Dr. Gail Rosseau interviewed by Nesita Kwan for Concussion Story

CINN neurosurgeon, Dr. Gail Rosseau, was interviewed by Nesita Kwan from NBC5, for a story discussing concussions in the high school athlete. Ms. Kwan also visited St. Rita High School and met with a football player that recently sustained a concussion. Zach Blaszak, certified athletic trainer for St. Rita works very closely with CINN clinical psychologist, Dino Kostas, Ph.D. in interpreting data from the ImPACT concussion management software and determining the appropraite timing for return to play.

This story is scheduled to air on Channel 5 during the 10:00 p.m. newscast on Thursday, October 29th.

Report on QB Tim Tebow underscores that rest is key to concussion recovery

The follow report on star QB Tim Tebow reinforces the challenges of dealing with concussions. Time and rest seem to be the keys to recovery. Interestingly, we now know it’s not just rest from athletics, but it also may include rest from school, from video games, from reading, from anything that “exercises” the brain. For more information on the signs and symptoms of concussion visit www.cinn.org to order a free concussion wallet reference card. Order one for yourself or one for each player on the team. It is CINN’s goal to provide this information to as many coaches, parents, athletes, and athletic supporters as possible to spread the word about the importance of diagnosing concussions in our youth athletes.

From bleacherreport.com

Tim Tebow’s Concussion Recovery: No News Is Not Good News

Reporting on the concussion recovery status of star Florida Gator quarterback Tim Tebow is kind of like trying to go out to brunch on a Sunday afternoon at the only open joint in town.

To begin with, the wait is insufferable.

Standing in line, you find yourself sandwiched between the well to do church goers, the emotionally spent college football crowd, and the NFL fans eager to find a quick cure for hard partying of the previous night.

Once seated you find that the menu contains only one tasteless and unsatisfying entree—“Tim continues to rest and recover. He also undergoes daily testing and we continue to monitor the resolution of his symptoms.”

You eat your bland meal while scanning the faces of the other patrons—hoping to catch a hint of emotion that betrays some element of original thought. You search for anything to help you present this information in a new and interesting light.

But you see none.

You leave feeling empty, cheated, and frustrated. You don’t even want to tip the wait staff.

Such is the world of attempting to report on a sports story when there isn’t much story to report.

The University of Florida has done a credible job in sharing information pertaining to the recovery of Tebow. As frustrating as it is, UF officials have shared only what they truly know and want to share—that Tebow is recovering and that his health is monitored daily.

This week in Gainesville, less is more.

Yes, rumors abound regarding Tebow’s sensitivity to light, his headaches, and his dizziness but that is all expected when you recover from a strong concussion. It’s also expected that he may actually feel a bit worse rather than better as his recovery progresses.

Concussions take time to heal, especially for first timers, and that is a difficult concept to put into a press release or announcement.

But there is something that isn’t being said that speaks volumes.

Knowing Florida head coach Urban Meyer’s love of information control one can wonder if there is an alternative motive behind this trickle of information.

Perhaps the man who owns the ultimate college football poker face is headed to the table against LSU with a load of chips and a pair of fives in his hand.

What we’re not hearing are reports that Tebow is progressing rapidly and that he is taking part in light workouts and passing drills.

We are also not hearing that the Gator football staff expects Tebow to play or start the LSU game this Saturday.

Comments on the offense are on hold with the exception of reports that backup quarterback John Brantley is working hard to prepare for the Tigers.

If one was to guess, that guess might be that Meyer and his staff are drawing near to deciding that Tebow will not be fit to play against LSU. Perhaps that decision has already been made, but not announced simply to keep LSU from focusing on preparing for Brantley.

Who knows?

The end result is that unless something truly tragic befalls Saint Tim, and that is highly unlikely, we will continue to be told that Tebow is recovering well.

Come Thursday or Friday night the veil will be lifted and an announcement will be made. It will be the major story of the day and will preoccupy the college football community until kickoff in Baton Rouge Saturday night.

