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10 hours ago · Surviving Cervical Cancer, Sharing Her Story

When Lena Spotleson sought treatment for unexplained stomach pain, the 26-year-old was shocked to learn she had late-stage cervical cancer. But the aggressive treatment Lena received at Mayo Clinic eliminated the cancer. Now, in an effort to help others, she's sharing her perspective on being a cancer survivor.

Lena Soptleson and Harshita Paripati, M.D.

When Lena Spotleson sought treatment for unexplained stomach pain, the 26-year-old was shocked to learn she had late-stage cervical cancer. But the aggressive treatment Lena received at Mayo Clinic eliminated the cancer. Now, in an effort to help others, she’s sharing her perspective on being a cancer survivor.


For a long time after Lena Spotleson was successfully treated for cancer, she didn’t want to talk about it. The treatment she received at Mayo Clinic in 2006 for advanced cervical cancer was intense and life-altering. When it was over, Lena — who was 26 at the time and newly married — put the painful episode behind her and moved on with life.

It wasn’t until years later when she found out someone she knew had been diagnosed with cancer that a light went on inside Lena and sparked a desire to help others walking the path she’d been down.

“I quit teaching and went to work for the American Cancer Society because I felt like I needed to give back,” Lena says. “It’s important for survivors to share their story, so other people living it are given that hope. They see somebody else survived what they are going through.”

From elite athlete to acutely ill

Before she was diagnosed with cancer, Lena — a lifelong basketball player and a high school basketball coach — was fit and athletic. Her annual physical and gynecological exams were routinely normal. But in November 2005, she began experiencing stomach pain and cramping. Each morning, Lena would wake with pain that lasted through the day.

When the pain started, she sought help from a number of medical specialists and received a series of tests, including MRI and endoscopy. But they didn’t find anything.

“I was teaching and getting my master’s degree,” Lena says. “My husband and I had just gotten married a month before, and they thought it was stress.”

Lena’s search for answers led her to her gynecologist’s office. An exam there revealed a mass, which was biopsied. When the biopsy yielded no answers, Lena’s gynecologist referred her to Mayo Clinic’s Arizona campus.


“The cancer has a long time to grow before it is picked up. When this one is picked up, it is usually very advanced.”

Javier Magrina, M.D.

Lena’s Mayo Clinic care team recommended she undergo a procedure to remove abnormal cells from the cervix, called a cervical loop electrode excision. Lena had the procedure, and the results were sent to Javier Magrina, M.D., in the Department of Obstetrics and Gynecology.

When Lena met Dr. Magrina, he told her the stunning news that she had late-stage cervical cancer. It had gone unnoticed because, unlike most cervical cancers that grow on the surface of the cervix and are easily detectable, Lena’s cancer started growing from inside her cervix.

“Because this type of cancer grows inside, it takes much longer to diagnose,” Dr. Magrina says. “The cancer has a long time to grow before it is picked up. When this one is picked up, it is usually very advanced.”

Not only had cancer invaded Lena’s cervix, it had spread to her uterus, left ovary, pelvic lymph nodes, gallbladder and appendix.

“For most of the patients that have this advanced cancer, the likelihood of them dying is greater than the likelihood of living,” Dr. Magrina says. “She is in the small group of women that will live.”

Intense intervention, critical care

Due to its advanced state, Lena’s cancer required a three-pronged treatment plan: surgery, chemotherapy and radiation therapy. On Aug. 16, 2006, Dr. Magrina performed a 6½-hour radical hysterectomy and removed Lena’s diseased organs and lymph nodes. When the cancerous tissue was gone, Lena received internal radiation to target any cancer cells that may have been left behind in her pelvis and abdomen.

After Lena recovered from surgery, Harshita Paripati, M.D., in Medical Oncology, and Sujay Vora, M.D., in Radiation Oncology began overseeing her treatment. “We went with an intense chemotherapy and radiation plan,” Lena says. “I essentially had both of them at the same time, figuring that I could handle it because I was young, and I was in fairly decent shape.”

In addition to her medical doctors, a mental health professional was part of Lena’s care team. “My counselor and I talked about how I was feeling, how my treatment was going,” Lena says. “She not only listened for my emotions, but if she thought I could benefit from mediation, for instance, she would talk to the doctor about it.”

Lena began chemotherapy and radiation treatments a few weeks after surgery. Her chemotherapy infusions were administered every three weeks. The first two went off without major complications. But in early December 2016, following the third dose, Lena started to feel ill. She developed a fever and began to vomit.

Lena’s sister drove her to Mayo Clinic Hospital in Arizona where Lena was given IV fluids. Chi-Hui Chang Fox, a nurse who had cared for Lena in the past, was working when Lena came in. She recognized that the symptoms were not normal for Lena. She contacted the on-call physician and voiced concern about Lena’s condition. The team decided to do a blood test. After that, Lena went home.

The next morning, Lena was feeling better when the phone rang. The blood test had come back positive for E.coli bacteria. She needed to get back to the hospital right away.

“When I got into hospital room, my heart started to hurt,” Lena says. “My nurse got the EKG machine on and put the stickers on my chest. She put the blood pressure cuff on. Lying on the bed, I saw that my blood pressure was 40 over 20. And then I blacked out.”

Remarkable improvement signals cure

When Lena woke up, she was in the ICU. She was told she had acquired a urinary tract infection that moved into her blood. While she was in the ICU, Lena required a breathing tube. She also was sedated to allow her body to respond to the high-dose antibiotics she needed to fight off the infection.

“The night they intubated me, they told my husband that it didn’t look good,” Lena says. “All my family and friends came down to the hospital. I don’t know if they thought I would make it through the night.”

But three days later, Lena began to come out of sedation and surprised her medical team by trying to communicate. Later that day, she was transferred out of ICU. Lena’s care plan called for her to receive another round of chemotherapy. Because of her weakened state after being hospitalized, however, the team decided against administering the final round.

In early January 2007, Lena received her first scan following treatment. It came back clear. Three months later, another scan showed no signs of cancer. The same went for the scan Lena received at six months, nine months and a year after treatment. Every scan since then has come back negative.


“I’ve been sharing my story with anybody that needs to hear it. If it helps one person, that’s all that matters.”

Lena Spotleson

“It was a very difficult case, and we knew it was a difficult case,” Lena says. “But it was never voiced that I wasn’t going to live. Dr. Paripati was very hopeful throughout the whole situation and very optimistic about the plan working.”

After her treatment ended, Lena was referred to a Mayo cancer survivors clinic where a team helped manage her care and assisted her as she navigated her journey through survivorship. Since then, Lena has thrived. Now, more than a decade after her diagnosis and treatment, she travels the country speaking to others affected by cancer. She offers her perspective on a disease that doesn’t discriminate.

“A lot of times when people hear survivors speak, they are mostly older adults, and it’s difficult to put a younger face to it,” Lena says. “I’ve been sharing my story with anybody that needs to hear it. If it helps one person, that’s all that matters.”

To Dr. Paripati, the outcome of Lena’s medical journey is truly remarkable. “Lena’s outlook and what she’s done to raise awareness is amazing,” she says. “This is one of the reasons I went into oncology. She is such a success story.”


