Kim Barney and her husband Christian Barney, MD, believe the adage that everything happens for a reason.
They are convinced that Dr. Barney was matched to the James Cancer Hospital and Solove Research Institute in 2014 for his residency training in radiation oncology so that she would eventually receive the expert treatment she needed for a relatively rare skull base tumor that was diagnosed here while she was pregnant with their fourth child.
“It was perfect,” says Kim, a native of Salt Lake City who had met and married Christian while they were in college in Utah.
Soon after the Barneys and their first three children moved to Columbus in August ’14 from Houston, where Dr. Barney had attended medical school, Kim began experiencing vision changes. This had also happened during her first three pregnancies, so she wasn’t overly concerned but saw an ophthalmologist who determined she was OK.
But when her problems intensified—difficulty focusing and reading, along with double vision—she saw Steven Katz, MD, a neuro-ophthalmologist at Ohio State who ordered an MRI that revealed a tumor known as a meningioma at the base of her skull. Meningiomas are predominantly benign tumors that arise from the coverings of the brain or spinal cord. When they grow, they can become disabling or life-threatening.
Dr. Katz referred Kim, who was by then 17 weeks pregnant, to Daniel Prevedello, MD, a neurological surgeon at Ohio State who specializes in skull-base procedures.
Not wanting to put the unborn baby at risk, Dr. Prevedello recommended that Kim delay surgery so her pregnancy could progress as far as possible before the procedure. However, after finding several weeks later that she couldn’t focus her left eye, she contacted him again, and a second MRI showed that the tumor had grown significantly, advancing around one side of her head and wrapping around her optic nerve. Tests indicated that she had lost 85-90 percent of her vision in the left eye.
A decision was made to induce labor a month early so Kim could undergo surgery as soon as possible. Her child, Virginia, was born Jan. 21, 2015.
Her subsequent surgery unfolded in two parts: a Jan. 28 minimally invasive endoscopic endonasal approach in which Dr. Prevedello and his team decompressed the optic nerve from inside the nasal cavity and removed some of the tumor, and then a Feb. 13 craniotomy, or surgical opening into the skull, to remove more of the tumor.
After the first procedure, her vision had not improved, and physicians feared that the tumor had perhaps destroyed her optic nerve. But after the second procedure, “I woke up and could instantly see. We were all crying and overjoyed.”
Kim says her surgeries have removed only a third of the tumor, including the part that was along the side of her head. The rest of it, she adds, is inoperable but is no longer around her optic nerve. Again she faced options for treating the slow-growing tumor, which is spurred by a pregnancy hormone called progesterone.
“We could do nothing and hope it doesn’t grow (since in theory it would grow only if she were pregnant again), or we could try radiation treatment to shrink and maybe kill it,” Kim says.
After six weeks of almost-daily radiation treatment that ended in August 2015, Kim learned that her tumor had shrunk significantly. Now she has MRI scans every six months at The James, where she is monitored by Dr. Prevedello and his team.
“I’ve had a great experience at The James,” Kim says. “Dr. Prevedello is a world-renowned expert, and he was so tender with me and my family. I knew it wasn’t common to have a pregnancy and this type of tumor, but I felt comforted in my situation. Drs. Katz and Prevedello treated me very special and not like a number, although I realize they treat everyone special because they know that every case is different.
“Their feelings were, ‘Let’s play this by ear and tweak her care as needed based on her unique situation.’ They got to know us and formulated a plan that would help me the most. And I’ll never forget Dr. Prevedello’s face when I could suddenly see again. He was almost tearful, he was so happy.”
She would not hesitate to recommend The James to anyone seeking expert and compassionate care for skull-base disorders. Throughout her medical travail, she says, “I never felt scared or that I was dealing with someone who didn’t know exactly what they were talking about. They worked together like a well-oiled machine.”