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11 hours ago · Spinal Surgery Saves Teen Swimmer's Mobility

When the position of his spine unexpectedly changed, 13-year-old Albert Mansour was unable to walk without discomfort. Using a unique surgical approach, Mayo Clinic surgeons were able to successfully repair Albert's spine and relieve his pain.

When the position of his spine unexpectedly changed, 13-year-old Albert Mansour was unable to walk without discomfort. Using a unique surgical approach, Mayo Clinic surgeons were able to successfully repair Albert’s spine and relieve his pain.


When 13-year-old Albert Mansour first walked onto Mayo Clinic’s Rochester campus in the fall of 2016, the steps he took were peculiar, painful and incompatible with the physique of the competitive swimmer he had been just a year earlier.

Albert, who lives with his family in Inver Grove Heights, Minnesota, walked bent-kneed and on his toes. His legs were angled awkwardly, and his lower back flattened to accommodate a lumber vertebra that had slipped forward and down onto the vertebra directly beneath it. He had back pain and sciatica nerve pain. His nerves were stretched taunt by his condition, known as spondylolisthesis.

“Spondylolisthesis, overall, is fairly common,” says Todd Milbrandt, M.D., in Mayo Clinic’s Department of Orthopedic Surgery. “But the kind that Albert had, which was nearly a complete slippage of the fifth lumbar vertebra onto the first sacral vertebra, is relatively rare.”

The spines of those affected by the condition lose their stacked-block structure when the bottom lumbar vertebra shifts down onto the top of the sacrum, which causes the pelvis to angle downward.

“That’s the foundation of the whole spine, and Albert’s vertebra had shifted toward the front and was putting a lot of pressure on his nerves. That was causing his walk to change,” says Dr. Milbrandt.

Albert’s spinal surgeon at Mayo Clinic Jeremy Fogelson, M.D., in the Department of Neurosurgery, explains that there is a grading system for the condition.

“There are five grades, and he was a grade four out of five, which is quite severe,” Dr. Fogelson says.

For individuals with high-grade cases of spondylolisthesis like Albert’s, an intensive surgery that includes laminectomy and spinal fusion is the best option to correct the defect.

Following a day-long operation in December 2016 — during which Albert’s surgical team members, including Dr. Fogelson and Dr. Milbrandt, corrected Albert’s misaligned vertebra and released the tension on the nerves to his legs — the teenager is moving normally again and looking forward to getting back into the swimming pool.

Damage and debilitation  

Albert’s medical problems started in late 2015. He was active on his junior high school swim team, but he began having trouble completing his swimming stretches, says Albert’s father, Ramy Mansour. His parents brought him to the family’s primary care physician, who attributed Albert’s pain to his legs growing longer.

A few weeks after that appointment, however, Albert began walking on his toes. Albert went back to the doctor. An X-ray and referral to an orthopedic specialist were ordered. The specialist visit yielded a diagnosis of spondylolisthesis and a referral to an orthopedic surgeon.

All the while, Albert’s symptoms continued to worsen. His gait became more awkward, his pain increased and he was forced to stop swimming.


“After we met with Dr. Fogelson, I asked Albert, ‘What do you think?’ and he said that he wanted to do the operation at Mayo Clinic. Dr. Fogelson handled this with Albert in an excellent way. Albert was very happy to do it there, and we were as well.” — Ramy Mansour


“Last year we discussed (with Albert’s local surgeon) that Albert needed to do the operation, but he was a little stressed about doing it,” Ramy says. “Although the surgeon we met was an excellent guy, Albert was still very stressed.”

Albert’s outlook changed after his Mayo Clinic visit.

“After we met with Dr. Fogelson, I asked Albert, ‘What do you think?’ and he said that he wanted to do the operation at Mayo Clinic,” Ramy says. “Dr. Fogelson handled this with Albert in an excellent way. Albert was very happy to do it there, and we were as well.”

Repair and recovery

There was a time that surgeons were hesitant to restore alignment for people who had spondylolisthesis, says Dr. Milbrandt, adding that Mayo Clinic surgeons now perform such operations more frequently.

The procedure, called spinal decompression surgery, requires physicians to remove a portion of the back of the vertebra, or lamina, to create room in the spinal column and take the pressure of the nerves. Next, surgeons use screws and rods to slowly coax the slipped vertebra back into place.

“By doing a decompression, the nerves that go down legs are free,” Dr. Milbrandt says. “For a long time, no one attempted the operation because the complication of losing the nerve function permanently was common, and the risk was very high.”

Dr. Fogelson explains that Mayo Clinic surgeons employ spinal monitoring throughout the operation to make sure the nerves are safe.

“The patient is still under anesthesia and asleep, but we use electrical signals and record the brain waves and muscle twitches to make sure the signals are still getting through  the nerves,” Dr. Fogelson explains.


“Because of the complicated and rarer nature of the operation, working as a multidisciplinary team with Dr. Milbrandt was helpful. This is something we frequently do at Mayo Clinic, bringing together doctors from multiple specialties to maximize the quality of care.” — Jeremy Fogelson, M.D.


To ensure Albert’s vertebra remains in place, a bone graft was placed onto the problem lumbar vertebra to fuse it with the bones immediately above and below it.

“Because of the complicated and rarer nature of the operation, working as a multidisciplinary team with Dr. Milbrandt was helpful. This is something we frequently do at Mayo Clinic, bringing together doctors from multiple specialties to maximize the quality of care,” Dr. Fogelson says. “Although Albert first saw me, and I specialize in the treatment of spinal deformities, I felt we could provide the best care possible if Dr. Milbrandt and I performed Albert’s surgery together.”

As expected, Albert woke up from his surgery in significant pain. But by the fourth day after surgery, his pain had mostly receded, and he was walking without any assistive devices.

“The key is, if you can get them walking, the bodily functions return and the pain gets better,” Dr. Milbrandt says. “But at first patients are usually hesitant to get out of bed because they’re afraid of the pain worsening.”

Albert was discharged six days after his surgery, and the family was overjoyed to be able to attend Christmas Eve mass together, Ramy says.

