Wake-up Call
Brain Surgery Gives Joliet Woman Hope
By Denise M. Baran-Unland
Special to the Herald News



Dulcy Hawksworth, 32, of Joliet, has a passion for community service that is reflected in her numerous outreach activities.

She participates in political campaigns, events that raise awareness for domestic violence and, recently, marketing an Ohio self-esteem and leadership day camp for children ages 9-13.

But Hawksworth's tendency to overschedule and micromanage every minute of her day, including her regular job as an account manager for Storandt Pann Margolis in La Grange, a health care marketing and communications firm, left her unable to pay attention to the subtler, more meaningful aspects of life, until she received the unexpected news that a brain tumor—a meningioma—was causing her severe chronic headaches and that she required immediate surgery.

"I used to think that I'd pay attention to God and schedule him in my life someday when I had the time," Hawksworth said. "The tumor was God's way of saying to me, 'Thou shalt sit.'"

Wake-up call
Benign and slow-growing most of the time, meningiomas can still be life-threatening because as they grow, the tumors can compress brain tissue. Meningiomas account for 27 percent of all primary brain tumors. They develop from the meninges, the protective linings of the brain and spinal cord. They may cause seizures as well as changes in vision and mental functioning.

This proves the point doctors have been making for years: Medical attention is necessary if someone experiences a headache for the first time or experiences a change in existing headaches, said Dr. Ramsis F. Ghaly, neurosurgeon at Rush-Copley Hospital in Aurora, who removed Hawksworth's tumor.

Ghaly said that meningiomas are most common in women aged 40 to 60, with some research also suggesting that women of childbearing age are particularly susceptible to meningiomas than older women or men are. This is due to the influence of the hormones estrogen and progesterone.

At first, Hawksworth was unconcerned about her headaches. She had her first migraine in college. Preceding the headache was an "aura," which migraine sufferers often describe as scintillating light flashes heralding the onset of a migraine. Lying down in a dark room for several hours cured the headache that time.

But as years passed, Hawksworth's migraine headaches accelerated both in intensity and frequency, requiring more medication—as well as an alarming amount of more potent medication—to control them. Desperate for pain relief, Hawksworth also experimented with a variety of natural remedies, including medication, yoga and massage therapy.

Ready for surgery

By May, with severe head pain a constant presence, Hawksworth's primary care physician ordered a CT scan of her brain, which revealed the orange-sized meningioma. Nevertheless, Hawksworth applied her bold and forthright approach to life situations to the meningioma. She interviewed two other neurosurgeons before deciding she wanted Ghaly to remove the tumor.

"I liked his patient care philosophy," Hawksworth said. "I was not just another craniotomy and I knew that the person cutting my head open had a really good plan for my health afterwards and that was comforting."

Hawksworth took a tour of a Rush-Copley operating room. She composed a comprehensive list of questions for both Ghaly and hospital staff about the tumor and the care she required and considered the responses. She wrote a prayer and sent it Ghaly, who read it before beginning surgery, since she would be unable to do so. She even prepared a list of complicated words so she could test her own memory following surgery.

Hawksworth also named her tumor "Snarky the Brain Tumor" and explained to it the necessity of her and it going their separate ways. To pass the time until the scheduled surgery date, Hawksworth even alphabetized her CD collection. Finally, there was nothing else Hawksworth could do but wait and pray.

Tricky operation
While Ghaly's intention was to remove the entire tumor, he was concerned about the tumor's location deep within the middle of her brain, a particularly inaccessible spot. The veins and arteries that control Hawksworth's legs were also in that area and could be damaged during surgery. Additional risks of surgery for Hawksworth included infection, hemorrhage, paralysis, reduction of or loss of smell, vision and speech or even death.

Also of concern to Ghaly was that the meningioma itself showed evidence of recent, rapid growth. Its center had begun to die, proof that the tumor had grown so rapidly that it starved itself of its blood supply, while also releasing toxic chemicals that caused the frontal lobes of Hawksworth's brain to swell.


Yet, during Hawksworth's seven-hour surgery June 12, Ghaly not only removed the entire tumor, he also removed about a two-inch area inside Hawksworth's brain that surrounded the meningioma, just in case the meningioma had infiltrated the brain. The biopsy showed that Hawksworth's meningioma was benign and very slow-growing.

Recovery

Still, Hawksworth will need regular check-ups with a neuro-oncologist to be certain the tumor remains at bay and MRIs every three months during the first year, every six months during the second year and annually after that. If the tumor shows signs of regrowth, Hawksworth may need radiation treatment at that point. Ghaly also recommended Hawksworth consult a neurologist for her migraine headaches, which may still occur.

Recovering at an astonishing rate, Hawksworth spent only one night in the intensive care unit following her surgery, was moved to a regular room the following day, passed her own memory test and was discharged 24 hours later.


At home, a marvelous support system surrounded Hawksworth that sped her toward full recovery. That system included her family, friends, daily visits from a home health nurse and twice-daily telephone calls from Ghaly himself. Hawksworth returned to work at the end of July. Her most recent MRI showed no tumor, Ghaly said.

Overall undaunted by her frightening experience, a stronger Hawksworth has a clearer vision for community service and a stronger drive to begin her own firm that specializes in non-profit consulting and event marketing. She hopes to bring the Ohio self-esteem camp to the Chicago area next year.

"I'll continue to get involved in causes that I feel are worthy and helpful to society. They just kind of find me, like some divine entity puts them there," Hawksworth said. "I have found that it enriches my own life to share my experience and mentor others. It's a way to put my mark on the future and provide opportunity for people. I am driven by hope. I have consistently found that with hope things can always get better."

08/31/06