Today’s money is that John Brantley will get his first start and Tebow will not dress for the game.

A Heisman hopeful is grounded and a new star attempts to shine.

The speculation continues…

CINN Patient Shares Story of Pursuit of Proper Diagnosis & Optimal Treatment

Part 1

 

I was referred to Dr John Helfrich, a neurologist at Christie Clinic in Champaign, Illinois, because for the past thirteen years I had slept no longer than 90 minutes at a time. I am a 51-year-old professor at a Big Ten university, 6’5″ tall, mentally and physically active. I would fall asleep easily but soon awaken, so my nights were a series of naps. I was fatigued during the day and frequently dozed off.

I had sought medical help many times over the past decade. I passed from doctor to doctor, including two psychiatrists and a psychologist specializing in biofeedback. I had been given antidepressants, although I had no symptoms of depression, dopamine agonists, though my legs didn’t seem restless, and a gamut of sleeping pills. My turbinates were surgically reduced to help me breathe at night. Nothing helped.

A sleep test showed I awoke whenever I entered REM, the restorative phase of the sleep cycle. I had a few sleep apneas over the course of the night, but they were mostly central apneas, the type associated with disruptions of the nervous system, rather than the normal obstructive variety.

For someone with a healthy lifestyle, I was dealing with a discouragingly long list of medical issues. I had frequent headaches and nearly constant jaw pain. Gaps developed in my lower teeth and they moved in front of my upper teeth. My dentist sent me to get braces and I was suffering through orthodontic treatment.

I was aware my carbohydrate metabolism was failing. After eating, I became sleepy. Two hours later, if I didn’t eat again, my blood sugar would plummet and I would fall into the symptoms of an insulin reaction. I tried to compensate by eating small amounts of food periodically around the clock, avoiding simple carbohydrates.

I exercised one to two hours a day, biking, walking and lifting weights, and watched my diet, but gained three or four pounds each year. Losing weight, formerly easy for me, had become especially difficult and I hired a weight loss coach to help. My diastolic blood pressure rose sharply and my resting heart rate was unusually high for a physically fit adult.

A colonoscopy eight years earlier had revealed a 3-cm cancerous polyp, but it had not spread past the stalk and was successfully removed. Colonoscopies in subsequent years revealed seven more polyps, mostly precancerous.

The previous year the fifth metatarsal in my right foot snapped unexpectedly. The fracture didn’t heal for months and a scan to find out why revealed low bone density, although I had no risk factors for osteoporosis. An endocrinologist diagnosed me with low blood calcium and hypercalicuria: my kidneys were shedding calcium into my urine. I had had a total of seven kidney stones.

Part 2

 

When I entered Dr Helfrich’s office, he was looking not at a file or computer screen, but at me. “You have big hands,” he said as he shook my hand. He gave me a physical exam and asked if I had always been big boned. No, I said, as a young adult I was skinny, but lately had become

barrel-chested. My face had changed appearance: my jaw was square and nose and forehead broad. He noted the enlarged pores and adult acne on my face, my skin tags and the scars from removing sebaceous cysts.

“I want to test you for acromegaly,” he said, explaining this was a rare condition in which the pituitary gland produces too much growth hormone. A blood test for IGF-1, a metabolite of growth hormone, showed an alarming level for someone my age, 674 ng/ml. The number should have been in the 100s. Dr Helfrich ordered an MRI of my pituitary gland, which revealed a tumor 12 mm across, much larger than the pea-sized gland it had grown from.

The tumor had developed from a secreting cell and was spilling growth hormone into my blood, raising my blood pressure and heart rate. It had impaired my carbohydrate metabolism, because high levels of several of the metabolites of growth hormone, molecularly similar to insulin, were playing havoc with my body’s mechanism for regulating blood sugar.

The hormone had caused my jaw to broaden and lengthen, necessitating the orthodontic treatment, and my hands to enlarge. It spurred colon cancers to grow and caused my kidneys to spill calcium, thinning my bones and giving me kidney stones. And for the past thirteen years it had killed my REM sleep.