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2 days ago · Heart Transplant Helps Elise Campbell Reach New Heights

A lifesaving heart transplant at Mayo Clinic helped Elise Campbell break free from the physical limitations of a rare genetic heart condition she had lived with since she was 14. Now Elise is relishing the opportunity to enjoy experiences she never thought possible.

A lifesaving heart transplant at Mayo Clinic helped Elise Campbell break free from the physical limitations of a rare genetic heart condition she had lived with since she was 14. Now Elise is relishing the opportunity to enjoy experiences she never thought possible.


Elise Campbell was 14 when doctors in her home state of Iowa told her there was something wrong with her heart. But they weren’t sure what it was.

“One of them finally said, ‘We don’t really know what you have, but we do know you have a pretty rare heart condition,” Elise says. It would be another 13 years, however, before Elise would get a diagnosis. “Finally, they said, ‘We’re going to send you to Mayo Clinic because they’re going to really be able to evaluate you and find out exactly what it is that you have,'” she recalls.

When Elise and her family drove north to Mayo Clinic’s Rochester campus, a team of medical professionals was ready to do just that. “They did a complete workup on me,” Elise says. “Through that, they determined I had left ventricular noncompaction cardiomyopathy, which — as my doctors in Iowa had said — is a pretty rare genetic heart condition.”

The news wasn’t easy for the 27-year-old to process. But with her family at her side and the support of her Mayo Clinic care team, Elise received the education and treatment plan she needed to return home and continue living her life. Several years later, though, the situation changed. After dealing with a stroke and battling ongoing fatigue, Elise learned her heart was giving out. She needed a transplant.

Although the process took some time, Elise eventually received that heart transplant. Since then, her world has opened to a host of new activities and adventures, including yoga, biking and hiking.

“Because I could never do it before, it’s more exciting to do all of this stuff now,” Elise says. “I never thought I was going to be able to do anything like this in my life.”

Welcome news

Elise’s path to a heart transplant began in 2010 when she was home alone one day, and she noticed an odd feeling. “I looked down, and my left hand was dragging across the table,” she says. “I thought, ‘That’s kind of weird.’ Thankfully, it only lasted about two minutes before I came out of it.”

The episode turned out to be a stroke. Elise and her family went back to Mayo Clinic. “They put me on blood thinners and implanted a defibrillator as a precaution,” Elise says. “After that, it was just more monitoring.”

When Elise’s husband was transferred to Phoenix for work in 2011, she worried about the future of that monitoring. Those worries eased when the couple learned about Mayo Clinic’s Arizona campus.

“The Arizona campus was actually a closer drive for me than it was from Iowa to Rochester, which was quite a blessing because, although I didn’t know it at the time, I was in the early stages of heart failure,” Elise says.


“When my care team told me I needed a heart transplant, I was like: ‘Oh, thank goodness. At least we now know what’s causing all of this.'”

Elise Campbell

Her body did know it, however, and had been sending her warning signs. “I was feeling more and more tired and just didn’t have a lot of energy,” Elise says. “But I always thought I’d feel better in a few days or the following week.”

When that didn’t happen, her care team in Cardiovascular Medicine intervened. “Dr. Robert Scott brought me in and said, ‘We need to figure out what’s going on,'” Elise says. “So he did more testing and determined I needed a heart transplant, which actually made a lot of sense.”

For Elise, who’d been living with the side effects and complications of a failing heart for so long, the news was a welcome explanation for what was going on inside of her.

“It was actually a relief because I was 32 at the time and just wondering why I was always so tired,” she says. “When my care team told me I needed a heart transplant, I was like: ‘Oh, thank goodness. At least we now know what’s causing all of this.'”

Waiting game

With a cause identified, it was time to start working toward a solution. “I had a wonderful team of doctors and nurses who guided me through the transplant evaluation process,” Elise says.

Initially, Elise was able to remain at home as she waited for a transplant. That changed when her heart function fell to less than 10 percent. “At that point, my care team told me I needed to stay in the hospital while I waited for my heart,” she says.

For the next three months, that’s what she did. “Thankfully, I had a great group of nurses who were about the same age as me, and so that really made my stay easier,” Elise says.

Her parents, recently retired, also had moved to Arizona and often spent time with Elise at the hospital. Elise’s husband came to see her each evening after work.

“I never wanted to complain because I was actually very lucky. I was at one of the best heart transplant hospitals in the world — if not the best — and I had all of these doctors and nurses who I enjoyed hanging out with and having fun with. And I had my husband and my parents there with me, too.”


“I had a wonderful team of doctors and nurses who guided me through the transplant evaluation process.”

Elise Campbell

Even amid all the support, though, there were times when doubt and despair would creep in — as they did one summer evening in July 2014. “My husband was there with me, and we were having a game night,” she says. “It was a Friday night, and when he got up to leave, I just started thinking that this wasn’t fair. We should be out having fun on a Friday night rather than sitting in a hospital room together. I was just feeling down on myself at the time.”

Her mood quickly changed when Elise heard the medical transport helicopter at the hospital’s helipad outside her window. “Right at that moment, I heard the helicopter landing,” she says. “I thought, ‘Here I am complaining, and here’s someone who’s coming in who’s obviously much sicker than I am.’ So I got over my self-pity and said a little prayer for them and for me. I said, ‘Whenever God is ready to send me my new heart, he’ll send it.’ I actually said that out loud.”

Thirty seconds later, cardiologist D. Eric Steidley, M.D., knocked on Elise’s door. “He came in and said, ‘We have a heart for you,'” Elise says. “The whole timing of it all was just so crazy.”

Elise immediately called her husband. “I told him to turn around and come back to the hospital because we had some good news,” she says. “I called my parents, and they came over, too. It was a very emotional time for all of us.”

New heart, new adventures

Elise’s care team wasted no time. The transplant was scheduled for the following day. Mayo Clinic surgeon Octavio Pajaro, M.D., Ph.D., performed Elise’s heart transplant, and everything went well. Elise says waking up after surgery and feeling her new heart beating inside of her was an experience she won’t forget.

“The first thing I noticed after waking up was this big, thundering ‘boom, boom, boom’ in my chest,” Elise says. “I was used to a heart that was very weak and to now have one that was actually efficiently pumping blood was crazy because I could feel it and hear it. My hands and feet were also warm, and that was something else I wasn’t used to.”

Another new sensation Elise was happy to get used to involved her leg muscles giving out before her heart did during the many rounds of physical therapy and rehabilitation her care team directed her to do after her transplant.

“Once I got out of the intensive care unit, they wanted me to start walking laps, and for the first time in many, many years, it was my leg muscles that got tired before my heart did,” she says. “My new heart was ready to go. My leg muscles weren’t, but my new heart was.”


“Seeing all of these new places in the world that I thought I’d only ever be able to see in pictures has been amazing.”

Elise Campbell

Once she left Mayo Clinic, Elise says wrapping her mind around her new reality took time. “The physical benefits of my new heart came easily to me,” she says. “It was the mental part that took some work — telling myself it was now OK for me to exercise, to run, to do yoga. My husband had to reassure me that it was OK for me to sweat during exercise because that’s what normal people do. But I’d always associated sweating with getting dizzy, and that I was about to faint or something.”

