Sweet reprieve

BY SUSAN STEVENS
Daily Herald Health Writer

Stacie Switzer was entering what should have been a glorious time of her life.

A year earlier, she'd married childhood friend Michael Ruth in a small, romantic ceremony in a Scottish abbey. Both in their 30s, Switzer and Ruth were delighted when she quickly became pregnant. On April 9, 2003, Madelyn was born five weeks premature - tiny, but perfect.

But by June an ache had crept into Switzer's neck. She'd always carried stress there; this was different. The pain became excruciating and regular painkillers couldn't touch it. Within two days, Switzer couldn't even turn her head.

An emergency room doctor advised an MRI. At 7 the next morning, Switzer got a frantic call from her doctor, who'd been trying to reach her all night.

She had a large mass inside her spinal cord, and it was bleeding. It didn't matter that the tumor wasn't cancerous; by its very location in her upper cervical spine, it was quite likely fatal.

In the space of a week, Switzer's life radically shifted course. Instead of building a new family, she contemplated never seeing her 9-week-old daughter grow up.

Calculating risk

Get your affairs in order, the first neurosurgeon advised Switzer.

Surgery, he said, could rob her of what normal life she had left. It would mean cutting open her spinal cord to scrape out a tumor that occupied the space of four vertebrae. She could emerge a quadriplegic.

But the longer she waited, the more debilitated she would become, and surgery could not reverse that decline. As it grew the tumor would gradually cut off function to most of her body, including the muscles in her legs and arms, her digestive system and her lungs. She would slowly become paralyzed. When it interfered with her breathing, she would die.

Other neurosurgeons thought surgery might be possible, but few had performed operations like this one. By chance, a friend mentioned Switzer's case during a job interview at the Chicago Institute of Neurosurgery and Neuroresearch, where a doctor specializes in brain and spinal tumors.

Dr. Edward Mkrdichian called Switzer immediately. She saw him the next day.

"We set up the surgery two weeks later," Switzer said. "Once we made the decision, it just became a matter of preparing myself."

Training for her life

Switzer had always been athletic. A competitive gymnast since age 3, she turned to running in college. She completed several marathons, including a 3:37 time that qualified her for the Boston Marathon.

When she became pregnant with Maddie, Switzer had been training for her first Ironman triathlon. She put off those plans but continued to exercise regularly, running or cycling five days a week. She was sitting on a stationary bicycle when she went into labor.

Switzer applied the same dedication to preparing herself for surgery. She consulted a nutritionist for an anti-inflammatory diet. She visited a psychologist to work through the emotional turmoil. She continued running to keep her body in peak condition.

"I looked at my surgery like I did a race," she said. "I was going to attack it from every angle."

The steroids her doctors prescribed to control swelling made her gain 45 pounds, so Switzer refused any last-minute family photos. She didn't want to be remembered that way.

On Aug. 18, 2003, her husband and her father drove her to the hospital. When doctors took her away for anesthesia, the two men stood in the hallway, watching Stacie's face as the elevator doors closed.

Six hours

In the operating room, Switzer lay face down on the table. Mkrdichian cut through four layers of muscle, broke off the tops of her vertebrae and sliced open Switzer's spinal cord.

Using magnification and tiny instruments, he slowly separated the tumor from healthy tissue.

The spinal cord is a narrow cable of densely packed fibers carrying information from the brain to the muscles and organs. Because Switzer's tumor was so high in her spinal cord, a wrong move could cut off signals to most of her body.

"This is a very, very risky procedure," Mkrdichian said. "A lot of people shy away from it ... but there was no other choice."

Mkrdichian had to cut through some spinal cord fibers just to get to the tumor, which was stubbornly adhered to healthy tissue in some places. To complicate the surgery, the confined space of the spinal canal leaves little room to maneuver.

So Mkrdichian began by carving out the tumor from the inside, letting the walls collapse in. Back and forth, over the course of six hours, surgeons picked out as much of the mass as they could.

Numbness

Switzer's first moments back remain fuzzy. But family members say that when she woke up, Switzer wouldn't stop wriggling her fingers and toes.

"I was so happy I could just move," she said.

But that soon disappeared. The trauma of surgery caused her spinal cord to swell, and she lost all feeling from the neck down. The discovery left her screaming.

Switzer was not paralyzed, but damage to her nerves resulted in numbness that would never completely go away. She couldn't distinguish between hot and cold. When she touched her daughter's face, she felt nothing.

Switzer could stand, but she had no balance. If she wasn't looking at her feet, she couldn't tell where they were, and if she stubbed her toe she wouldn't feel it.

