Caring for the caregiver
UF Health Jacksonville neuro intensive care nurse treated for benign brain tumor
By Jesef Williams
Elizabeth Wiard, R.N., has a special connection to the patients she cares for in the neuro intensive care unit at UF Health Jacksonville. That’s because not too long ago, she was a patient in that very same unit, recovering from a risky but highly successful operation to remove a large brain tumor.
Wiard recalls having frequent headaches, but was able to treat them with ibuprofen. Unfortunately, those headaches turned into migraines. Then she realized she was having cognitive lapses.
“Things were off,” she said. “I would say left when I meant right. I was forgetting people’s names.”
Wiard first saw Edward Urban, M.D., a neurologist at UF Health Jacksonville, who found she lacked peripheral vision. An MRI showed she had a brain tumor the size of an apple. She was then referred to Daryoush Tavanaiepour, M.D., a UF Health Jacksonville neurosurgeon who specializes in skull base surgery.
Tavanaiepour said the benign tumor, located in the middle of her head, was causing swelling and high pressure in the brain, and was likely the reason for her vision and speech issues. The tumor had progressed to a point where radiation was not an option and surgical intervention was highly recommended.
“The tumor was large and was located in a critical area of the brain,” Tavanaiepour said. “If left untreated, it could have led to blindness, caused a coma or even resulted in death.”
Tavanaiepour said he took a week to prepare for Wiard’s surgery, figuring out which approach and angle to use for entering the brain. There was a large vein attached to the tumor that Tavanaiepour was particularly cautious about. If that vein were injured during surgery, Wiard could have entered into a coma.
The operation involved putting Wiard to sleep and placing her on her stomach. Tavanaiepour’s incision was in the back of the head, near the top. He entered, probed at a downward angle and used neuronavigation — think GPS for the brain — technology, an operating microscope and state-of-the-art micro-instruments to resect the tumor.
The operation was a success, as was Wiard’s recovery. Tavanaiepour points out the importance of a multidisciplinary team approach when it comes to brain tumor removal. Such vital collaboration led to the development of the UF Health Skull Base Center – Jacksonville
The center, which focuses on patients with complex head and neck tumors, includes fellowship-trained physicians in oral and maxillofacial surgery; neurosurgery; ear, nose and throat; neuropathology; and neuroradiology. Tampa is the nearest city with such a center.
“Taking care of Elizabeth was a team approach,” Tavanaiepour said. “We were connected and integrated to provide great continuity of care.”
Following rehab, Wiard eventually resumed her full-time nursing duties in the neuro ICU at UF Health Jacksonville. While compassion and respect are always emphasized when caring for patients, Wiard can now add empathy to the mix.
She believes the brain tumor experience allows her to better communicate with patients. There are times when Wiard has been asked by a fellow nurse to speak with patients on a personal level, to give them insight and let them know everything is going to be OK.
“Going through that really confirmed that I’m where I need to be,” Wiard said. “Nursing is what I love and now having been a patient, I really can relate to my patients.”