including the potential for partial or complete vision loss. Since the tumor was on her left side and located near where her optic nerves converged, there was a risk of affecting vision in both eyes. Other risks included damage to nearby critical blood vessels and the possibility of post-surgery complications such as strokes, which could lead to weakness, numbness, or speech problems.
My husband is in the health care field, so he was aware of the risks associated with these types of brain surgeries. But I didn鈥檛 want to know the details because I didn鈥檛 want to be more stressed out about it. I just knew I had a brain tumor and I wanted to get it out. I had enough trust and faith in Rennert, and in God; I knew I would be fine.
Before the surgery, which was expected to last between eight and 10 hours, Stacey's husband expressed concern about potential side effects. However, she reassured him that she felt completely calm and prepared. Though she couldn't quite explain why, she was confident that everything would go smoothly and she would emerge from surgery with no issues.
鈥淲e consider this a complex skull base meningioma,鈥 Rennert said. Neurosurgeons at U of U Health perform more than 100 of these procedures a year, but most are not as complex as Stacey鈥檚. When patients come in with these tumors, doctors consider observation and radiation in situations where a tumor is relatively small or located in a place where it would be difficult to surgically remove. But for most patients with larger or symptomatic tumors, surgery is the best option.
鈥淭hese tumors are relatively rare and can be challenging when they occur in areas with high-risk anatomy,鈥 Rennert said. 鈥淚t鈥檚 crucial to find someone with proper training who specializes in operating on complex tumors of the skull base.鈥 As an academic referral center, U of U Health often deals with such complex cases from referring physicians in the Mountain West. The neurosurgeons collaborate with colleagues from other U of U Health departments to address complex lateral and anterior skull-base tumors. 鈥淲e鈥檙e adept at handling cases like this because we encounter them at a much higher frequency than smaller non-referral centers,鈥 Rennert said.
Stacey鈥檚 tumor was fibrotic, vascular, and calcified, meaning it was firmer than expected and required a more aggressive and time-consuming approach. The surgery to remove it took 14 hours. Fortunately, Stacey experienced no complications and had no residual tumor, preserving her vision and making the procedure a complete success.
After spending two nights in the ICU, Stacey's first glimpse of herself in a mirror post-surgery was shocking. Her hair was partially shaved, and her face was swollen. During the surgery, Rennert opened a small window of bone in her skull to access the tumor, securing it with metal plates. Months later, she is still adjusting to her changed appearance. Although she initially felt tired and weak, Stacey recovered quickly and was discharged five days after surgery.
She received instructions for post-operative recovery and set small goals to regain her physical strength. Within a week of returning home, she worked up to walking one and a half miles a day. She returned to work after three weeks and, at her five-week follow-up, inquired about resuming marathon training. With the tumor removed and the pressure on her brain relieved, Stacey regained her energy. Rennert authorized her to begin training as soon as she felt ready. She and her family set a new goal to run the St. George Marathon together in October 2024.
My husband gets teary when we talk about it and says it was my faith that got the whole family through. It was a good learning and growing experience. It brought our family closer together and made us appreciate how fragile life can be. It also helped us see God鈥檚 hand in our lives, that if we put our trust in the doctors and the people who have this knowledge, miracles can happen.
She will see Rennert once a year and get scans to check for tumor regrowth, but for now things are back to normal鈥攁nd chaotic, in a good way鈥攆or the busy Montana mom. She is grateful she chose U of U Health and had the skilled hands of her neurosurgeon to remove her brain tumor.
鈥淚 just love Rennert,鈥 Stacey said. 鈥淗e treats you like he cares, like you are important. When you see how he has dedicated his life to neurosurgery, you know he must love what he does.鈥