Part 3

 

Dr Gail Rosseau, the brilliant neurosurgeon at Chicago Institute of Neurosurgery and Neuroresearch who is a leading candidate to be Barak Obama’s Surgeon General, together with Dr Stephen Becker, a head and neck surgeon at Northwestern University Hospital, planned a transsphenoidal approach to the tumor. It had grown against my right carotid artery and was pressing against my optic chiasm, causing visual disturbances.

Dr Becker removed my septum and cut a passage into my sphenoid sinus. Dr Rosseau passed an endoscope up through my nostril and cut into my brain cavity. Looking through a flexible microscope, she extracted the tumor, bit by tiny bit. She was aiming for a complete removal, to deter re-growth, while taking care to leave a functioning pituitary and avoid nicking my carotid artery or optic nerves.

I spent the night in intensive care and the next morning was removed from the morphine pump. My braces had been causing intense pain for almost a year, but even with the morphine withdrawn the jaw pain and headaches had disappeared. I declined further pain medication: I was in less pain after surgery than before.

The next night, the nurses awakened me hourly to check my condition and take blood samples. Still, it was the best night of sleep I had had in over a decade! In the morning I removed my bandages, showered, and dressed in my street clothes. When Dr Rosseau made morning rounds, I told her I was ready to go home.

“This man,” she announced to her entourage, “had brain surgery less than 48 hours ago!” I was released from the hospital that afternoon. Three and a half weeks later I returned to teaching my classes.

Part 4

 

Two and a half months after surgery, Dr Helfrich had trouble picking me out in his waiting room. With my jaw not swollen and nose less broad, my face had changed shape. My skin was no longer coarse and oily, and my acne had disappeared. My carbohydrate metabolism returned to normal immediately after surgery. No longer needing to eat every two hours, I had lost twenty pounds without special effort. Even my eyes had changed color, from light green to deep brown.

The IGF-1, the indicator of growth hormone levels, in my blood had dropped from 674 to 133 ng/ml. My blood pressure had fallen from 130/100 to 105/70 and my resting heart rate from around 90 to about 65. My blood sugar and glycolated hemoglobin levels were optimal and my serum calcium normal; I was no longer was at risk of diabetes, or further thinning of my bones.

I was sleeping uninterrupted six or seven hours a night and felt invigorated during the day, never dozing. My mucus membranes shrank and I no longer snored. My allergies disappeared. I had had not a hint of a headache since surgery and my braces, now painless, would be removed soon. I was using seven prescription medications before surgery, but now I took only a daily multivitamin.

I need to be vigilant against cancer, because acromegalics develop the disease at four times the rate of the general population, and take care to avoid injuring my thinned bones. My cardiovascular system took a beating for more than a decade, so it’s important to maintain my blood pressure and cholesterol at optimal levels.

Four months after surgery, I was with my children in the Netherlands Antilles, learning to SCUBA dive. In a five day trip, friends and I will soon traverse “The Maze” in Canyonlands National Park by mountain bike. I send my doctors a lot of flowers.

(The patient)

April 4, 2009

 

