8 Incredible Medical Stories
Local patients and doctors share eight remarkable tales of real-life medical drama right here in Pittsburgh.
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Dr. Neil Busis, chief of neurology at UPMC Shadyside Hospital, and Lauren Cantalope.
In June 2011, 23-year-old Lauren Cantalope, an X-ray technician in Hastings, Pa., began suffering from terrible headaches. It was the start of a medical mystery that would land her in a coma — and near death — until the tangled threads of her symptoms were unraveled by Pittsburgh neurologist Neil Busis.
Lauren’s headaches were soon accompanied by a high fever, facial numbness and severe nausea. “At first, my doctor thought it could be migraines or a stomach bug,” she recalls, “but I kept getting worse.” She had tests done at an Altoona hospital, but the results only muddied the waters, revealing that it might be meningitis or encephalitis. A spinal tap showed inflammation and unusual cells, suggesting meningitis again — or even leukemia.
By this point, Lauren had sunk into a state of severe fatigue and confusion. She was transferred to the Hillman Cancer Center, a division of UPMC Presbyterian Shadyside Hospital, for what doctors thought would be a cancer diagnosis.
Dr. Busis, the hospital’s chief of neurology, was asked to consult on her case. “I didn’t think it was cancer,” he says. Instead, he suspected a benign ovarian tumor, called a teratoma, which he noticed on her CT scan might be the cause of her symptoms, albeit in a very unexpected way. Meanwhile, Lauren’s condition became critical. “Within two days of arriving, she was comatose, on a ventilator and seizing,” says Dr. Busis. “Highly unusual for a healthy young woman.”
As he was pondering the mystery of Lauren’s condition, Dr. Busis remembered a neurology lecture he’d attended a year earlier. “A light bulb went off,” he says. The speaker had briefly mentioned the very rare paraneoplastic syndrome, in which young women with tumors like Lauren’s suffered from brain disease when the tumors triggered the body’s autoimmune response. Although only 150 cases of the disease had ever been documented, Dr. Busis realized that Lauren’s symptoms were almost identical. “The immune system fights off the tumor threat with antibodies,” he explains. “[The] problem is [that] the antibodies cross-react with normal brain tissue and make the brain sick.”
Curing the syndrome called for tumor removal and treatment of the immune system. “So I called an obstetrician/gynecologist here at the hospital,” Dr. Busis says, “and told him, ‘I think the teratoma is the problem. I’d like you to take it out; it might save her life.’” The simple operation went off without a hitch. Post-surgery treatment of Lauren’s immune system included intravenous immunoglobin to block bad antibodies and steroids.
Lauren’s symptoms abated; Dr. Busis had made the right call. While she had only been in a coma for 24 hours, she did not wake up for 3 weeks after the surgery. Only then did she began to learn about all she’d been through and about the doctor who had saved her life. “Honestly, everything from that July to September is a blur to me,” she admits. “I don’t remember much about Altoona or Shadyside … or meeting Dr. Busis. But my family told me how great he was, along with everyone else at the hospital.”
It took Lauren a long time to feel truly better, but given her grave illness, Dr. Busis calls it “a remarkable recovery;” she spent a month in the hospital and several more months in physical, speech and occupational therapy in Altoona. Today, she’s home in Hastings, working again and also engaged. She says “things are finally normal again.”
Dr. Raymond Benza, director of Allegheny General Hospital’s Advanced Heart Failure, Transplant and Pulmonary Vascular Disease Program, and Jean Magazzu.
Two years ago, Jean Magazzu began having trouble breathing. Her doctor thought it could be allergy-related — or perhaps a case of bronchitis. But multiple rounds of antibiotics didn’t help, and her breathing worsened to the point where she couldn’t even walk across a room without sitting down.
An X-ray revealed the frightening truth: Her lungs were filled with blood clots and scar tissue, a symptom of pulmonary hypertension (PH). She was immediately transferred to Allegheny General Hospital, where cardiologist Dr. Raymond Benza diagnosed her. “Pulmonary hypertension is a rare disease, affecting only 15 people in 1 million,” says Dr. Benza, a nationally recognized leader in the treatment of PH. “It’s also rapidly progressing and deadly — probably as mortal as any cancer we treat.”
Jean’s form of PH — related to the chronic clots in her lungs — was even more rare. The disease is characterized by high blood pressure in the lung’s pulmonary artery, which forces the heart to essentially work itself to death. “When she came to us, she was already in the throes of severe heart failure,” says Dr. Benza.
Along with his team, he determined that Jean needed to undergo an extremely delicate and difficult surgery to remove the clots and scar tissue. The procedure can take 12 hours, and requires stopping the heart and deep-chilling the body and brain; it’s performed in only a handful of U.S. institutions.
Fortunately, AGH recently joined that exclusive club. Dr. Benza had arranged for AGH cardiothoracic surgeon Dr. Robert Moraca to receive the months-long training necessary to perform the procedure, which took Dr. Moraca to hospitals in San Diego, Canada and Alabama.
Jean was the first person to undergo this procedure at AGH, but she says Dr. Benza’s manner helped lessen her fears. “He understood this was scary, but he explained things so I could understand them — and told me, matter-of-factly, what they were going to do,” she says. “I really wanted to know, so I appreciated that. His and Dr. Moraca’s confidence really helped.”
Jean’s surgery required a bypass machine to produce total circulatory arrest. “You can’t have any blood going through the lungs because that’s where we were operating,” Dr. Benza explains. After her body and brain were chilled, lead surgeon Dr. Moraca opened up all the blood vessels in her lungs and carefully teased away the clots from the vessels. “Deciding what’s real tissue and abnormal tissue inside the vessels is one of the real challenges here,” explains Dr. Benza. “And if you make a mistake and puncture a blood vessel, that’s usually fatal.”
The positive results of Jean’s surgery were apparent immediately — the high pressure in her lungs dropped to normal, and her circulation responded in kind. “Although I was weak from the surgery, I remember sitting up and taking a breath and thinking, Wow, a real improvement!” Jean says. “I was only in the hospital a week, and back to normal quickly.”