“Albert is essentially back to normal,” Dr. Fogelson says. “We have him on some restrictions for now to not overstress his fusion. But otherwise from the outside, you couldn’t tell anything different about him. He’s hopefully cured.”

To Albert and his family, the ability to go to Mayo Clinic and witness the care Albert received was the experience of a lifetime.

“I used to be a specialist of internal medicine for about 20 years in Egypt before moving to the United States, and we know as students of medicine that Mayo Clinic is one of the most eminent names on our planet,” Ramy says. “Its reputation is beyond excellent. It was just a dream.”


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5 days ago · Second Opinion at Mayo Clinic Changes a Nurse's Destiny

Distressed by the news that she had an inoperable brain tumor, Jessica Kenser sought a second opinion and received life-altering treatment from Mayo Clinic neurosurgeons.

Distressed by the news that she had an inoperable brain tumor, Jessica Kenser sought a second opinion and received life-altering treatment from Mayo Clinic neurosurgeons.


December 2016 brought an end to an eight-day period in Jessica Kenser’s life that was bookended by events both devastating and astounding. That span of days began with the news that she had an inoperable brain tumor. It ended with that tumor being completely removed by Mayo Clinic neurosurgeons. Throughout the long week in between, there were many moments Jessica credits for the stunning change of events.

The first came just two days after Jessica, who is a nurse, learned she had a brain tumor deemed too deep to remove. While she was doing online coursework for a doctorate of nursing degree, an advertisement for Mayo Clinic appeared on her monitor. The ad spurred her to action.

Jessica called Mayo Clinic’s Rochester campus to request an appointment. She received the welcome news that she could get appointments the next day with physicians in Mayo Clinic’s Department of Neurology and Division of Neuro-oncology.

“Talk about by the grace of God,” says Jessica, who, with her husband, left her home in Brooklyn Park, Minnesota, immediately after that phone call and spent the night in Rochester to be ready for her 7:30 a.m. meetings.

Another life-changing moment arrived when her Mayo Clinic neurosurgeon Terry Burns, M.D., Ph.D., informed Jessica that her tumor could, in fact, be removed, and the tumor’s location actually made surgery a promising treatment option. On Dec. 30, just two days after meeting a team of Mayo Clinic neurosurgeons, Jessica underwent surgery. The tumor, a low-grade noncancerous growth called a pilocytic astrocytoma, and its surrounding tissues were successfully removed.

Six months later, not only has Jessica recovered with minimal side effects, but she says the experience has deepened her faith and an increased her desire to spread goodness in the world.

“Had I not sought another opinion, eventually this tumor would’ve changed into a higher grade and grown enough to cause permanent damage, and it could’ve killed me,” Jessica says. “God literally answered all my prayers. I prayed that my tumor would be operable, that it would be low grade and that I would be healed.”

Frightening findings 

Jessica discovered she had a mass in her brain in May 2014. An MRI, ordered by a primary care physician who was concerned about symptoms Jessica had experienced, found a 10 millimeter spot in her right temporal lobe. That’s the part of the brain responsible for processing and integrating memories with the senses of sight, sound, taste and touch.

Because the spot did not feature signs of having its own blood supply, her neurologist told her it was likely scar tissue.

“I said, ‘Wait. Is there a possibility that it’s a tumor of some sort? Let’s just get it out!'” Jessica recalls. “But he said nobody would even attempt that because of where it’s located deep in the temporal lobe. He said, ‘We’ll monitor it.'”

Accepting her physician’s advice to monitor the mass, Jessica underwent twice-yearly MRIs to check the growth. For two and half years, Jessica’s brain mass showed no change. But in late 2016, a test revealed that the growth had developed a blood supply. Terrified of what the change could mean, Jessica demanded to know if it was cancer.


“Had I not sought another opinion, eventually this tumor would’ve changed into a higher grade and grown enough to cause permanent damage.” — Jessica Kenser


“My doctor said, ‘No, we’ll just monitor it a little closer now,”‘ Jessica recalls. “And I said, ‘I want this out of my head.'”

Her physician’s response: “No one will touch it.”

Devastated by the news, but lacking another option, Jessica began praying, and she immersed herself in her work — until she saw the words ‘Mayo Clinic’ flash across her computer screen.

“Of course I’ve heard of Mayo Clinic, but I’m not from Minnesota. I’m from California,” Jessica says. “So when the ad went on my screen, I was like, ‘Mayo Clinic’s here!’ I literally called down to Mayo right then. They got me appointments with my neurosurgeon and my neuro-oncologist 12 hours after I called.”

Immediate intervention

When Jessica arrived at Mayo Clinic, she didn’t know — and her physicians, including neuro-oncologist Brian O’Neill, M.D., couldn’t tell using the MRI scans alone — the type of tumor that had taken up residence in her brain. But Jessica’s team was confident they could remove it, and they wasted no time proceeding to treatment.

“I was there on a Wednesday, and Dr. Burns said, ‘How about Friday morning?’ I was in surgery less than 48 hours later. That’s unheard of.”

Despite her savvy in the health care field, Jessica had never required surgery and admits being unnerved by what was before her.

“I’ve always been extremely compassionate, but I’ve never been the patient before. I didn’t fully get how real that fear is,” she says, adding that her nurses took extra care to allay her worries.

“The nurses down there were phenomenal,” she says. “When I first talked to Dr. Burns, I was just a wreck, and I was crying. His nurse Lucinda cried with me and held my hand.”


“I was there on a Wednesday, and Dr. Burns said, ‘How about Friday morning?’ I was in surgery less than 48 hours later. That’s unheard of.” — Jessica Kenser


The nurse who wheeled her to surgery was equally comforting and soothed Jessica throughout the trip to the operating room.

“I told her how scared I was, and she said, ‘I got you,'” Jessica says. “All the way she held my hand and was mouthing to me. ‘It’s all right.'”

After nearly seven hours in the operating room, Jessica’s tumor and much of the surrounding tissues were removed. When Jessica woke up, her thoughts immediately went to the code word she and her husband had chosen to indicate she was OK.

“I remember going into surgery. I remember waking up,” she says. “I have zero lapse in memory.”