Wife of CINN Patient Thanks Dr. Mkrdichian and Staff

I saw the article on Dr.Mkrdichian in the Sun-Times and it got me to thinking about our story with Dr. Mkrdichian and CINN and I thought this may be a good time for me to share it. My husband (Bill) was diagnosis by CINN back in 1992 with a disease called Von-Hipple Lindau which caused my husband to have over 25 surgeries in the years following, he had brain surgeries, 4 Gamma Knifes, lost both kidneyâ s, did dialysis, had a kidney transplant, eye surgeries and endured a month long coma. In 1992 Dr.Mkrdichian performed the first of 11 brain surgeries on Bill and from that moment on we were bonded with Dr.M and the stuff at CINN for over 16 years, and they saw and helped us through a lot during those 16 years. My husband had to have MRIs s every six months along with a doctor’ s appointment to see Dr. Mkrdichian and sometimes he delivered us good news and sometimes bad, but Bill and I always felt safe knowing it would be Dr.Mkrdichian doing the surgery.  Sometimes I think Dr. Mkrdichian was more worried than we were, that’s how safe he made Bill and I feel. I still can remember the big smile on Dr. Mkrdichian’s face as he’d walk down the hallway after each surgery he performed to tell me that Bill was fine and that Bill was something special. Then there’s the nurses who some of them we’ve known since 1992, and saw Bill and I through a lot including that month long coma, those nurses are very special people of which I will always be thankful of , and in some weird way they were like our second family. I can not thank them enough for all the things they did we for us over those 16 years, you always took such good care of Bill that I never had worry. Bill and I entrusted Bill’s life to Dr.Mkrdichian and that great stuff at CINN many, many times, and they never let us down, so all I can say is thank you and know how special you all were in our lives.
I lost my best friend, my beloved husband (Bill) April 9th, 2008, and the world lost something very special that day.
Thanks Dr. Mkrdichian and Bill really liked you a lot.Lynn

Dr. Gail Rosseau, CINN Neurosurgeon Still in Running for US Surgeon General

Colleagues,

As reported in MedScape Today … There is no shortage of interested candidates for the country’s top public-health job, say officials. The search for the next US surgeon general is back on after CNN medical correspondent Dr. Sanjay Gupta announced late last week that he will no longer be pursuing the role. Among those mentioned in MedScape article are:

Acting Surgeon General Dr. Steven Galson.

Gail Rosseau, MD, from the Chicago Institute of Neurosurgery and Neuroresearch, in Illinois, was on a short list for the job late last year. Dr. Rosseau is director of cranial base surgery and is 1 of 300 female neurosurgeons nationwide. She has declined to comment at this time.

Arthur Kellermann, MD, professor and founding chair of the department of emergency medicine at Emory University, in Atlanta, Georgia.

Irwin Redlener, MD, director of the National Center for Disaster Preparedness at Columbia University, was named in the New York Times as another potential candidate.

Also expressing interest in the position is George Lundberg, MD, a former editor at Medscape and a previous editor of the Journal of the American Medical Association. “If done right, this can be the most important public-health job in the world,” Dr. Lundberg said.

Teacher thankful for doctors who helped save her life

BY DONNA VICKROY Staff Writer

Something was definitely wrong.

Dawn Marchese was getting dizzy for no reason. Sometimes if she laughed a lot while goofing with her brothers and sisters, she’d get a massive headache.

Sometimes, she’d get nauseated.

“For months, I went to different doctors who couldn’t find anything,” said the Southwest Side elementary school teacher. Finally, the then-18-year-old’s mother took her to see a neurologist.

Marchese had completed just one quarter of community college at the College of DuPage when CAT scans revealed something suspicious.

“That doctor told my mother I needed to go to a specialist,” she said.

A life-saving decision

As her mother flipped through the pages of insurance-friendly specialists, the name Len Cerullo jumped out at her. Cerullo is founder of the Chicago Institute of Neurosurgery and Neuroresearch.

“My mom thought she’d read something somewhere about him being a great doctor,” Marchese said.

Whether it was mother’s intuition or some greater force at work, the decision to call Cerullo, Marchese believes, saved her life.

Marchese’s mom explained her daughter’s symptoms to Cerullo over the phone.

Then Cerullo said something that both frightened and surprised Marchese’s mother: He told her he wanted to see her daughter’s scans that day.

It was a Sunday.

Accustomed to seeing patients on weekends and holidays, Cerullo invited Marchese’s parents to his house that afternoon.

Marchese was hospitalized later that day. Within the week she underwent surgery to remove a brain tumor.

“She had a very serious condition that required immediate care,” Cerullo said.

How was he able to see what other doctors had missed?

“Two things,” he said. “Ask the right questions, and listen to the answers.

“Unfortunately, a lot of doctors spend too little time listening,” Cerullo said.