With the help of her husband and newfound friends in Mayo Clinic’s heart transplant support group, Elise began to realize she didn’t have to worry anymore.

“One of the most memorable things someone told me was that as good as you feel one year post-transplant, you’ll feel twice as good two years out,” Elise says. “Then every year after that, you just start to feel more and more normal as you begin to transition out of that patient mentality and into being a regular person again.”

Once Elise began to make that transition, she realized that many of the things in life she never thought she’d be able to do were now available for her to try.

“My husband and I really enjoy the outdoors, and we’ve now made that our priority,” she says. “We’ve hiked Angel’s Landing in Zion National Park — where you’re holding on to chains as you’re climbing up the switchbacks of the mountain — and we’ve also hiked in Canada, in Montana, and we’re going to Yellowstone National Park this summer, as well. Seeing all of these new places in the world that I thought I’d only ever be able to see in pictures has been amazing.”

Elise says it’s all thanks to her care team at Mayo Clinic, to her family and to her donor — whose mother Elise had a chance to meet and personally thank.

“To say that was emotional would be an understatement,” Elise says. “It was a very special moment. The best thing about it was her mom said if her daughter and I had known each other, we likely would have been very good friends because we liked to do a lot of the same things. She said she loves to see me out hiking and biking, and doing other things outdoors now because her daughter loved doing those same things, too. And it’s because of her daughter, and the decision she made to become an organ donor, that I’m now able to.”


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4 days ago · Navigating Breast Cancer With Support and Strength

Brenda Braatz has been dealing with breast cancer since 2013. Although the diagnosis and its treatment haven't been easy, Brenda is thankful for the expert care, compassion and encouragement she's received from her Mayo team.

Brenda Braatz has been dealing with breast cancer since 2013. Although the diagnosis and its treatment haven’t been easy, Brenda is thankful for the expert care, compassion and encouragement she’s received from her Mayo team.


On Jan. 4, 2013, Brenda Braatz stepped on a roller coaster and didn’t get off for five years. At least that’s how it felt on that cold winter day, when Brenda — then 49 — was diagnosed with breast cancer. Testing revealed the cancer was estrogen receptor positive and HER2-negative, and it had spread to her lymph nodes and breast skin.

“It was overwhelming,” the Sparta, Wisconsin, resident says of coping with the news and the treatment that followed.

Fortunately, Brenda wasn’t alone on her journey. Her husband, Mark, was beside her. And Brenda says there was another group supporting her every step of the way: the doctors, nurses and other care providers in the Cancer Center at Mayo Clinic Health System — Franciscan Healthcare in La Crosse, Wisconsin. “They were my strength,” she says. “They became like family.”

Tackling treatment

Soon after her diagnosis, Brenda met with Paula Gill, M.D., a hematologist-oncologist, to discuss a treatment plan. The plan began with two rounds of chemotherapy. When follow-up imaging showed that the medication had failed to shrink the tumor in Brenda’s left breast, she decided to have a mastectomy. Surgeon M. Kathleen Christian, M.D., had talked with Brenda at an earlier appointment about the types of surgery and reconstruction available to her.

“When I was first diagnosed, Dr. Christian and her nurse talked to me about my surgery options,” Brenda says. After reviewing her choices, Brenda chose to have a skin-sparing procedure. This newer technique can preserve breast skin and allow for a more natural breast appearance following the procedure.


“When I would see [the Cancer Center staff], I felt rejuvenation and hope.”

Brenda Braatz

The day of Brenda’s surgery, Dr. Christian removed the tissue, nipple and areola from Brenda’s left breast. Then Matthew Sherrill, M.D., a plastic and reconstructive surgeon, placed a temporary expander under Brenda’s skin to make space for the implant that eventually would replace her breast tissue.

When Brenda healed from surgery, she began another round of chemotherapy. When that treatment was finished, she started seven weeks of daily radiation therapy. Brenda remembers that as an exhausting, stressful time. “Radiation was taxing for me,” she says. “It wore me out.”

Caring for body and spirit

During those difficult days, Brenda says she drew strength from Cancer Center staff. “When I would see them, I felt rejuvenation and hope,” she says. “I felt like they were protecting me and giving me life. They made me feel I could do treatment just one more time. They’re just amazing people.”

Despite the challenges of treatment, Brenda continued to work 40-60 hours a week as a manager at a local restaurant. Her work became another source of strength.

“I felt like I needed to get out, and not stay home and stress and dwell on things,” she says. “I only missed one day of work throughout my treatment. I couldn’t have done it if the company wasn’t so flexible and wonderful.”

While Brenda was receiving treatment, another member of her family also was diagnosed with breast cancer. That prompted Brenda to undergo genetic testing at Mayo Clinic’s Rochester campus to learn if she had any gene mutations that might have contributed to her cancer.

“It was a scary decision to make,” she says. “You really have to think before you do genetic testing because you have to decide if you’re going to do anything based on the results.” When she received her results, Brenda learned that she had the CHEK2 mutation, which put her at higher risk of developing breast cancer again. Based on those results, she decided to have a second mastectomy.


“[The staff] gave me so many things: strength, love, courage. I would have never made it through without those people. They are my angels.”

Brenda Braatz

“I’d already had a lot of lump scares in my right breast,” Brenda says. Although none were cancerous, she was ready to have the breast removed. She again turned to Drs. Christian and Sherrill for the procedure and reconstruction.

When Brenda healed, she made another decision, electing to have 3D nipple and areola tattooing. The procedure uses tattoo needles to create realistic-looking nipples.

“After my mastectomies, all I saw when I looked in the mirror was a big line through my chest,” Brenda says. Initially, that didn’t bother her. But after she’d healed completely from surgery, she began to feel differently. “I’m very glad I did it and would recommend tattooing to any breast cancer survivor who wants to get their body back,” Brenda says. “I will always have scars, but they’re not the first thing I see any more when I look in the mirror.”

Moving ahead in gratitude

Today Brenda’s journey continues. She still has treatments ahead of her, and she lives with side effects from treatment, including tingling in her fingers and tongue. But that’s not what Brenda chooses to focus on.

Instead, she focuses on celebrating life. Brenda retired in 2018, and soon after, she and Mark embarked on an extended vacation. Among the highlights of their trip: visiting national parks in Canada and Alaska, where Brenda enjoyed close encounters with grizzly bears, buffalo, wolves and whales. “We made a list of animals we wanted to see, and we’ve seen them all — most of them with babies,” Brenda says. They also visited family, including their son in Washington and grandchildren in California.

Before she left on the trip, Brenda stopped by the Cancer Center to drop off a gift: a handmade card thanking the staff for her care. It’s something she’d worked on for months, trying to find just the right words to show her gratitude.

“I scribbled things down on a notepad every time I thought of something I wanted to say,” Brenda says. “But you can’t fit it all into words. They gave me so many things: strength, love, courage. I would have never made it through without those people. They are my angels.”

Note: A version of this story previously was published in Hometown Health.


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Fri, Mar 15 7:48am · Less Is More: Losing Weight, Gaining Perspective

A lifetime of food addiction resulted in Jessica Erickson's weight becoming unmanageable. When she looked for medical help, she found a Mayo Clinic team that offered her the care and support she needed to become a smaller, healthier version of herself.