Rapid recovery

Less than 48 hours after waking, Jessica was discharged from the hospital. Eleven days after that, she resumed her studies. Over the course of the next few months, she achieved three As and one B, and completed 150 hours of clinical work. In February, as soon as her driving restriction was lifted, Jessica returned to her job working with patients in need of respiratory therapy.

There were some difficulties along the way, though. Jessica says she struggled with anxiety and fear immediately after her operation. And although she could previously remember her many professional and familial obligations, she must now write things down to keep her busy schedule organized. But on the whole, Jessica says she feels her life has shifted for the better as a result of her ordeal.

“My husband asked me if I could go back and not have the brain tumor, would I? And I honestly can’t answer that because my faith and appreciation for life is so different,” she says. “My outlook on life is that I am blessed to be sitting in traffic. I’m blessed to be here. The little stuff does matter, and every day I wake up with a positive attitude. My whole goal is to make someone happy today.”


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Wed, Jul 19 8:00am · Therapist Celebrates 10 Years of Vitality After Surgery for a Rare Brain Tumor

In July 2017, Sally Kirilloff marked a decade since her care team at Mayo Clinic successfully removed a large, rare brain tumor, enabling her to continue enjoying her work, her hobbies and her family.

In July 2017, Sally Kirilloff marked a decade since her care team at Mayo Clinic successfully removed a large, rare brain tumor, enabling her to continue enjoying her work, her hobbies and her family.


For Sally Kirilloff, July 5 is a day to celebrate.

“That day means another chance,” says Sally, who this year marks a decade of survival after surgeons at Mayo Clinic removed a rare brain tumor.

“It’s miraculous. I tell people all the time to go to Mayo,” Sally says. Because of Mayo Clinic, she says, “I can do the work I love, be with my family, practice yoga and go to one of my family’s favorite places: the Florida Keys.”

An alarming diagnosis

 Sally, a psychotherapist in private practice in Jacksonville, Florida, noticed the first signs of trouble in 2007. She was having difficulty keeping her balance during yoga. She began bumping into objects while walking. To find out what was wrong, Sally had an MRI. The results were alarming.

She was diagnosed with pilocytic cerebellar astrocytoma — a type of glioma brain tumor typically found in children and adolescents.

“I was 56 years old. My youngest son was in college, and my oldest son had just graduated from college. I was shocked,” she says.

Her primary care physician referred her to Ronald Reimer, M.D., a neurosurgeon at Mayo Clinic’s Florida campus, who discovered that Sally’s brain tumor was not only uncommon for an adult, it also was large, measuring 5 centimeters. Although these tumors often are slow-growing, this tumor could cause confusion, progressive weakness and a depressed level of consciousness.


“I had never had surgery before. The thought of someone operating on my brain was overwhelming. But Dr. Reimer told me what to expect and explained the odds of any serious problems were small.” — Sally Kirilloff


“This type of tumor is extremely rare in patients Sally’s age. She was the first adult patient seen with this specific tumor at Mayo Clinic’s Florida campus,” Dr. Reimer says. “Her imaging revealed she was about to develop obstruction of the ventricular system, which would result in hydrocephalus and increased intracranial pressure.”

Removing the tumor would require a complex surgery because it was close to the brain stem, which controls the flow of messages between the brain and the rest of the body. That includes those that cue basic body functions such as breathing, swallowing, heart rate and consciousness.

“I had never had surgery before,” Sally says.” The thought of someone operating on my brain was overwhelming. But Dr. Reimer told me what to expect and explained the odds of any serious problems were small.”

A fulfilling aftermath

The surgery was scheduled for July 5, 2007. Sally had only two weeks to close her practice and prepare her family.

“I was so anxious when I went into surgery, but Dr. Reimer came and looked me in the eye and made me feel that everything was going to be okay,” Sally says.

The five-hour procedure, called a suboccipital craniectomy, involved removing bone at the base of Sally’s skull and opening the membrane protecting her brain. That allowed an incision into the cerebellum that gave the team access to the tumor. The surgery was a success, with the tumor completely removed.

Sally remained in the hospital for five days. She then began a six-month regimen with a physical therapist to help her relearn how to balance and to strengthen the left side of her body.

“You have to relearn where your foot goes,” she says. “It took at least a year to be back to my full self.”

Follow-up MRIs have been uneventful. There has never been any sign of tumor recurrence. Sally was able to return to work four months after the surgery. In the decade since, she has treated more than 850 patients, and she’s had the pleasure of seeing her family grow.

“In the years since surgery, both of my sons have graduated from college and law school,” Sally says. “They have brought new people into our family, including a beloved grandchild who is now in first grade.”


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Mon, Jul 17 5:09pm · The Sky's the Limit for College Freshman After Double-Lung Transplant

Thanks to a double-lung transplant at Mayo Clinic, Logan McCaskill is breathing easier and on her way to a healthier future.

Thanks to a double-lung transplant at Mayo Clinic, Logan McCaskill is breathing easier and on her way to a healthier future.


University of Central Florida freshman biology major Logan McCaskill has her sights set on a career with NASA. The Orlando native hopes to work for the agency researching how to grow plants in space. It’s an ambitious goal. One she could never have dreamed of pursuing before a double-lung transplant at Mayo Clinic.

Logan was born with cystic fibrosis, a disease that causes the body’s secretions to become sticky and thick. Instead of acting as a lubricant, the secretions clog tubes, ducts and passageways, especially in the lungs and pancreas. Her older sister, Jordan, also was born with the condition.

Despite the genetic illness, Logan says she had a pretty normal childhood — sleeping over at friends’ houses, spending time at the beach, and going to Disney World. But starting at about age 8, the mucus that filled her lungs began causing repeated infections.

By the time Logan entered middle school, she was being hospitalized for several weeks about twice a year.

Logan had to wear a vibrating vest for 40 minutes a day to help break up the mucus from the walls of her lungs. She also saw a physical therapist to put pressure on her chest twice a day to help her cough up the mucus.