And even fewer take the time to see patients on their days off.

“You wonder why I see patients at my home? It is because of stories like this. I know I can make a difference, but patients need access to me for that to happen.”

Giving thanks

Last month, having been given the clear on her annual MRI, Marchese, now 34, wrote a letter thanking both Cerullo and surgeon Edward Mkrdichian for saving her life. She enclosed a copy of the certificate she received after earning her Master of Arts degree from Chicago State University in August.

Marchese, who teaches gym, music and art at Dawes Elementary School on Chicago’s Southwest Side, said she went from barely being able to walk or speak following the surgery through radiation treatments and therapy to fulfilling her dream of becoming a teacher.

“This degree has let me put the past behind me,” she said.

Today, she is grateful for her doctors’ talents, for their persistence and for their willingness to really listen when others wouldn’t.

In her letter, she writes, “Thank you for choosing to be neurosurgeons.”

Oddly enough, that profession was not even on Cerullo’s radar when he entered college.

“I thought I wanted to be an English teacher. Then I thought maybe I’d be a psychiatrist,” he said. “I didn’t want to go to be a doctor.

“But I guess you gotta go where your gut tells you to go,” he said.

Marchese said during her most recent visit to Mkrdichian, she promised to send him a copy of her diploma.

When it finally arrived in October, she decided to add the letter of gratitude.

“I felt like I should thank my doctors because they probably don’t get thanked a lot,” she said.

Cerulla said he has received a surprising number of letters throughout the years.

“I’ve had the privilege of taking care of many patients. A percentage do badly, and that takes a big chunk out of you. But the ones who do well inspire us to continue on,” he said.

As for Marchese, she says she is thankful for every day.

“Things that go wrong don’t mean as much,” she said.

Sure, the hair that fell out during radiation grew back much thinner. And she worries that the treatment may affect her ability to have children someday.

But she takes heart in the positives life has afforded her, namely the professional title of teacher.

Kennedy brain surgery hailed as ’successful’

The Washington Times, June 3, 2008 — by Amy Fagan

Sen. Edward M. Kennedy underwent successful surgery Monday at Duke UniversityMedical Center for a cancerous brain tumor in what was “just the first step” of his treatment plan, his surgeon said.

“I am pleased to report that Senator Kennedy’s surgery was successful and accomplished our goals,” Dr. Allan Friedman, chief neurosurgeon at Duke University Hospital said after performing the 3 1/2 hour procedure early Monday.

“Senator Kennedy was awake during the resection and should therefore experience no permanent neurological effects from the surgery,” Dr. Friedman said.

After the surgery, Mr. Kennedy, 76, told his wife, Vicki, “I feel like a million bucks,” and joked “I think I’ll do that again tomorrow,” an aide to the senator said.

The senator from Massachusetts was diagnosed last month with a malignant glioma on the left side of the brain. In a statement earlier Monday, he said he would undergo surgery at Duke, recuperate there for one week and then begin radiation and chemotherapy at Massachusetts General Hospital.

“I look forward to returning to the United States Senate and to doing everything I can to help elect Barack Obama as our next president,” said Mr. Kennedy, a Democrat who has served in the Senate since 1962.

According to the American Association of Neurological Surgeons (AANS), a surgeon’s goal in an operation such as Mr. Kennedy’s is to remove as much of the tumor as possible without damaging surrounding brain tissue. Dr. Friedman didn’t specify how much of the tumor he was able to remove in Mr. Kennedy’s case.

Doctors at Duke University Medical Center report Monday’s surgery on Sen. Edward M. Kennedy was successful and he should have “no permanent neurological effects.”

Surgeons sometimes opt to keep the patient awake during the procedure and track their language function before deciding which portions of the tumor are safe to cut, said Dr. Gail L. Rosseau, a neurosurgeon at the Chicago Institute of Neurosurgery and Neuroresearch and a spokeswoman for AANS. It’s a way to test the tumor’s perimeters, she said.