A lifetime of food addiction resulted in Jessica Erickson’s weight becoming unmanageable. When she looked for medical help, she found a Mayo Clinic team that offered her the care and support she needed to become a smaller, healthier version of herself.


When Jessica Erickson walks up the stairs these days, the only thing she worries about is whether her fitness tracker accurately records all the flights she climbs. It’s a dramatic shift from three years ago when Jessica weighed more than 400 pounds and couldn’t climb one flight of stairs, much less the 12 she now strives for each day.

After an innovative bariatric surgery at Mayo Clinic in October 2016, Jessica lost more than half her body weight. She now weighs about 168 pounds. But getting to a point where she could achieve that success took a long time. Jessica resisted weight-loss surgery and put it off for years.

“There is a stigma attached to patients who’ve had bariatric surgery — that it’s the easy way out,” Jessica says.

It wasn’t until Jessica accepted that the surgery was treatment to manage a medical condition that she agreed to the seldom-performed operation known as a biliopancreatic diversion with duodenal switch.

“Bariatric surgery is never a shortcut,” says Jessica, who lives in Red Wing, Minnesota. “It’s a tool that you’re given that will help you in the process. That’s all it is. Bariatric surgery provides you with a tool.”

Encouraged by a multidisciplinary Mayo care team who supported her through her weight loss, Jessica has lost and kept off 250 pounds for nearly two years.

“Weight is no longer a number for me. It’s more about being healthy, and being able to move around and do the things I want to do,” Jessica says. “I know, without a doubt, that if I remain healthy, I’ve got a longer life than I would have before. I honestly believe that these doctors saved my life.”

Reaching out for help

Jessica battled obesity her entire life. She tried dozens of weight-loss strategies. On three separate occasions, she lost and gained back 150 pounds. But it wasn’t until her weight began preventing her from interacting with others that Jessica decided she needed help.

“I’m a very social person,” she says. “I love talking, and I was noticing — particularly at my son’s basketball tournaments — that I was always waiting and looking for a place to sit, and not looking at my son’s games.”

During one game, Jessica had an epiphany. “I thought, ‘Is this what I want to do — spend the rest of my life looking for a place to sit down and not engaging with people around me?'”


“At the appointment, [Dr. Radtke] asked me why I was there, and I said, ‘I have to do something, or I’m going to die.'”

Jessica Erickson

After that, Jessica met with Jennifer Radtke, M.D., a primary care physician at Mayo Clinic Health System in Red Wing. “At the appointment, she asked me why I was there, and I said, ‘I have to do something, or I’m going to die,'” Jessica recalls.

Dr. Radtke agreed that Jessica’s weight posed a serious risk to her health. She recommended Jessica visit a specialist at Mayo Clinic’s Rochester campus for targeted weight-loss therapy.

In Mayo Clinic’s Department of Endocrinology, Jessica met Kurt Kennel, M.D. During their first meeting, Jessica learned she was too heavy to qualify for a sleeve gastrectomy. Sleeve gatrectomies, which accounted for 60 percent of all bariatric procedures performed in the U.S. in 2017, can help patients lose approximately 50 percent of their excess body weight, Dr. Kennel says.

“For Jessica, even if she lost half of her extra weight, she would still have been overweight,” Dr. Kennel says.

With a duodenal switch procedure, patients can lose 70 to 80 percent of their excess weight, Dr. Kennel explains. “The switch has always been specialized for certain situations, and typically those are very heavy patients,” he says.

During the operation, a patient’s stomach is refashioned into a small tube. In addition, a patient’s digestive structures are rearranged, so digestive bile from the pancreas doesn’t encounter food in the small intestine until the end of the tract. As a result, only a small percent of what a patient eats is absorbed.

Learning she’d require more extreme measures to achieve her goal gave Jessica pause. “I agreed that we would start the 12 weeks of classes required before the surgery, and halfway through it, I would decide,” she says.

Changing diet and mindset

In May 2016, when Jessica began the behavioral health education course required before surgery, she altered her diet to better align with the diet she’d need after surgery. She began by reducing carbohydrates — first making small changes and then larger ones.

“I focused on a style of eating better,” she says. “I cut back on calories to under 1,000 a day, which is the where I’d need to be if I went through the procedure.”

In addition to a change in diet, Jessica began exercising. “I started by walking around the block,” she says. “I would go one length and have to stop and rest. I had no strength and endurance. I started doing anything I could do to get in any exercise, even if it was just doing arm circles at the table — anything I could do to try to increase my caloric burn.”

By the time Jessica was near the end of her 12-week course, she’d lost 75 pounds. “I was at the point to where people were saying, ‘If you’ve lost that much, you really don’t need to have surgery,'” Jessica says. “But it was at that point I was starting to stumble. That’s when you start cheating, deciding you don’t need to exercise that day.”

Jessica had two moments of clarity that convinced her to continue toward surgery. The first was when she noticed she could stand for longer than five minutes. “The second one was a week and a half before my surgery when I realized that I was going to gain that 75 pounds back if I didn’t have the surgery,” Jessica says. “It was given. I was going down the same path as before, and it was in that realization that I knew I’d made the right decision.”

Shifting weight and outlook

Mayo Clinic surgeon Michael Kendrick, M.D., performed the two-phase procedure on Jessica on Oct.18, 2016. The first few weeks after her operation, the weight lost was mainly surgery-acquired water weight. Around Christmas, Jessica’s new anatomy began working for her, and she started shedding pounds.

Some weeks she lost three pounds. Other weeks, she lost six. Over the course of a month, 20 pounds might come off. Jessica, who is 5 feet, 8 inches tall, set her goal weight at 185 pounds. In August 2017 — a month she lost 16 pounds — it became clear Jessica needed to slow her weight loss. Jessica began to incorporate more fruit and the occasional sweet treat into her diet. In September, she lost eight pounds. By the October anniversary of her surgery, she was at her goal weight. Since reaching her goal weight, Jessica has increased her daily caloric intake to about 2,000.

Although Jessica had lost nearly 250 pounds of fat, she continued to struggle with the effects of her obesity. In spring 2018, she had surgery, performed by Mayo Clinic plastic surgeon Basel Sharaf, M.D., D.D.S., to remove excess skin from her abdomen and breasts. An additional surgery to remove excess skin under her arms is planned, as well.


“This whole process is about healing me, making me healthier and making me more of the person who I am.”

Jessica Erickson

For most patients undergoing this transformation, plastic surgery is an important part of the process, Dr. Sharaf says. “The excess skin can have implications for their health, due to skin infections or interference with their activities of daily living, exercising and staying healthy.”

What’s more, the negative body image held by many patients after weight-loss surgery can have psychological implications on their overall well-being. Improving that self-image is an integral component of the patient’s journey to physical and mental health, Dr. Sharaf adds.

“This whole process is about healing me, making me healthier and making me more of the person who I am,” Jessica says. “Dr. Sharaf is helping me become the ‘me’ that I’ve been waiting for years to be.”