“It was so hard to breathe because my lungs were so damaged. I felt physically exhausted all the time. Even doing homework was exhausting.” — Logan McCaskill


People who have cystic fibrosis can experience nutritional challenges if the mucus blocks the tubes that carry digestive enzymes from the pancreas to the small intestine. Without these enzymes, nutrients from food are not completely absorbed. Because of this complication, when she was 9 years old, Logan was given formula nightly through a feeding tube to ensure she got the essential calories and nutrients her body needed.

The frequent lung infections caused scarring in her lungs, and once Logan entered high school, her lung function had dropped so significantly that she had to carry a backpack with an oxygen tank.

“It was so hard to breathe because my lungs were so damaged,” Logan says. “I felt physically exhausted all the time. Even doing homework was exhausting.”

Halfway through her sophomore year, Logan was in an out of the hospital so much she had to leave school.

A different option

Logan’s sister had undergone a double-lung transplant at a Central Florida hospital when one of her lungs collapsed shortly after Christmas 2013.

“We didn’t want Logan to go through her transplant as weak as Jordan was when she went through hers,” Logan’s dad, Darrell McCaskill, says. “We wanted to look at other options.”

In early 2014, the family headed to Mayo Clinic’s Florida campus for an evaluation in the Transplant Center. According to David Erasmus, M.D., a Mayo pulmonologist and lung transplant physician, Mayo Clinic performs 40 to 45 lung transplants per year in Florida, with a total of 556 lung transplants since 2001.

Logan, then 17, met with Francisco Alvarez, M.D., a physician in Mayo Clinic’s Lung Transplant Program, who gave her hope.

“He was friendly, and very knowledgeable and informative. He assured me of the process and talked to me a lot about the recovery,” says Logan, who was expending an average of 5,000 calories daily just to breathe.

Logan was added to the transplant waiting list in May 2014. That began a long nine months for the family. Logan advanced to 11th grade and tried to stay positive.


“[Dr. Alvarez] was friendly, and very knowledgeable and informative. He assured me of the process and talked to me a lot about the recovery.” — Logan McCaskill


“I knew there was a chance that it might not work out,” she says.

Finally, the call came a little before midnight on Feb. 6, 2015. Two lungs were available.

“It was surreal because I had waited so long,” Logan recalls. “But it was also scary, because I was about to have this life-changing surgery.”

“I was excited for Logan because by that time, her oxygen tank didn’t last enough for her to watch a movie,” Darrell says. “There was nothing worse than waiting, especially when her health was declining so quickly.”

A breath of fresh air

Once she was taken off the ventilator after the transplant surgery, Logan remembers taking in too much air with a single breath.

“I wasn’t used to breathing so deeply and having so much air capacity with my new lungs,” Logan says. “I think it took about two to three days to really get used to breathing normally.”

Logan and her father spent three months in Jacksonville after her surgery, juggling school assignments and going to rehab three times a week.

“She worked hard,” Darrell says. “I knew she was in pain, but she knew she would have to fight through to get better.”


“They were genuinely interested in Logan and her well-being. She wasn’t just a patient or a project to work on. They were vested in her.” — Darrell McCaskill


He credits Mayo Clinic’s Transplant Center and the pulmonology group for Logan’s successful surgery and recovery.

“I can’t say enough about them. They were knowledgeable and engaging. They were genuinely interested in Logan and her well-being,” Darrell says. “She wasn’t just a patient or a project to work on. They were vested in her.”

Logan was able to return to school full time to complete her senior year.

“I had so much energy, and felt more focused and alert,” she says. “I was able to go to homecoming and prom, and do everything else everyone my age could do.”

That includes graduating with her class.

“Her graduation was a great day. She accomplished something that 90 percent of people probably wouldn’t be able to do,” Darrell says. “I’m just so proud of her.”

Two years after her transplant, Logan is enjoying college life and looking forward to the future.

“I can now do anything I want, and my confidence is higher because of the transplant,” Logan says. “I feel normal.”


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Fri, Jul 14 8:38am · Saving Grace: Finding Hope for a Seizure-Free Future

After suffering her first epileptic seizure at just 10 days of age, Grace Chan required six separate brain surgeries as surgeons worked to remove the harmful tissue that was causing her seizures.

After suffering her first epileptic seizure at just 10 days of age, Grace Chan required six separate brain surgeries as surgeons worked to remove the harmful tissue that was causing her seizures.


Ten days after giving birth, Christina Chen, M.D., was feeding her newborn daughter, Grace, when the young child’s arms and head suddenly began making brief jerking movements.

“It looked like a small seizure to me. But newborns do such strange things with their movements, I wasn’t quite sure what to make of it,” Christina says. A few minutes later, Grace did it again. And then again. “I knew immediately at that time that we had to take her to the hospital,” Christina says. “She was having clusters of seizures.”

Grace’s first hospitalization at Mayo Clinic’s Rochester campus, when she was only 10 days old, was scary for Grace, and for Christina and her husband, Aaron Chan. That’s in part because all of Grace’s lab tests, imaging studies and MRI scans looked normal. And while an electroencephalogram, or EEG, did confirm the seizures, it didn’t pinpoint a cause.


“I lost many nights of sleep either watching Grace’s every movement or researching literature about her condition. I had never felt so helpless in my life.” — Christina Chen, M.D.


“All we knew was that something was disturbing her brain’s electrical activity,” Christina says.

A fellow in Mayo Clinic’s Geriatric Medicine Fellowship at the time, Christina began thinking back to her “distant knowledge of pediatric neurology” and coming up with a harrowing array of worst-case scenarios.

“My mind was consumed with questions, and I poured over literature and readings about pediatric epilepsy,” says Christina, who’s now a senior associate consultant in Mayo Clinic’s Division of Employee and Community Health in Rochester. “I lost many nights of sleep either watching Grace’s every movement or researching literature about her condition. I had never felt so helpless in my life.”

An answer finally comes

The family’s search for answers, and a diagnosis, began to take shape when Grace’s care team in Mayo Clinic’s Department of Neurology — who Christina calls “some of the most thorough, compassionate and intelligent people I have ever met” — took a closer look at Grace’s MRI scan. The team, led by pediatric neurologist Lily Wong Kisiel, M.D., found an area over the right side of Grace’s brain that didn’t look right.

