Bounce Back

Patients share how they are recovering faster and getting back to enjoying life after innovative treatments at 330 hospitals. Improvements on procedures help their doctors address concussions, aneurysms, knee pain and more in new ways.

Fresh Mind

The last thing Susan Oswald remembers about Oct. 22, 2018, was being at a baby shower.

“I was just sitting with friends — that was it,” recalls the 55-year-old Rittman resident. “I woke up in the hospital.”

Her husband, Steve, frantically rushed her to the hospital after she had a severe headache that rapidly escalated. By the time they arrived, she needed a breathing tube. Imaging revealed she had a subarachnoid hemorrhage, a type of severe bleeding in her brain. 

“We had no idea if she was going to survive — or what her condition would be like when she came out,” recalls Steve.

The cause of the bleeding was an aneurysm, a weakness that results in an outpouching of a blood vessel, that had ruptured on a blood vessel in the brain, disrupting oxygen and nutrient flow. 

“Four major blood vessels go to the brain. If they rupture, it can be deadly — up to 20 percent die before they get to the hospital,” says Dr. Alexander Venizelos, director of neuro-interventional surgery at Summa Health’s Akron campus. 

To treat it, Venizelos performed an endovascular coiling procedure — a newer, minimally invasive alternative to an open brain surgery in which the blood flow to the aneurysm is cut off. Venizelos inserted a catheter into the blood vessel, injected a dye to highlight the blood vessel and used rotational X-rays to highlight the dye, creating a 3D map of Oswald’s blood vessels for the surgery. He used a wire to guide a tiny platinum looped coil into the aneurysm and used an electrical current to detach the wire, releasing the coil to seal off the aneurysm. 

“Now that the blood’s not flowing inside the barrier, it clots it off,” Venizelos says. “But blood flows into the blood vessel still.”

Oswald had a second coiling to treat another aneurysm and also received two post-operative treatments for cerebral vasospasms, a complication of hemorrhaging in which blood vessels clamp down. The bleeding in her brain also impaired Oswald’s vision, so she had four eye surgeries.

With hard work and support from family and friends, Oswald has regained perfect eyesight in her right eye and partial vision in her left eye. While she has a third aneurysm that must be carefully monitored, she’s just happy to be alive, enjoying little things like riding her bike and is excited for the holidays. 

“I can’t wait to see Christmas lights,” she says. 

Joint Approach

Meadow Hynd’s swimming career was on the line. 

The then 16-year-old Gilmour Academy swimmer felt excruciating pain while weightlifting and was diagnosed with a tear in her labrum, the cartilage ring around the edge of her hip socket, and hip dysplasia.  

“The socket is shallow, and part of the ball and socket is uncovered. The joint loads the edge of the socket. That can lead to early failure of the cartilage and arthritis,” says Dr. Michael Salata, director of University Hospitals’ Sports Medicine Institute who practices at the Beachwood,  Medina and Twinsburg locations. 

It hurt for Hynd to walk distances, stand for long periods and swim, but she pushed through to finish her junior season. Eventually, she couldn’t cope anymore.  

“It was very painful. I knew I wouldn’t be able to keep swimming if I didn’t have the surgery,” Hynd says. 

Under the same anesthesia, Hynd got an arthroscopy by Salata and a pelvic osteotomy by Dr. Robert Wetzel, a UH orthopedic traumatologist. UH’s unique approach of having two experts successively perform typically separate operations lowers risks and shortens recovery. 

For the arthroscopy, Salata inserted a camera into the hip joint to assess the labrum damage and repaired it by sewing it back down to the bone where it belongs. Instead of inserting a post into the narrow hip joint to pass the camera through, Salata employed a safer method of using a traction pad to elevate the patient’s feet and using the patient’s weight to pull the joint open. He finished by tightening loosened hip capsule tissue and using a motorized burr to make the ball rounder in the socket.

Wetzel followed with a pelvic osteotomy to reorient the hip socket by making an incision in the pelvic area, chiseling the hip to free the socket from the pelvis, rotating and screwing it in place. 

“It’s a more stable hip and more normal distribution of the load and joint,” Salata says. “It’s a powerful joint-preserving surgery in addition to a pain-relieving and function-improving operation.” 

Following eight months of physical therapy, Hynd returned to the pool, achieved her best time — 57.8 seconds on the 100-meter backstroke — and earned a swimming scholarship to Barton College in North Carolina. 

“It was an amazing feeling to get back in the water,” Hynd says. “It allows me to keep doing what I love — which is swimming.” 

Out of the blue

At a checkup in late 2018, Eddie Bush’s family doctor saw something suspicious in his urine. Dr. Jay Krishnan, a urologic oncologist at Cleveland Clinic Akron General, did more tests and confirmed he had early stage bladder cancer even though the 82-year-old Akron resident was always tinkering with projects and felt fine. He didn’t want treatment to slow him down.

“We just want to do what we need to do,” says his daughter, Starlett Mitchell. 

When Krishnan moved to Northeast Ohio two years ago, he brought with him Cysview — a pharmaceutical solution containing a fluorescent dye recently approved by the Food and Drug Administration that’s a more accurate way to detect bladder cancer. Akron General became the first and is still the only Akron area hospital to use it. 