Dr. Rosseau said surgeons wouldn’t be able to remove all of Mr. Kennedy’s tumor because malignant gliomas have roots. That’s why radiation and chemotherapy are used afterward.

Mr. Kennedy’s tumor is on the left side of his brain, so it has the potential to impair speech and mobility on his right side, she said, noting that after surgery patients may display speech or mobility weakness that disappears as they recover. “If he is weak on his right side [in the hours following surgery] it doesn’t necessarily mean he’ll remain weak on that side,” Dr. Rosseau said.

Researchers at Duke have spent the past few years investigating a cutting-edge vaccine that could potentially double the survival time for patients who have Glioblastoma multiforme (GBM).

Mr. Kennedy’s doctors have only said that his tumor is a malignant glioma. The most deadly type of malignant glioma is a GBM, which is categorized as a stage 4, Dr. Rosseau said.

The latest results of the vaccine trial, conducted by Duke and MD Anderson Cancer Center, were presented Monday at the American Society of Clinical Oncology’s annual meeting.

The vaccine targets a specific protein found in about half of GBM tumors. It enhances the body’s immune response to the protein and kills tumor cells that contain it, said Gary Archer, a Duke researcher on the team who holds a doctorate in neurosurgery. The vaccine, administered in the groin, is given to patients who already had surgery, radiation and chemotherapy.

So far, the vaccine has helped 23 patients survive, tumor-free, for a median of 16 months, more than double the typical six-month period. On average, patients who got the vaccine lived 33 months, compared to the average 14-month survival of GBM patients.

The trial has expanded to 20 sites and more patients nationwide and is now being run by a private company, Mr. Archer said.

If this vaccine continues to succeed, “it will be huge,” he said. “We’re really excited.”

Standard treatment for malignant brain tumors is surgery, followed by radiation and a chemotherapy drug called temozolomide, Mr. Archer and other specialists said.

Several other chemotherapy drugs and new ways of administering them are being investigated, according the American Brain Tumor Association (ABTA).

For instance, sometimes after brain tumor surgery, doctors will opt to pack the wound inside the brain with dime-sized wafers filled with a chemotherapy agent called carmustine, which slowly dissolves and treats remaining tumor cells, according to ABTA.

The American Cancer Society estimates that about 13,070 people in the United States will die of malignant tumors of the brain or spinal cord this year.

Listen to what Dr. Cerullo had to say about Kennedy’s brain surgery

Surgery ‘first line of treatment’ against glioma tumors

The Washington Times — By Amy Fagan - May 21, 2008

The type of brain tumor that Sen. Edward M. Kennedy has — a glioma — originates in the brain and accounts for 77 percent of malignant brain tumors and 42 percent of all brain tumors, medical experts said yesterday.

Mr. Kennedy, Massachusetts Democrat, has a “malignant glioma in the left parietal lobe,” according to a statement from his doctors at Massachusetts General Hospital. Read more

Despite a devastating diagnosis, local resident found they had options

By Susan Stevens | Daily Herald Staff

Laurie Radtke knows the value of a second opinion. The Johnsburg mother sought 27 of them when her 7-year-old daughter Taylor was diagnosed with an “inoperable” brain tumor.

After an exhaustive, nationwide search, the Radtkes found a surgeon willing to perform the risky surgery. Today Taylor is doing fine, though she does face struggles as a result of nerve damage. Her mother has turned into a resource for other families facing similarly devastating diagnoses. Read more

Fighting for a Future

By MARCIA SAGENDORPH Staff Writer

November 1, 2007 Jennifer Berg has just about had her fill of doctors, but she is now signing up for more.

Berg, 35, of Antioch was diagnosed with Stage 4 breast cancer April 30 when she was 22 weeks pregnant with her third child. She had to undergo three rounds of chemotherapy while she was pregnant, taking precautions to protect the baby.

“Talk about life-changing decisions,” she said of undergoing treatment while pregnant. “We really wanted (our baby) so bad. Thank God we are over that hurdle.” Read more

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