Realizing goals and reaping rewards

Despite reaching her goal weight, Jessica still has moments when she loses touch with her current appearance. “When you lose a lot of weight, it’s hard to really understand where you are in size in relation to the rest of the world,” Jessica says. “Body dysmorphia is when you brain doesn’t allow you to see how you really are. My brain has not completely adjusted, but I am much better than I was.”

From the start of her process, it was clear to Dr. Kennel that Jessica was fully committed to losing the weight.

“She was a person who had a goal in mind and very much wanted to do it the right way,” he says. “She was fully embracing the process — and it can be a long process. Even before surgery, she was showing herself to be capable and committed, and doing things that make you think, ‘Yeah, this person is probably going to do very well.'”

In addition to being lighter, Jessica’s weight loss has resulted in the resolution of weight-related health issues such as high blood pressure, high cholesterol and high blood sugar. Jessica’s sleep apnea also disappeared.

The appreciation Jessica has for the medical team that supported and facilitated her new appearance, good health and fresh outlook cannot be overstated, she says.

“Never did I feel in any way like I was being judged in a harsh way,” Jessica says. “They have always been there to answer questions and be helpful, and encourage and point me in the right direction. It’s such an inspiration for me to see them changing people’s lives. Not just mine, but so many people out there. I’m just incredibly grateful for everyone out there.”


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Wed, Mar 13 5:00am · Liver Transplant Puts Pam Stubbs Back in the Saddle

Pam Stubbs hadn't felt well in years. But now, thanks to a successful liver transplant at Mayo Clinic, Pam feels better than ever, and she's channeling newfound energy into her passion for horseback riding.

Pam Stubbs hadn’t felt well in years. But now, thanks to a successful liver transplant at Mayo Clinic, Pam feels better than ever, and she’s channeling newfound energy into her passion for horseback riding.


Pam Stubbs had felt so bad for so long that she’d forgotten what it was like to feel good. Initially chalking up bothersome symptoms to an ongoing push to expand her real estate career in Scottsdale, Arizona, Pam’s health issues came to head in late 2015.

“It was around the holidays, and I just wasn’t feeling well,” she says. “I was really tired. But I thought it was because I was getting older, so I didn’t think it was a big deal.”

But when Pam also started getting short of breath, she began to worry there was something seriously wrong with her heart. She decided to see a cardiologist. “He did a scan of my heart, an ultrasound, and he said, ‘Your heart is fine,'” Pam says.

There was another problem, however. “The ultrasound caught the top of my liver, and the cardiologist said, ‘While your heart is fine, I do see a spot on your liver,'” she says. “He didn’t know what it was exactly, so he told me to see a gastroenterologist.”

That’s what Pam did, and what that gastroenterologist told her is something she never saw coming. “They did another CT scan, MRI, and blood work, and they discovered my liver was cirrhotic,” Pam says. “And I said: ‘I don’t even drink. I’ve never had hepatitis, so how can that be?'”

Pam’s gastroenterology team went on to tell her it’s likely she’d been born with an inherited disease called alpha-1-antitrypsin deficiency, and it had been slowly destroying her liver. When she heard that, Pam began thinking back to several family members she’d lost to liver failure. Not wanting to suffer the same fate, she turned her attention toward treatment. At first, Pam thought perhaps medication would be enough. That’s when her gastroenterologist delivered more unexpected news: Pam needed a liver transplant.

She was dumbfounded: “I thought: ‘That’s impossible. How am I going to do that?'”

Finding answers, building confidence

Before Pam’s health troubles began, one of her passions in life was riding horses. After her diagnosis, it was during a ride with a friend that Pam began to see a way forward to the transplant she needed. Her friend knew Bashar Aqel, M.D., a Mayo Clinic transplant hepatologist. The friend connected the two.

“Dr. Aqel was nice enough to talk with me, and he said, ‘Here’s who you need to talk to, and here’s what you need to do,'” Pam says.

Following Dr. Aqel’s advice, Pam called the Transplant Center at Mayo Clinic’s Arizona campus. What happened next, Pam says, was nothing short of fantastic.

“They scheduled an appointment for me, and I went over there and said: ‘I don’t care if I’m here all day long. I want whatever tests I need done. I want to get on the transplant list as soon as possible,'” Pam says. “They got all of the testing I needed in order to qualify for a transplant done within three weeks. I was officially on the transplant list by April 15. Everything happened really quickly.”


“Everyone was so positive from start to finish. I wasn’t worried about a thing.”

Pam Stubbs

With her name added to the national transplant waiting list, Pam’s next concern was to get her body ready. For help with that, she turned to her transplant surgeon, and chair of Transplant Surgery, Adyr Moss, M.D. “We hit it off right away,” Pam says of Dr. Moss. “He told me as I prepared for the transplant to work out like I was training for a marathon — to get as physically fit as I possibly could.”

So that’s what she did, hiring a personal trainer and working out three times a week. In addition to getting her body ready for the transplant, Pam also prepared her mind by joining a support group through Mayo Clinic that connected her with other liver transplant patients.

“We met once a week, and that was also a great help to me,” she says. “The support group made me feel so safe and so confident about what was to come.”

Pam also credits Dr. Moss and the rest of her care team at Mayo Clinic for helping her feel good about the transplant.

“Everyone was so positive from start to finish,” she says. “I wasn’t worried about a thing. I knew I was going to be fine and that I was in the best hands possible because my care team never gave me a reason to feel otherwise.”

Because of that, when Mayo Clinic called Pam on July 1, 2016, to tell her a liver was available for her transplant, Pam says she knew the procedure would go smoothly.

“I was so confident, in fact, that when the hospital chaplain came in to my room before the transplant and asked if I wanted to talk or pray about anything, I said, ‘No, I’m good,'” she says. “Thanks to the confidence and comfort my care team had instilled in me, I was ready.”

Feeling great, riding high

Pam’s confidence was well-founded. Dr. Moss successfully transplanted her new liver, and her recovery went smoothly. After that, Pam set her sights on another goal: returning to her lifelong love of competitive horseback riding.

“I couldn’t wait to get back home and start looking for a new horse,” she says. “I had my transplant on July 1, and I was back riding that September. I found my new horse in October.”

Since then, Pam and her growing stable of horses have done quite well together. She won two world championships at the 2017 American Quarter Horse Association World Show and another three world championships, along with a reserve world championship, at the 2018 World Show.


“I feel like an entirely new person right now. It’s unbelievable.”

Pam Stubbs

“All of that’s because I feel fantastic right now. I feel like a new person,” Pam says. “I think I was so sick for such a long time that I’d forgotten what it felt like to be healthy. But all of that changed within just a few days of my transplant. I feel like an entirely new person right now. It’s unbelievable.”

Pam readily acknowledges that her newfound health is not only thanks to Drs. Aqel and Moss and the rest of her care team at Mayo Clinic, but also to all those who make the choice to become organ donors. “Thank God for them because they help save so many lives,” she says. “It’s an incredible gift they’re giving to others like me.”


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Mon, Mar 11 8:39am · Pancreas Transplant Frees Mary Shelley From the Grip of Diabetes

Mary Shelley struggled for years to control her erratic blood sugar levels, which affected every aspect of her life. A pancreas transplant in 2018 helped her overcome many of the symptoms and side effects of diabetes, and it has allowed her to experience life in ways she never thought possible.

