“To have and to hold, for better or for worse, for richer, for poorer, in sickness and in health, to love and to cherish; from this day forward until death do us part . . .”

As Jane was being prepped for emergency brain surgery, Michael Greener remembered the vows that he and Jane had declared to each other exactly four years earlier. Today would be the 4th anniversary of their marriage. It was a scary time. Michael feared, would Jane remember me? Would she forget the things that brought us together and the life we shared the past four years?  Never did he or Jane realize that twenty five years later Jane would again be having brain surgery.

Since being diagnosed with an epidermoid brain tumor, Jane and Michael have been on a never ending journey.  When Michael joined the Epidermoid Brain Tumor Society in 2013, he wrote of his and Jane’s journey since her diagnosis in 1989 and of the first surgery to remove it. The rare epidermoid tumor is congenital and benign.  It is seen in 1% of all brain tumors, and is life threatening with location in and around the brainstem. At diagnosis, patients watch the tumors with MRI’s yearly and wait as long as possible before surgery. As symptoms continue, the patient’s quality of life deteriorates as symptoms create situations of seizures, hydrocephalus, trigeminal neuralgia, impaired balance, hearing loss along with many other physical disabilities. Surgery is the only treatment for epidermoid brain tumor patients, but this must be balanced against preservation of functioning cranial nerves. Skull base neurosurgery is still the most difficult and challenging of all surgeries. Although surgery removes the tumor, there are great risks involved, and often the patient is left with deficits. The epidermoid is recurrent for some, and surgery after surgery takes a toll on the patient and their family over the years.

Living in Ft. Wayne, Indiana, Jane had surgery there in 1989. The next year, scans showed that the tumor had returned, and her neurosurgeon provided options for consults at Mayo Clinic or NYU Medical. In 1990 with the tumor back, Jane had surgery at Mayo Clinic which left her with TBI (Traumatic Brain Injury) deficits. Then in 1997 after a follow-up scan showed regrowth pressing into the brain-stem, the third surgery at Mayo was done, and she was told by her surgeon that 99% of the epidermoid tumor was removed.

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Jane and Michael welcomed a son, Christopher, in January, 2002, to their family. Life was normal. Until . . . until it wasn’t.

Skip to 2013, having had 2 seizures two months apart, after being seizure free for 20 years and with onset symptoms of torticollis, and gait issues developing; the MRI’s showed  the tumor had regrown as large as it was or bigger than in 1989 and had entered the hippo-campus. Jane would face her fourth surgery for the epidermoid.

In the fall of 2013, they were at Mayo Clinic for another consult. They were shocked when the first words their neurosurgeon told them were, “I gave it my best shot in 1997”. Mayo informed Michael and Jane on this consult for her 4th surgery that this surgery was much too risky for Jane to again undergo a fourth surgery. With growth now reaching involvement in critical areas, Mayo was reluctant to go ahead as before. He described the consult at Mayo as being one of discouragement. The fourth surgery would not provide relief and only be a temporary fix until new regrowth started causing symptoms again. Also with risks in the vascular area that it now had enveloped, there could be possibility of a hemorrhage or stroke causing coma or death. And to go through surgery with a 30 % risk of further neurological deficits or death was not the best decision for Jane. The choice was to wait for quality of life to be to a low point, where the surgical odds outweighed the quality of life at that point.

That evening while surfing the web for Epidermoid Brain Tumor surgical alternatives, the Epidermoid Brain Tumor Society site popped up. Michael reached out to the Epidermoid Brain Tumor Society asking for any information of new treatments since Jane’s surgery at Mayo in 1997. He wrote that he knew the advances from 1990 to 1997 were remarkable in the evolution of new technology; yet he was hoping since her last surgery with the use of microscopic technology that EBTS knew of other alternatives that would help Jane. Dr. Takanori Fukushima’s name and accomplishments had been mentioned on the EBTS Face Book page by other members. When Michael contacted his office asking if he would review Jane’s scans, he was told that an appointment in person had to be made. They declined to travel another 10+ hour trip to North Carolina only to be possibly told the same as the Mayo consult.

As an option for treatment, Mayo Clinic offered Accutane experimental treatment. With nothing else offered, Jane completed the 6 month trial treatment. The follow-up MRI reported no decrease in tumor size and may have grown even more. At this point they had run out treatment options. Michael commented that they would be going back to Mayo to check into Proton Beam treatment that may help, but Michael again asked if EBTS had answers.

Knowing of the potential risk of surgery for Jane Greener, EBTS hesitated, but in the years of their organization, they knew of one skilled skull base neurosurgeon that undertook the most difficult surgeries with successful outcomes. EBTS sent Dr. Fukushima’s contact address to Michael. He replied back saying that he had given permission to Mayo Clinic to share Jane’s file with Dr. Fukushima in Raleigh, North Carolina.  He wanted to know if Dr. Fukushima had thoughts about surgery for Jane. Michael had been following the posts on EBTS Facebook and knew of successful surgeries that Dr. Fukushima had done for difficult brain tumors for EBTS patients.

On February 16, 2015, they were told by Dr. Fukushima of a 5% surgical risk.  Jane Greener’s epidermoid brain tumor was resected by Dr. Fukushima and Dr. Zomorodi.

The surgery had gone very well that day!  So well, that the same evening, Michael watched unbelievably as Jane ate a chicken salad sandwich. The next morning he and his son, Christopher, arrived to ICU to find Jane had just walked with help from the nurses, less than 24 hours after surgery!

At this time, since surgery, Jane Greener is recuperating, exercising daily, and living her life free of symptoms and stress from the epidermoid brain tumor. When asked about Jane’s progress, Michael Greener simply said, “This is Miraculous.”   This May 25th, 2015  Michael and Jane Greener celebrated 30 years of marriage together!

Update:  July 1, 2015, Jane had her second surgery with Dr. Fukushima and Dr. Zomorodi. The surgery was successful. Jane suffered a few seizures and was in Intensive Care for the first day, then moved to her room. She walked the second day, although unsteady. She was released July 6th, and they began their drive home. Jane is doing well, unsteady on her feet, but not using any walker or cane! We wish her and Michael well!