“It was so subtle that it was initially missed,” Christina says. “All the EEG studies correlated to her seizures coming from that focal area of her brain.”

With this new finding, Grace’s care team felt confident diagnosing her with cortical dysplasia, which Christina describes as “basically an area of the brain where the nerve cells didn’t migrate normally during development.” As scary as that may sound to some, Christina says the diagnosis comforted her and Aaron. “We were actually overjoyed to hear this information,” she says. “We had a diagnosis that was not terminal. We had answers.”

They also learned that the only long-term treatment option for Grace’s condition would be surgery. Naturally, the thought of Grace going through brain surgery at such a young age was terrifying for her parents.


“Cortical dysplasias are a notorious cause for seizures and will not go away unless removed surgically. But at least cortical dysplasia is something that is potentially treatable.” — Christina Chen, M.D.


“Cortical dysplasias are a notorious cause for seizures and will not go away unless removed surgically,” Christina says. “But at least cortical dysplasia is something that is potentially treatable.”

The family wouldn’t find out for sure, however, until Grace got a little older. “The recommendations were to grow her a little more until she was at least 6 months old, ideally a year old,” Christina says. “Her little brain at 10 days old was way too fragile for such a major surgery.”

To help her get there, doctors prescribed medications to control Grace’s seizures. They then allowed Christina and Aaron to take her home, where the next five months were seizure-free for Grace.

“We watched her grow each day,” Christina says. “She was developing so well, smiling and laughing with us all the time. She loved people and being around strangers. We watched all her milestones evolve. She was rolling over, sitting by herself, trying to crawl. It was incredible.”

A six-week nightmare

All of that changed on the way home from a family trip to Chicago.

“Grace wasn’t acting right in the car,” Christina says. “She was staring off into space and wouldn’t stop drooling. She looked a little swollen around the face and seemed like she was having a hard time breathing.”

Christina and Aaron took Grace to a local emergency department where she was treated for what they believed was an anaphylactic reaction to something she ate. Grace recovered from the episode. She was soon discharged from the hospital and on her way back home with her parents. But the next day, her seizures returned.

“This time, she was in status epilepticus (non-stop seizures), and it went on for 45 minutes before we were finally able to control it,” Christina says.

That incident, Christina says, marked the beginning of the family’s “six-week nightmare” in the hospital with Grace. Doctors at Mayo initially had trouble getting Grace’s seizures under control.

“The first week, we had to repeat all of her studies,” she says. “She had wires hanging from every extremity. That made it difficult for us to hold her and comfort her. The whole time she was having seizures that required rescue medicines to stop them. Basically, by the end of the week, our routine was trying to get Grace to take naps because once she was awake, she would have seizures.”

From bad to worse

A week later, Grace’s condition deteriorated to the point that she required a breathing tube and was transferred to an intensive care unit, where she was put on a continuous drip of medication to stop her seizures.

“This was probably one of the darkest and most difficult times Aaron and I have ever gone through,” Christina says.

Through their church, Christina and Aaron had come to know Sheri Crow, M.D., a pediatric intensivist at Mayo Clinic who happened to be working in the ICU the week Grace was admitted.

“She treated Grace with the utmost, thorough care, and provided our family with such amazing support,” Christina says of Dr. Crow.


“Aaron and I were so grateful that we were receiving care at Mayo Clinic, because I don’t think things would’ve been expedited so quickly at any other institution.” — Christina Chen, M.D.


After Grace was stabilized, her first brain surgery would come much sooner than expected, due to the growing severity and frequency of her seizures.

“Aaron and I were so grateful that we were receiving care at Mayo Clinic, because I don’t think things would’ve been expedited so quickly at any other institution,” Christina says.

Grace’s first surgery, performed by Nicholas Wetjen, M.D. in the Department of Neurosurgery, took approximately four hours. After the procedure was finished, Christina says she was just happy to see her little girl still alive.

“Her face was a little swollen and her right eye was swollen shut, but she was extubated pretty quickly,” she says. “She looked at us afterward and smiled a few times. Our hearts melted, and we were filled with hope that this was the end of it all.”

As the family would soon find out, however, that would not be the case.

A ‘miraculous recovery’

Despite the perceived success of Grace’s initial surgery, her seizures returned a few days later, and they were worse than before. She began having seizures that would wake her from sleep, so she wasn’t able to get a good night’s rest. Sleep deprivation then made the seizures worse. Grace’s care team ordered more EEG and MRI exams. Those exams showed that part of the abnormal tissue causing Grace’s seizures was still inside her brain. That, of course, meant another surgery.

“They wanted to make sure that this was the only place of seizure focus, so after another week on the ventilator, she underwent a larger surgery, this time in a two-part process,” Christina says.

It was during that surgery that Grace’s neurosurgeons discovered there were more areas of her brain that were affected than originally thought. That meant Grace would need more surgeries to remove all of the abnormal tissue and ensure her seizures stopped for good.


“[Grace is] a consistent reminder that anything is possible, and that we wouldn’t be here if it wasn’t for Mayo Clinic.” — Aaron Chan


All told, young Grace would have a total of six separate brain surgeries at Mayo Clinic. And while each one came with its own brand of complexity and uncertainty, taken together, they’ve helped Grace become a happy, healthy and seizure-free five-year-old. A five-year-old who, among other things, loves playing outside, going to zoos, eating vanilla ice cream and playing games on her iPad.

Grace also recently participated in her first play, graduated from preschool, and is preparing to start kindergarten this fall — just like other kids her age. For that, her parents couldn’t be more thankful.

“Every year that passes since her surgery, I’m reminded of her miraculous recovery,” Aaron says. “We really had no idea how she would recover. Now she is going to be starting kindergarten next year. She’s a consistent reminder that anything is possible, and that we wouldn’t be here if it wasn’t for Mayo Clinic.”