Mary Shelley struggled for years to control her erratic blood sugar levels, which affected every aspect of her life. A pancreas transplant in 2018 helped her overcome many of the symptoms and side effects of diabetes, and it has allowed her to experience life in ways she never thought possible.


When Mary Shelley was 1½ years old, Mayo Clinic helped save her life. She was in a coma in a Miami hospital, and her doctors reached out to a pediatric endocrinologist at Mayo Clinic for help.

“Whatever information they provided allowed me to be here today,” says the medical coder, who ended up getting a job at Mayo Clinic’s Florida campus in 1996.

Mary was diagnosed with Type 1 diabetes, a chronic condition in which the pancreas produces little or no insulin. The hormone is needed to deliver sugar — also called glucose — to the body’s cells, so they can produce energy. To control her diabetes, Mary used an insulin pump for 36 years, and she diligently worked to manage her blood sugar through her diet.

“The pump was a wonderful asset to my life. But after decades of having it attached to my arms, legs and abdomen, I ended up with lots of scar tissue under my skin,” Mary says. “There were only so many places on my body left to attach it and absorb the insulin.”

As the years went on, Mary’s blood sugar levels became harder to control, and it was taking a significant toll on her health and her life. In 2017, Mary’s Mayo Clinic care team suggested she consider another option: a pancreas transplant. That was the solution Mary needed. Since the transplant in 2018, Mary has enjoyed activities and adventures she never dreamed of participating in before.

“Thanks to Mayo, I have a whole chance,” she says. “I’m so grateful to work here. My life made the full circle.”

Daily struggles

When Mary’s blood sugar began to be more unpredictable and difficult to manage, it affected almost every aspect of her life, even small daily tasks.

“There were times when I would have confusion and just blank out because my blood sugar was so erratic,” Mary says. “One day, I was in the checkout line at the grocery store, and when I took out my checkbook, I couldn’t remember my name or how to spell it.”

Mary had developed a condition known as hypoglycemia unawareness. It happens when the body and brain no longer produce signs and symptoms that warn of low blood sugar, such as shakiness or irregular heartbeats. The disorder increases the risk of severe, life-threatening hypoglycemia — a condition caused by extremely low blood sugar.


“There were times when I would have confusion and just blank out because my blood sugar was so erratic.”

Mary Shelley

Mary tried to cope as best she could. Before leaving work each day, for example, she would make sure to check her glucose levels in the parking lot to avoid getting into an accident during her 45-minute drive home.

On top of her other concerns, Mary also had painful gastroparesis. The condition, which can be triggered by diabetes, affects the movement of the muscles in the stomach. It can interfere with normal digestion, cause nausea and vomiting, and lead to problems with blood sugar levels and nutrition.

“I would get dizzy and throw up,” Mary says. “Then I would get dehydrated, and my electrolytes would be off, so I’d end up in the ER.”

Mary felt like she was running out of options. Up to that point, she had escaped some of the most serious complications of Type 1 diabetes, such as heart attack and stroke, as well as nerve, kidney and eye damage. But Mary was concerned that if she couldn’t consistently control the fluctuations in her blood sugar, she would eventually succumb to those problems.

“I got the point where I couldn’t get a grip on things,” Mary says. “I was scared that I could die.”

A better way forward

It was then that Catherine Coyle, D.N.P., a Mayo Clinic nurse practitioner and certified diabetes educator, offered Mary another way. Dr. Coyle, who’s worked with Mary to manage her diabetes for 15 years, recommended Mary explore the possibility of a pancreas transplant.

“She had always been diligent about her self-care, which made her an excellent candidate for transplant,” Dr. Coyle says.

Mary took the advice to heart. She began the transplant evaluation process in August 2017 and was added to the transplant waiting list in January 2018.


“Going into this whole thing, the team was so positive. They make you feel extremely confident that you’re going to be OK.”

Mary Shelley

On March 10, 2018, Mary was visiting her grandchildren when the phone rang. “Mayo called to tell me there was a potential organ available. I nearly fainted,” Mary says. “I shook all over thinking this might really happen. I was so overwhelmed that Mayo was going to save my life again.”

Fortunately, the organ was a good match. Mary was wheeled into surgery the afternoon of March 11. Surgeon Justin Nguyen, M.D., performed the transplant, and Martin Mai, M.D., chair of Transplant Medicine, was part of the team that monitored her in the ICU.

“Going into this whole thing, the team was so positive. They make you feel extremely confident that you’re going to be OK,” Mary says. “Everyone had a this-isn’t-going-to-fail attitude.”

The benefits Mary stood to gain from the transplant were considerable, according to Dr. Mai.

“The best part of a pancreas transplant is seeing normal blood sugars with no hypoglycemia, finger sticks or insulin,” he says. “In some cases, this type of transplant can improve eyesight, neuropathy and gastroparesis problems. It can also potentially improve or limit the progression of cardiovascular disease.”

When Mary woke up after surgery, the first thing she noticed was a change in her vision.

“Everything was so crisp. Before, I felt like I was always looking through fog, and the fog was gone,” Mary says. “That was overwhelming.”

A new zest for life

Mary named her new pancreas Polly, after her dad, whose name was Paul. She says life with Polly has been fantastic.

“It’s like Christmas every day. I used to wake up sluggish, and now I have energy. I’m not mentally confused,” Mary says. “I can actually drive a car by myself on a long trip. I can actually go out to dinner, and if the dinner is at 8 p.m., it’s OK. I don’t have to be afraid to live my life.”

Mary is excited she can now go for long walks and bike rides. She’s looking forward to engaging in activities that were out of reach before the transplant. Last year, she went to Atlanta with her husband to take part in the NASCAR experience and got to ride along with a driver.

“Never in my life would I have attempted that because I was too worried about whether I would pass out,” Mary says. “I had always sat on the bench. Now I’m ready to take the world.”


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Fri, Mar 8 5:00am · Innovative Imaging Charts Course to Successful Cancer Treatment

When Bruce McVety's prostate cancer returned after a seven-year remission, his doctor suggested he go to Mayo Clinic to receive a test that wasn't available locally. Bruce listened. Today, after comprehensive treatment, the cancer is undetectable, and Bruce is grateful for his renewed health.

When Bruce McVety’s prostate cancer returned after a seven-year remission, his doctor suggested he go to Mayo Clinic to receive a test that wasn’t available locally. Bruce listened. Today, after comprehensive treatment, the cancer is undetectable, and Bruce is grateful for his renewed health.


As a pastor and retired police officer, Bruce McVety is no stranger to death. He’s witnessed others passing on and has counseled those dealing with its finality. Bruce also has faced his own mortality more than once.

Bruce’s fate first became uncertain in 2010 when he was diagnosed with prostate cancer. At the time, Bruce was treated with radiation therapy, and it seemed to work. For seven years, Bruce had tests to check his level of prostate-specific antigen, or PSA. His numbers remained normal, and life with his wife and family went on.

But in March 2017, Bruce’s PSA was elevated. The resident of Princeton, Illinois, again was forced to confront a future in doubt. Bruce’s local medical team attempted to locate the cancer cells that were triggering the PSA rise. MRI and CT scans were done, but imaging came back negative for cancer.

