Wednesday, March 24, 2010
Angioma survivor offers hope for Westmoreland
By Gordon Edes
FORT MYERS, Fla. -- Terry Francona needed extra outfielders for Tuesday night’s game with the Minnesota Twins, so the call went down to the minor-league complex for two kids to fill in for Mike Cameron and Jacoby Ellsbury, both of whom were due for a night off.
Under different circumstances, one of those call-ups almost certainly would have been Ryan Westmoreland, the 19-year-old Red Sox prospect of such great promise.
It was a week ago Tuesday that Westmoreland, a native of Portsmouth, R.I., underwent five hours of brain surgery in a hospital in Phoenix. That night, the team released a statement attributed to the neurosurgeon who performed the operation, Dr. Robert Spetzler, saying that the surgery “went well.”
Last Friday, the team announced that Westmoreland had been released from intensive care and moved to the hospital’s neuro-rehabilitation unit, where he was to undergo physical and occupational therapy.
"Ryan is right on track and we expect progressive improvement," Spetzler said.
Red Sox general manager Theo Epstein, meanwhile, acknowledged in the statement that Westmoreland's recovery process is “long and complicated.’’
There have been no further updates, as team officials have said they are sensitive to the family’s wish for privacy.
Savannah Hollis underwent surgery to remove a cavernous angioma from her brain stem, as did Red Sox prospect Ryan Westmoreland.
What might be involved in Westmoreland’s recovery? Savannah Hollis, a 24-year-old student at the University of Texas-Arlington, knows better than most. She contacted ESPN Boston after reading of Westmoreland’s condition and wrote that three years ago, she, too, had undergone surgery to remove a cavernous angioma -- a mulberry-shaped malformation of abnormal blood cells -- from her brain stem.
“I was initially misdiagnosed with a migraine,’’ she wrote, “until the doctor ordered a CT scan when I lost my ability to walk, talk and see. I met with three neurosurgeons that refused to operate on my brain stem, before the chief of neurosurgery at UT-Southwestern, Dr. Duke Samson, agreed to perform my surgery.
“Dr. Samson was super frank with me since I had to make the choice to have the surgery or not. The bad thing is once the lesion bleeds, you face a 20 percent chance of it bleeding again every year for the rest of your life. He said there was a chance that he would get in there but not be able to get to it, that the surgery might set me back worse than the night of my bleed if it didn't kill me, or I could wake up and be completely normal.’’
Hollis’ symptoms were far more advanced than what Westmoreland had experienced, according to sources. He had headaches and some numbness before having a seizure, according to club sources, which caused the Red Sox staff to spring into action.
“When it involves the brain stem,’’ Hollis wrote, “there is no small damage. Once an angioma bleeds, you face a great chance of having another bleed, and due to the location of Ryan's, it can be detrimental. After my bleed, it was four weeks before they could see the lesion, after the blood reabsorbed.
“It takes a while to determine the extent of the bleed, especially in the brain stem, because the nerves are packed so tightly and cover such a large portion of functioning. Before they let him fully take part in any rehab, they probably want to be absolutely sure the location of the angioma is stable, because if it isn't or they missed anything, an increase in blood pressure, altitude, stress, etc., could cause blood to leak into the brain stem.
“They'll do a battery of tests, I'm sure, to test the functioning of his cranial nerves, which exit at the brain stem. Three of mine were damaged, and there is no way of guessing how long it takes for nerves to heal. Since Dr. Spetzler felt comfortable doing the surgery, I'm sure he is just playing it safe. That's usually why they are hesitant to give a prognosis, because the most basic things can cause bleeding, and so it is better to make sure everyone is being cautious until the area can 'settle.'
“It sounds like they don't want to get anyone’s hopes up, but the news is the best you could ask for.’’
Hollis’ surgery was, by any measure, a success.
“I didn't face any setbacks due to the surgery,’’ she wrote. “It was successful at removing the angioma, according to all of the follow-up MRIs. After surgery, I returned to therapy. I can walk normally, my vision returned and my voice came back.
“The longest-lasting thing in my case was that the location of my bleed was where several of the cranial nerves exit the brain. The muscles in my throat and the rear of my mouth suffered, and I had a feeding tube until last August (three years) because the opening of my esophagus closed in protection mode that night, and healed slower than everything else.
“My voice is fine, and I can finally eat normally, as long as I don't get in a hurry.’’
Hollis said she is due to graduate this spring with a degree in biology. In the last couple of weeks, she said, she has begun running and jogging in advance of a run to raise awareness for angiomas, to be held in Dallas on March 27 (www.AwarenessFunRun.myevent.com).
“My doctors and physical therapists told me repeatedly that my health before my 'stroke' was the main thing contributing to my recovery,’’ she wrote. “It helps speed up your recovery exponentially. I am working on my fine motor coordination, and exercise physiologists tell me plyometrics are the best for nerve/muscle response repair.’’
Hollis said she thinks of Westmoreland and his family often.
“I would love to send my support for Ryan and his family,’’ she wrote, “as I am sure they are dealing with frustration, anger and unanswered questions.
“To make it this far in baseball shows he's determined and strong. That pays off much more than you would think, when a therapist is griping at you at 7 a.m. to get out of bed to walk up and down stairs. Ryan and his family have plenty of prayers and well wishes being sent their way.’’