You can watch more of Grace’s story in the video below:


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Wed, Jul 12 8:00am · Mesothelioma Patient Finds Complex, Comprehensive Answer

A frightening diagnosis of mesothelioma brought Sally Kirkvold to Mayo Clinic. To her great relief, the prompt and thorough care she received put the cancer into remission, allowing her to turn her attention back to normal life.

A frightening diagnosis of mesothelioma brought Sally Kirkvold to Mayo Clinic. To her great relief, the prompt and thorough care she received put the cancer into remission, allowing her to turn her attention back to normal life.


When mesothelioma strikes, it is aggressive and often deadly. Caused primarily by exposure to asbestos, the cancer grows in the mesothelium, which is a thin layer of tissue surrounding the body’s internal organs. This cancer most often affects the lung lining — a condition called pleural mesothelioma.

The condition thickens the lining and causes fluid to develop under the lung. That often leads to labored breathing, coughing and chest pain.

Those symptoms plagued Sally Kirkvold for months, but she didn’t know the cause. “I was a sick lady for a while,” she says.

Sally sought treatment repeatedly near her home in Fairbanks, Alaska. She was diagnosed with pneumonia, among other things. When her symptoms didn’t improve, she underwent a chest CT scan, which showed a thickening of the lung lining on the right side of her chest. A subsequent biopsy revealed that Sally had malignant pleural mesothelioma. The cancer appeared to be confined to the lining of her right lung.

Sally’s doctors immediately referred her to Mayo Clinic’s Arizona campus. There, in January 2016, the multidisciplinary thoracic oncology team took on the challenge of helping Sally with this rare and potentially life-threatening cancer.

The team recommended a three-pronged treatment strategy. With Helen Ross, M.D., in Medical Oncology, the team first recommended chemotherapy. That improved the appearance of the cancer on PET/CT scans. Next, Mayo Clinic surgeon Staci Beamer, M.D., was able to remove the tumor and the right lung lining. Following recovery from surgery, Terence Sio, M.D., in the Department of Radiation Oncology, recommended proton beam therapy for Sally.

Today, after a nearly year-long relocation to Arizona, the 77-year-old grandmother has resumed life with her husband in Fairbanks. “Sally, with all of the intense and necessary treatments that have been given to her, has recovered remarkably well,” Dr. Sio says. “She remains disease free and side-effect free to this day.”

Lowering the risks of treatment

Sally didn’t smoke, and her living conditions didn’t put her at high risk for developing mesothelioma. But mesothelioma can take 20 to 30 years to develop, so people may not realize they were exposed to asbestos years before. Asbestos is also present in the natural environment in some areas, which can present a risk of mesothelioma. In some cases, the cause of mesothelioma is never identified.

As part of her treatment plan, Sally was evaluated and proved to be a good candidate for proton beam therapy. This therapy is particularly attractive as a treatment for people with mesothelioma because using proton beams can reduce radiation exposure to the lungs and heart, while allowing effective doses of radiation to cover the chest wall and lung lining.


“They were very open with me and explained thoroughly what was going on and what I had to do as far as the treatments.” — Sally Kirkvold


With conventional radiation therapy, the radiation spillover is much broader and deeper than proton beam therapy. The side effects of radiation spill over to the lungs and heart can be dangerous. The precision of proton beam therapy can minimize those risks. The protons are focused exactly on the target, so the radiation goes to that point and then stops.

“With proton beam therapy, the chance of spilling radiation into the other lung was virtually zero. The dose to the heart decreases by a lot, too,” Dr. Sio says. “As a result, the chance of her developing a life-threatening side effect from the treatment immediately or afterward hopefully decreases to be minimal.”

Home away from home

Although Sally had the most advanced medical science behind her, she says her first appointment at Mayo Clinic in February of 2016 was nerve-wracking. At that time, she didn’t know anything about mesothelioma, and she was anxious about what the doctors might tell her, says Sally’s granddaughter Jeannette Atkisson, who accompanied her grandmother and grandfather to the appointment.

“But I think after that first meeting, she’s been a lot more calm and feeling like everything is going to work out,” Jeannette says.

Part of Sally’s peace of mind came from her physicians keeping her informed about her care plan throughout the process.

“They were very open with me and explained thoroughly what was going on and what I had to do as far as the treatments,” Sally says.


“Hope Lodge gave us a chance to be right there, and we had a very good experience. It’s just one big family, with everybody helping each other.” — Sally Kirkvold


The proton beam sessions were 15-minute appointments, Monday through Friday, for five and a half weeks. Sally and her husband had travelled frequently to Phoenix to visit Jeannette and her family. But because they didn’t have a local address, they qualified for housing at Hope Lodge. An extended-stay residence for cancer patients undergoing treatments, Hope Lodge, is a component of the Village at Mayo Clinic and operated by the American Cancer Society.

“Hope Lodge gave us a chance to be right there, and we had a very good experience,” Sally says. “It’s just one big family, with everybody helping each other.”

They even met another couple at Hope Lodge who were from Alaska, living just a few miles from them in Fairbanks.

Although Sally says her first dose of her chemotherapy was “a doozy,” and she experienced slight burning from where the proton beams entered her skin, she was pleased with her care at Mayo Clinic overall.

“My husband and I keep saying that we’ve seen plenty of doctors and many nurses at Mayo Clinic, and we haven’t met anyone that we haven’t liked,” she says. “They are all really attentive.”

The way Sally has been received has prompted her to return to Mayo Clinic for her follow-up care, which will consist of quarterly visits for repeat scans to monitor for new cancer growth.

“Once we started down here, I just felt more comfortable,” she says. “They know what they’re doing.”

Having a reason to travel to the warmth of Arizona and visit her granddaughter makes those trips all the sweeter, she adds.


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Tue, Jul 11 11:00am · From Living on One Meal a Day to a Fellowship at Mayo Clinic

Bucking tradition and her mother's wishes, Salma Patel, M.D. traveled to the U.S. from Tanzania with just $500 to cover her college costs. Through hard work, resilience and determination, Dr. Patel became what she had dreamed of being: a physician who treats patients with kindness and humility.

Bucking tradition and her mother’s wishes, Salma Patel, M.D., traveled to the U.S. from Tanzania with just $500 to cover her college costs. Through hard work and determination, Dr. Patel became what she had dreamed of being. She shares her story here.