Her husband moved everything in their Chicago townhouse to a single floor. Family members rotated through town to help care for her and Maddie, because Switzer had to relearn daily tasks from scratch.

"The little things you take for granted, like brushing your hair or your teeth, my husband would have to help me with," she said.

As her body recovered, sensation gradually returned to her back, then to her arms and hands. Instead of numbness, she felt pins and needles. Pain radiated from her neck and her nerves burned.

"It felt like someone had taken a lighter and was holding it under my skin," she said.

Yet she had begun the first halting steps toward recovery.

Switzer spent hours pacing up and down her long deck, holding on to the railing for balance. By November 2003, Switzer could walk Maddie in a stroller, though it took an hour to go a single mile.

Jogging again

In 2004 Switzer and her husband moved to a house near downtown Barrington. When her doctor gave the OK for her to try jogging, they chose a favorite trail in the area for her first run.

It was a triumph.

"I only went a couple hundred yards," Switzer said. "I couldn't go anymore. But I was so happy I could even jog, we both started bawling."

Switzer followed with daily jogs, gradually building up to a 5k race in Gilberts in December 2004. By this time she had befriended the doctor overseeing her physical rehabilitation. Dr. Christine Villoch, an avid runner the same age as Switzer, became Maddie's godmother.

The pair decided to train for a half marathon this spring in Columbus, Ohio, where Switzer had attended law school. Villoch paced her patient the entire race.

"Seeing her cross that finish line was the most amazing thing," Villoch said. "It wasn't finishing a race, it was her getting back to a normal life."

Doctors tell Switzer it takes someone two to five years to recover from a surgery like hers. Her body is still trying to heal, so she accepts the slow pace. But exercise is a balm, too.

"If I don't run on a regular basis, I'm in a ton of pain," she said. "Exercising and eating healthy has been a way I'm able to manage my pain without a ton of medication."

Switzer crossed several milestones just learning to run at all, but she still had a significant goal to conquer: She wanted to run another marathon.

She and Villoch chose the Dec. 4, 2005 marathon in Las Vegas. For months, every Saturday, they hit the trails for long training runs.

The marathon was always hard, even before her surgery. But then the question was how fast would she run it - not whether she would finish.

It was a struggle. The endurance runs tapped her strength unlike anything she has faced.

"The half-marathon my body tolerated pretty well, but once we hit the 20-mile mark for the marathon, it's just been so hard," Switzer said. "I'll just be in tears thinking how am I going to do this?"

New perspective

Even before she left for Las Vegas, Switzer's life turned around.

Switzer was never very religious, but recently began attending church with her husband and is taking classes to become a Catholic.

"It's changed my life in a very spiritual way," she said. "I can't question anymore that there's a God overlooking my life and taking care of me. Certain things in my life have happened and I questioned what that was about. Now I see."

As an undergraduate, Switzer majored in biology and planned to go to medical school. But doctors she met after graduation persuaded her cardiology was not a family-friendly profession. Instead she went to law school.

It turned out to be a good move. After this surgery, she never would have been able to practice medicine, Switzer said.

Switzer even manages to find grace in the timing of her illness. No one knows what causes spinal cord tumors, which affect roughly 1 in 100,000 people. The tumor could have lain there for years, slowly growing.

It's probably coincidence that Switzer's tumor acted up soon after she gave birth, but pregnancy could have played a role, Mkrdichian said. Pregnancy often increases blood pressure, which might have caused the tumor to bleed and trigger symptoms.

"I almost feel like God was watching over me," Switzer said. "This has probably been in my body since I was born, or since I was a teenager. It didn't manifest itself until I was older, had a husband, a child, had a pretty stable environment that supported my recovery."

Marathon day

At 6 a.m. Dec. 4, Switzer, Ruth and Villoch walked up to the starting line in Las Vegas. It was cold and windy, and except for the fireworks and lights of the casinos, still dark.

The first five miles went easy. The lights and sights of the Las Vegas strip provided plenty of distraction. After that Switzer took the course one mile at a time, walking through all the water stations.

At mile 25, it hit her. She started to remember where she was two years ago, when she thought she might never walk again or hold her newborn daughter. In four hours and 24 minutes - an hour faster than she predicted - Switzer crossed the finish line, crying, into the arms of her husband and daughter.

"I had the most positive experience I ever had in a marathon because I wasn't running for time, I was just running to get to the finish line," Switzer said.

Of course, it hurt. Her legs burned and she was exhausted. After a marathon, "you can hardly move," she says.

"I am in so much pain, but I love it," she said, walking back to the hotel from the marathon. "I love this pain. This is great pain."

She's already making plans for the next race.