For the next six months, Bruce’s PSA levels were monitored. Each month, they got higher, and in August 2017, he had another scan. Afterward, Bruce was told that the scans were negative. But that wasn’t all the doctor said.

“I remember him looking at me and saying to me he wanted me to go to Mayo Clinic,” Bruce recalls. “He said: ‘Bruce, there is something in there, and I can’t find it. I’m a smart man, but the people at Mayo are a lot smarter than me and have access to a test that I don’t have.'”

In September, Bruce met with Mayo Clinic physicians Eugene Kwon, M.D., in Urology, and C. Richard Choo, M.D., in Radiation Oncology. A short time later, Bruce underwent a pioneering test developed at Mayo Clinic that would change the course of his future.

A Choline C-11 PET scan, which Mayo Clinic designed and received Food and Drug Administration approval for in 2012, allowed Bruce’s team to see what conventional scanning technology could not: the location where his cancer had spread. Following the scan, Bruce’s team devised a treatment plan that involved proton beam therapy and hormone therapy. When Bruce returned to Mayo for a repeat PET scan six months after his final proton beam therapy session, there was no trace of cancer.

“I don’t see miracles around every corner,” Bruce says. “But I do believe God is capable, and he works by opening doors. This was incredible to see the doors open.”

Precision testing enhances care

The first door that opened for Bruce was receiving a referral from his hometown physician to Mayo Clinic. The second was having access to the Choline C-11 PET scan. The scan involves administering a chemical tracer, called Choline C-11, into the patient’s vein just before the test. Prostate cancer cells readily absorb choline, so when patients are scanned, areas that have absorbed the tracer are highlighted. In Bruce’s case, the test revealed nine spots of cancer within his abdominal and pelvic lymph nodes that had previously gone undetected.

“This is really about the imaging we do here,” Dr. Kwon says. “We are able to demystify what’s going on with the cancer, then assign a very aggressive and sometimes combined form of therapy.”

Bruce’s therapy entailed taking a medication called Lupron — a form of hormone therapy that suppresses the amount of testosterone the body makes. He also had 26 sessions of proton beam therapy. While the area of lymph nodes that Bruce’s cancer had metastasized into was extensive, the fact that cancer had not spread above his diaphragm meant radiation therapy might be a viable option to shrink the growths and to possibly offer a chance of cure.

“Any other hospital might send me home to die, but Dr. Choo said: ‘This is Mayo Clinic. We do things differently here,'” Bruce says.

His care team opted for proton beam therapy for several reasons. They included the significant lymph node involvement in Bruce’s abdomen and pelvis; the vital organs located near the affected lymph nodes; and the potential for significant side effects to those organs from traditional radiation therapy.


“Any other hospital might send me home to die, but Dr. Choo said: ‘This is Mayo Clinic. We do things differently here.'”

Bruce McVety

“The proton beam has a unique physical characteristic,” Dr. Choo says. “As it enters the body, the tissues and normal organs in front of the target still receive some radiation. But when the proton beam reaches the target, the bulk of its cancer-fighting energy is released, and not much radiation goes beyond that. This means much less radiation to normal organs beyond the target. Proton beam can be an important tool to maximize the chance of tumor control while minimizing radiation side effects.”

Using the results of the Choline C-11 PET scan that identified the locations of the recurrent cancer, Dr. Choo devised a map of Bruce’s tumors and created a plan to target them with proton beam therapy. That plan included administering the therapy through Bruce’s back. When proton beam therapy is delivered that way, explains Dr. Choo, it spares many of the organs nearby from being exposed to unnecessary radiation.

“Once it delivers the radiation dose to the target area, the areas beyond that — the small bowel, the large bowel, the stomach, the liver, and some of the kidney — don’t get that much radiation because there’s no exit dose with proton beam,” he says.

Having the proton beams enter Bruce through his back also minimized the side effects of radiation. Typical side effects can include nausea, vomiting, diarrhea and fatigue. Despite the large area that received radiation, Bruce says he experienced no side effects from the treatment.

“I looked at the people going through it all, and their physical conditions were often so serious. Yet I was getting the treatment, and walking around and exercising. I couldn’t believe that I wasn’t having any side effects,” Bruce says. “I talked to Dr. Choo about it and said, ‘I don’t feel sick enough to be here.’ And he said, ‘You are very sick, even though you don’t realize it.'”

Bruce McVetyPromising results spark insight

The use of proton beam therapy still is relatively new, and few studies exist about its overall effectiveness in treating prostate cancer. Due to the lack of data on the utility of proton beam therapy for a situation like Bruce’s, his medical team couldn’t be certain how well the treatment would work against his advanced disease.

Despite the uncertainty, Bruce’s team felt that the proton beam therapy, at a minimum, would decrease radiation side effects. This translated into an improved benefit-to-risk ratio for proton beam therapy, according to Dr. Choo. It was a strategy that paid off.

Bruce’s proton beam therapy concluded in November 2017. Six months later, Bruce and his wife, Elaine, returned to Mayo Clinic, so he could have another scan. Afterward, Dr. Kwon had surprising news for them: Bruce’s cancer cells were gone.

“They couldn’t find it anywhere. From my eyes to my thighs, there was no evidence of cancer,” Bruce says. “Dr. Kwan said it doesn’t mean I’m cancer-free because it can hide. But there was no evidence of it, and I should live a normal life.”

Six months after that appointment, in December 2018, a second Choline C-11 PET scan confirmed the results of the first. Bruce’s cancer was nowhere in sight. At that time, he was able to stop taking the Lupron.


“They couldn’t find it anywhere. From my eyes to my thighs, there was no evidence of cancer.”

Bruce McVety

“The part that’s fortunate for this gentleman is he got the imaging, which then showed the location of the relapsing cancer,” Dr. Kwon says. “With the PET scanner, we’re able to identify the exact location of the prostate cancer. Without it, the whole thing is sort of blind mystery. In his situation, we had a good idea of where the cells spread, which triggered a very specific form of therapy. That’s the magic and the miracle of treatment here at Mayo.”

While is too early to say whether Bruce’s cancer is cured, his progress so far is encouraging, Dr. Choo says. For the next few years, Bruce will return to Mayo Clinic for repeat Choline C-11 PET scans every six months.

The renewed health Bruce experienced since his treatment at Mayo Clinic has been bittersweet. In August 2018, just three months after learning his cancer was gone, Elaine died unexpectedly. The loss of his wife, says Bruce, brings into focus the grace and fortune by which we live.

“The reality is that we have very little control over the future,” Bruce says. “That doesn’t mean we’re fatalistic and we don’t plan long range. But all of those plans have to be held in the sense of if it is God’s will. This experience has reinforced in a very stark way — especially with the loss of my wife on top of it — that there is no guarantee for the future as far as living in this sphere, this dimension, is concerned. We live one day at a time.”


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Wed, Mar 6 5:00am · Heading Forward With Gratitude and Grace

For Marisa Bella, living with a rare neurological condition meant managing sustained pain and an unnatural head position, as well as dealing with unwanted reactions from strangers. For years Marisa navigated life while suffering the physical, mental and emotional effects of her illness. That all changed in 2018 when a Mayo Clinic neurosurgeon helped her get her life back.