By Salma Patel, M.D.

I came to the U.S. in January 2002 to attend Luther College in Decorah, Iowa, when I was 16 years of age. It had been three years since my father passed away.

We were living in Dar-es-salaam, Tanzania. My widowed mother could not afford to raise me financially, and we went hungry many days. I began working after school to help support my household. Thankfully, we had a place to live. It also was easy for me to wear my older clothes on an ongoing basis, as I only lost weight with time, and we took great care of the little we had.

My mother wanted me to get married so as to ease the financial burden. The few marriage-related suitors I had met prior to leaving the country made it very clear — in a nice way — that marriage would mean quitting school and becoming a homemaker or helping with their family business. I was not ready to give up on my education and future. I would also be possibly financially abandoning my very poor mother if I did this.

I began to dream of becoming something more someday: a physician. I had skipped a few grades in high school due to good grades and tested out relatively well when it came to college entry requirements for the U.S.

The $500 in my pocket to pay for tuition, room and board was not easy to pull together. My mother, brother and sister looked into their own savings — which were practically nonexistent — and gave me as much as they could. We then begged all our relatives, friends, bosses and co-workers to contribute some money for my traveling and school expenses. Some would give 3,000 shillings (about $3) and others 50,000 shillings (about $50). This is how I ended up with the plane ticket and $500 for my remaining expenses in the U.S.


“The physicians here have always portrayed the ideal physician … where the best interests of the patients are the only interests considered — one who treats the patients with kindness and humility.” — Salma Patel, M.D.


I applied to colleges all over the world and went to the one that gave me the most financial aid. I was lucky that I ended up at Luther, which is such a good college. I worked about four jobs at a time most of the time while I was in school. I don’t know when I slept or studied. The jobs ranged from washing dishes in the college cafeteria and cleaning dorm rooms for custodial services to working as a nursing assistant at the local nursing home or an emergency room unit clerk at the local hospital.

At Luther, I was a nursing major working multiple jobs to make ends meet. I would eat once a day to save money for tuition. Without parental or family support, it was not an easy ride in a foreign land and a new culture.

I majored in nursing because I knew being a nurse could guarantee me a job upon graduation. I would still be caring for patients and in health care. It was imperative that I had a job after graduation, as I needed to continue to send money home to support my mother’s household.

The Luther College nursing program is affiliated with Mayo Clinic, and we moved to Rochester from Decorah for a year to rotate through the different subspecialties as nursing students. I knew I wanted to stay within the system, as the model of patient care here lined up well with my own beliefs. My exposure to the hospital, clinic and nursing home as a nursing student further reinforced my plans to eventually become a physician.


“I strive for academic and clinical excellence every day because of what I have seen here. I am thankful to Mayo Clinic for the inspiration and guidance.” — Salma Patel, M.D.


I was a nurse extern at Mayo Clinic’s Arizona campus in 2005. I had been touched by the people who worked at Mayo Clinic and knew that I wanted to work for Mayo Clinic once I was done with nursing school. As soon as I graduated from nursing school, I worked for Mayo as a critical care nurse in Arizona and then as a clinical research coordinator from January 2006 through June 2013. During this time, I also was taking premedical courses at Arizona State University and then in medical school from the summer of 2009 at the University of Arizona.

I graduated from the University of Arizona Medical School with an M.D.-M.P.H. and, in June 2013, transitioned from my role as a nurse to a resident physician on the Arizona campus. I am now completing my Sleep Medicine Fellowship at Mayo Clinic’s Rochester campus.

I have had many excellent mentors over the years at the Mayo Clinic in my premedical and medical years and wouldn’t be here today were it not for them. The staff and physicians at Mayo Clinic inspired me to pursue medicine. The physicians here have always portrayed the ideal physician that I would want to be where the best interests of the patients are the only interests considered — one who treats the patients with kindness and humility. My husband, Imran, family and friends also have been personal cheerleaders and supporters throughout the process.

I strive for academic and clinical excellence every day because of what I have seen here. I am thankful to Mayo Clinic for the inspiration and guidance. The facility and people here have grown to be my family.


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Wed, Jul 5 8:00am · A Sudden Detour for Heart Transplant, Then Back in Stride

When Yasmin Mullings found out she needed a heart transplant, she wasn't sure she could go through with it. But with support and encouragement from her Mayo Clinic care team, Yasmin successfully navigated the transplant. Today, with a healthy heart, she's back to her active life.

When Yasmin Mullings found out she needed a heart transplant, she wasn’t sure she could go through with it. But with support and encouragement from her Mayo Clinic care team, Yasmin successfully navigated the transplant. Today, with a healthy heart, she’s back to her active life.


In 2015, Yasmin Mullings was relishing a fast-paced life. In her role as a county prosecutor in St. Paul, Minnesota, she regularly handled complex and challenging cases. Outside of work, she was a marathon runner, exercise enthusiast, world-traveler and mentor to middle-school girls. Fit and healthy, Yasmin says medical concerns weren’t on her radar.

That changed dramatically in early 2016. Yasmin returned to running after a short hiatus, and instead of going her usual 10-plus miles, she couldn’t run even one. The incident was the beginning of a medical odyssey that, within six months, took her to from local care providers to Mayo Clinic’s Rochester campus and then to Mayo Clinic’s Arizona campus, where she ultimately received a heart transplant.

“The kindness, the compassion, the caring, the humanness of what the people at Mayo Clinic did for me throughout this process is something I didn’t expect,” Yasmin says. “Everyone — both in Rochester and Arizona — made me feel like they wanted to take care of me. They wanted me to be OK. They wanted me to be emotionally and physically ready and able to cope. They wanted to be part of it with me. These people could not have treated me any better if I was their own family member.”

A troubling decline

In December 2015, Yasmin began the first of three courtroom trials scheduled back-to-back. During that time, she was also training for a marathon to be held in June. By early February, as Yasmin began the third trial, her grueling schedule had taken its toll, and she was battling a severe cold. She took a few weeks off from running, finished the trial, and began to feel better. Yasmin got on her treadmill to restart her marathon training, but before she hit the one-mile mark, she was so short of breath, she had to stop.