Cysview is an improvement on a standard cystoscopy wherein doctors insert a camera into the bladder via the urethra and scan footage for signs of a tumor using the naked eye. But 80 percent of bladder cancers manifest on the bladder’s interior lining, so it’s difficult to see growths, resulting in a high margin of error.

In April 2019, Bush underwent the improved procedure. Krishnan injected Cysview into Bush’s bladder via a catheter and let it sit. More of the dye gets soaked up by cancerous tissue than healthy tissue, so when he inserted a camera with a blue light, the tumors glowed pink on the monitor.

“It allows us to see the tumors before we can see them with a white light — sometimes up to a year before,” Krishnan says. He removed the growths and Bush completed six chemotherapy treatments. Afterward, Krishnan checked Bush with the blue light and Cysview to confirm all of the  bladder cancer was removed. 

This more effective procedure allows doctors to see and remove cancer sooner and more thoroughly. “You ultimately get a better treatment response and cure faster,” Krishnan says. 

Bush was declared in remission in October, less than a year after his diagnosis. Though he must have frequent checkups and lost close to 70 pounds, the active octogenarian is enjoying getting back to puttering with his 18-foot motorboat. “I feel pretty good now,” he says.  

Cold Rush

Archbishop Hoban High School football player Keshawn Haynes was in action at a game this October when he took two big hits to his head.

After colliding helmets with players on the opposing team, Haynes was called to the sidelines. Dr. Joseph Congeni, the team’s doctor, and another doctor observed Haynes’ significant concussion symptoms, and Haynes was rushed to the hospital.

Luckily, Congeni is also the medical director of the Sports Medicine Center at Akron Children’s Hospital and is researching the new Pro-2-Cool cooling cap developed by a Cleveland company to help treat concussions.

The cap fits across the head and neck like a headband and scarf, is attached to a chiller and circulates cool water around the brain. Much like how a bag of ice treats injuries, the cool cap decreases the body’s temperature and metabolic rate, giving the body time to adapt to trauma and possibly reduce inflammation and heal faster. 

This summer, Congeni completed the pilot Akron Children’s study that separated 60 patients ages 12 to 19 into two groups: One received the standard treatment of rest, and the other received two cooling cap treatments. Both groups were evaluated after initial impact and again 72 hours later. 

“We had really encouraging results,” Congeni says. “People with the cool cap group had a reduction of symptoms sooner.” 

In August a pivot study began to examine more patients in collaboration with other children’s hospitals. 

Haynes was in the cooling cap group. “After the treatment, I immediately felt better,” the 16-year-old says. “My headache wasn’t as bad. I was not as drowsy or foggy.”

Although the cooling cap is still being researched and needs approval from the Food and Drug Administration, it has shown promising success.

It could be a groundbreaking development in treating the rising number of concussions, which can lead to traumatic post-concussion symptoms like chronic headaches, dizziness, blurred vision and difficulty thinking clearly. 

As for Haynes, he completed the cooling cap treatment and has returned to the field — something he was eager to do. 

“I had to watch the Notre Dame-Cathedral Latin game, and that made me feel terrible,” he says. “I don’t ever want to watch another one from the sidelines again.”

Self Starter

Akron District Fire Chief Scott Pascu likes to make a joke about his right knee. “My knee is now the smartest part of me,” says the 47-year-old Uniontown resident who has relied on his knee to lead rigorous firefighter training exercises. 

That’s because his knee underwent a rare, cutting-edge procedure called a Matrix-induced Autologous Chondrocyte Implantation or MACI. It involved implanting some of his own cartilage cells that had been removed and sent to a lab at the Massachusetts company Vericel where they were reproduced on a special film called a matrix.

MACI was recently approved in the U.S. When Crystal Clinic orthopedic surgeon Dr. Daniel Myer implanted Pascu’s regenerated cartilage cells in late 2018, Pascu became one of the first patients in Ohio to undergo a MACI.

The letter M makes a world of difference. In the previous labor-intensive ACI procedure, a collagen membrane was sewn on the knee injury, and the patient’s cartilage cells were reproduced in a petri dish and then injected under the collagen, often resulting in the formation of excess scar tissue.

With the new MACI procedure, the patient’s cells are directly reproduced on a new collagen membrane, cutting out several steps. A surgeon doing a MACI can cut the membrane with the cells already on it to the exact size and shape needed to repair the injury, resulting in a quicker operation with less scarring. The membrane gets absorbed into the patient’s tissue as cartilage cells grow.

Myer says patients who opt for a MACI have a better chance of regrowing their own cartilage, remaining active long term and avoiding a future knee replacement — but only after almost a year of intensive physical therapy.

From using a passive range-of-motion machine for six to eight hours a day right after surgery to progressively adding exercises and weight bearing, Pascu has spent the past year painstakingly rebuilding his strength. He’s back to work training firefighters but with less physically demanding duties. In the past few months he was happy just to go bike riding with his two teenage kids. 

“It’s given me the opportunity to do the things they love as they’re growing up,” he says.