Marisa Bella, right, with her daughter.

For Marisa Bella, living with a rare neurological condition meant managing sustained pain and an unnatural head position, as well as dealing with unwanted reactions from strangers. For years Marisa navigated life while suffering the physical, mental and emotional effects of her illness. That all changed in 2018 when a Mayo Clinic neurosurgeon helped her get her life back.


Marisa Bella spent much of her life dissatisfied and depressed about the image reflected back at her in the mirror. But two years ago, Marisa’s feelings about her appearance were transformed when she underwent gender affirmation surgery at Mayo Clinic. Even after the feminization surgery, however, Marisa suffered from body issues.

Due to an uncommon neurological condition called cervical dystonia that caused her neck muscles to contract, Marisa’s head had become fixed in an upward-looking position. The disorder triggered migraines and caused tremors in Marisa’s neck muscles, which made her neck hurt and her head bob.

Not only did Marisa’s condition affect her mentally and emotionally, the dystonia posed serious health risks. Because Marisa was unable to look forward or down without bending from the back and hips, using the stairs or driving her car were frightening propositions.

For years, Marisa worked to manage her symptoms with physical therapy. It wasn’t enough. In 2016, she went to Mayo Clinic’s Department of Neurology for care. Botox injections helped for a while, but the breakthrough came in 2018 when neurosurgeon Robert Spinner, M.D., performed an innovative operation for Marisa that restored her head to a more natural position.

“What a difference; it’s like night and day,” Marisa says. “I can actually walk up the stairs without falling down, walk down the stairs without falling. That has helped with my panic attacks. It’s helped with my depression and with my anxiety. It’s not that Dr. Spinner fixed just my dystonia. He fixed my life, too.”

Arriving at a diagnosis

Marisa first felt neck pain related to dystonia in 2005. “It started as an annoyance, like a constant pulling and tightness in my neck,” she says. “It progressively got worse, and the only way to get relief was by pulling on the back of my neck.”

Marisa sought advice from a number of physicians, but none provided insight into the strange pulling and pain in her neck. In 2016, Marisa stumbled upon a physician who put a name to her symptoms.


“I just broke down and cried because somebody actually knew what was wrong and put a diagnosis with it.”

Marisa Bella

“I ended up making an appointment to have vocal surgery in Seoul, South Korea, for voice feminization,” Marisa says. “I flew all the way over there for the procedure, and when I walked into the clinic, the [doctor] looks at me and says, ‘You have vocal dystonia, spasmodic dystonia.'”

The doctor advised Marisa to see a specialist back home to investigate the condition. When she returned to the U.S., Marisa made an appointment with her primary care physician, Majken Wingo, M.D., in Community Internal Medicine at Mayo Clinic’s Rochester campus. Dr. Wingo referred her to Anhar Hassan, M.B., B.Ch., a Mayo Clinic neurologist, who identified the condition as cervical dystonia.

“I just broke down and cried because somebody actually knew what was wrong and put a diagnosis with it,” Marisa says.

Facing an all-encompassing problem

Dystonia is a movement disorder in which muscles contract involuntarily, causing repetitive or twisting movements. It can affect any part of the body. Dystonia is an uncommon condition, occurring in about 50 people out of every 1 million, according to the National Institutes of Health. The condition can be extremely painful. When patients are fatigued or stressed, symptoms often worsen.

“Not only are the muscles overworking and pulling you in a different position, but other muscles are pulling the opposite way,” Dr. Spinner says. “There are many problems with that. The first is neck pain. The second is the abnormal position. And the third, obviously, is how people look at you.”

Marisa’s dystonia touched all aspects of her life. Her irregular head position made driving almost impossible. She’d recline the seat and rely on the side mirrors to see behind her. She avoided walking distances. Stairs were impossible. Migraines affected her regularly. Any interaction with someone she didn’t know often was met with an awkward reaction.

“My head would bobble, like one of those bobbly dolls. It was uncontrollable,” Marisa says. “It’s really distracting when you’re talking to other people. It doesn’t do much for one’s self-confidence.”

Marisa’s dystonia also caused her vocal chords to spasm, which created tremors in her voice when she spoke.

Treating an intricate illness

To ease her symptoms, Marisa received botulinum toxin, or Botox, injections. They stopped the spasms by temporarily paralyzing her neck muscles. The effects of the treatment only worked for Marisa for 18 months, however. After that, her symptoms returned.

But the window of time when she was symptom-free was large enough to allow Marisa to have gender affirmation surgery — one of the final steps in her transition from male to female. As a patient at Mayo Clinic’s Transgender and Intersex Specialty Care Clinic, Marisa worked with a team of endocrinologists and surgeons to plan for the surgery. On Feb. 24, 2017, under the direction of Mayo Clinic plastic surgeons Jorys Martinez-Jorge, M.D., and Oscar Manrique, M.D., Marisa underwent the first vaginoplasty performed at Mayo Clinic.

After Marisa recovered from that surgery, she was ready to overcome the last obstacle in her journey to health and happiness: surgery to correct the cervical dystonia.


“Each of the surgeries I’ve had at Mayo, it’s like they’ve fixed my whole life. … When they say they’re all about the whole body, the whole person, the whole patient, they absolutely are.”

Marisa Bella

Dr. Hassan had presented Marisa with a surgical option, called selective denervation, as a possible treatment for the dystonia. The procedure would involve removal of the nerves affecting the abnormal movement, and it would restore Marisa’s head position to a more natural one.

“[Surgery] was really scary because they’d be taking nerves out,” Marisa says. “But with the pain I had, I was like, ‘I will consider anything.'”

On July 2, 2018, Marisa underwent the procedure. “The surgery I did — selective denervation — is not widely performed,” Dr. Spinner says. “While it’s not any more difficult to do than many other surgeries we do in neurosurgery, it’s just not taught widely.”

During the operation, Dr. Spinner took out several small nerves that supplied signals to the problematic muscles. He also removed a portion of Marisa’s neck muscles.

Enabling an authentic life

The effect of the surgery was almost immediate. The pain and pulling in her neck are gone, and the tremors have been reduced significantly. Although Marisa continues to attend physical therapy three times a week to strengthen her neck muscles, she has her life back.

“Before I was falling three to four times a week because when I was walking around, my eyes were looking straight up,” Marisa says. “Now I can actually look straight forward. I don’t bobble as much. I can see where I’m going.”

To Marisa, undergoing the surgery to return her neck and head to normal was a significant step toward realizing a true and happy self.

“Each of the surgeries I’ve had at Mayo, it’s like they’ve fixed my whole life,” Marisa says. “It’s your whole outlook, your whole being. When they say they’re all about the whole body, the whole person, the whole patient, they absolutely are.”

The transformation Marisa’s surgeries have enabled is emblematic of the type of holistic care Mayo Clinic provides, Dr. Spinner says.

“She’s had a very nice postsurgical improvement. Her head position is better, so her pain is better,” he says. “She’s dealing with some other challenges, and this is one less challenge for her. This story just highlights what Mayo Clinic represents: treating patients — not diseases.”


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