“Before the cold, I had been feeling super healthy, running 17 or 18 miles on the weekends,” she says. “Then I couldn’t run a mile? I had no idea what was happening.”

Her local physicians were stumped, too. Within a month, Yasmin had five medical appointments, with no answers. Meanwhile, her health deteriorated. In early March, she stood up to make an argument in court and briefly lost consciousness. A trip to the emergency room didn’t reveal any clues. The providers there thought she might have a lung condition called pleurisy. But that wasn’t the case. She returned home without a solution.


“In the three days I spent at Mayo Clinic, I received more information and useful recommendations than anything I had previously.” — Yasmin Mullings


“That night, I couldn’t lie down to go to sleep,” Yasmin says. “I felt like I was drowning. I couldn’t catch my breath. I’ve had asthma since I was a child, but it’s been well-controlled for years. Some of the health care professionals said it must be that. I knew it wasn’t. I know what asthma feels like. This wasn’t the same.”

Yasmin went back to the local health care clinic the next day and saw a new physician. He suspected something different. He thought her symptoms could be the result of a heart problem and sent Yasmin to see a cardiologist.

An echocardiogram and other tests confirmed those suspicions. They revealed that a virus had infected Yasmin’s heart, damaging the middle layer of the heart wall, called the myocardium. That condition, known as viral myocarditis, affected her heart’s ability to pump blood and led to heart failure.

A grim situation

Heart failure sometimes can be managed with medication. But Yasmin’s symptoms continued to get worse despite taking a variety of medications. She was in and out of the hospital several times. Then a friend urged her to try a different tactic.

“She was at the hospital with me and said, ‘They don’t have any answers for you here, Yasmin. You’ve been here three times, and it’s not getting any better,'” Yasmin recalls. “Then she said, ‘I’m going to call Mayo Clinic to see if they can get you in.’ That’s what she did, and I got an appointment.”

In April 2016, Yasmin traveled to Rochester, Minnesota, for three days of tests and appointments. During that time, she met with John Schirger, M.D., in Mayo Clinic’s Division of Cardiovascular Diseases. He told her the tests confirmed the diagnosis of viral myocarditis. He also found that damage from the infection enlarged the chambers of her heart — a condition called dilated cardiomyopathy — and that was the underlying cause of Yasmin’s heart failure. After talking with Dr. Schirger, Yasmin finally felt as if she understood what she was facing.

“He clearly explained to me what was going on, so I knew how and why this was happening to me,” Yasmin says. “In the three days I spent at Mayo Clinic, I received more information and useful recommendations than anything I had previously.”


“I don’t believe for one second that anyone else could have convinced me that a transplant was the way to go. But they did. They were there with me, and I never felt like I was on my own.” — Yasmin Mullings


Yasmin also soon came to realize that her situation was much more serious than she had imagined. Her heart was in severe failure. In the weeks following her first Mayo Clinic visit, efforts to help it heal didn’t work, and she was admitted to Mayo Clinic Hospital — Rochester. In early June, Yasmin’s Mayo Clinic care team told her it was time to consider a transplant.

“When Dr. Schirger said the words ‘heart transplant,’ I can only imagine the look on my face. I was shocked,” she says. “I was 52 years old. I didn’t know of anyone who had an organ transplant of any kind. No one in my family ever had heart issues. I just kept thinking, ‘How is this possible?'”

At first, Yasmin says she was overwhelmed by the prospect of a transplant. Living alone with no family in the Midwest, she wasn’t sure she could handle going through the transplant process by herself. But she soon found out that her care team was ready and willing to support her.

“The doctors and nurses were so amazing to me. In the first rush of everything, I was bombarded with so much information. But every time the doctors met with me, one of the nurses would stay in the room, too, so I could ask them questions later if I needed to,” she says. “They would also get the doctors back if I had questions they couldn’t answer or if I felt uncomfortable or unsure about what we were doing.

“I don’t believe for one second that anyone else could have convinced me that a transplant was the way to go,” she adds. “But they did. They were there with me, and I never felt like I was on my own.”

A speedy and successful transplant

After being approved for a heart transplant and added to the waiting list, Yasmin learned that her wait in Minnesota would likely be six to 12 months. With her heart getting worse by the day, her care team feared that she didn’t have that long. So they offered another option. Yasmin could be transferred to Mayo Clinic’s Arizona campus, where her wait for a transplant would likely be shorter. Yasmin quickly agreed. Arrangements were promptly made, and within five days, she was in Arizona.

“I wasn’t worried about going to Arizona because it’s still Mayo Clinic. Different location, different people, but Mayo is Mayo,” she says. “Everyone in Arizona is just as fabulous as the people in Rochester.”

Her care team had been correct in their assessment of the wait time. Yasmin arrived in Arizona on a Thursday. She received her heart transplant the following Wednesday — July 20, 2016. Recovery went smoothly, and she was back home in St. Paul in less than three months.


“I wasn’t worried about going to Arizona because it’s still Mayo Clinic. Different location, different people, but Mayo is Mayo. Everyone in Arizona is just as fabulous as the people in Rochester.” — Yasmin Mullings


Yasmin still has regular checkups at Mayo Clinic and requires periodic heart biopsies to make sure her transplanted heart is healthy. But she feels great. Within three months of the transplant, with her care team’s encouragement, she was back to running. She’s now returned to working full-time, too, although not yet taking courtroom cases. And she’s started traveling again.

Reflecting on all she’s been through since that fateful day on the treadmill in February 2016, Yasmin says she most admires the level of personal care she received during her time at Mayo Clinic.

“I’ve been a prosecutor for 28 years. No matter what, I always want victims to know they are not just another case to me. So I don’t know why it so shocked me that was the experience I got at Mayo Clinic every step of the way. They cared about me as a person, an individual,” she says. “I cannot tell you of even one time in my Mayo Clinic experience that I said, ‘Oh, I don’t like the way I was treated.’  By anyone. It’s just something about the way they are. What they do there is so awesome.”


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