Isaac was at school one day last fall when he started to vomit. Less than 12 hours later, he had emergency surgery to remove pressure on his brain caused by a tumor. Today, because of the care he received at Cincinnati Children’s, Isaac is back at school and back to being a normal kid.
It was an ordinary Monday morning last fall when 11-year-old Isaac left for school. He’d been in New York with his family over the weekend for a wedding and then spent Sunday evening with his parents at a church festival.
Isaac’s mom, Crystal, was working from their home in Mason, OH, that day when she received a call from the school nurse at 3 p.m. “She said that Isaac was in the office sick, that he’d been vomiting, but she didn’t seem too concerned,” Crystal said.
Crystal picked Isaac up from school and, when they got home, took him downstairs to the basement. Isaac is the youngest of four kids, and Crystal’s older daughter had a history of migraines that darkness seemed to help, so Crystal hoped it might help Isaac, too.
“He was just consistently vomiting,” she said, “but I thought it looked like a migraine.” The two stayed in the basement for the next few hours, with Crystal setting an 8 p.m. deadline to go to the emergency department if Isaac didn’t improve by that time.
Eight o’clock came and went, and Isaac didn’t improve, so Crystal led him outside to the car. “I noticed he seemed a bit off-balance,” she said. “He kind of bumped into the front headlight of the car. But I figured it was because he was suffering from a terrible migraine and was completely dehydrated.
When they arrived at Cincinnati Children’s Liberty Campus emergency department, Isaac was treated for a migraine. But then a doctor made a “lifesaving” choice, Crystal said. The doctor, Lynn Babcock, MD, MS, associate director of research in the Division of Emergency Medicine, was prompted to take a closer look at Isaac when one of the nurses mentioned that, while he was treating Isaac for a migraine, he “didn’t like” the way the patient looked.
“I remember looking at Isaac and noting that he clearly didn’t feel well,” Dr. Babcock said. “He was really pale. I didn’t like it, and I wasn’t 100% sure what we were dealing with, so I decided to send him for a CT scan to give us peace of mind.” She added, “When one of your experienced nurses says a patient doesn’t look right, you pay attention.”
What happened next is something Crystal will never forget: A social worker sat her down to explain that Isaac’s CT scan showed a mass in his brain had hemorrhaged, and he’d have to be flown by helicopter to Cincinnati Children’s Burnet Campus for emergency surgery to relieve the pressure.
“It was like something out of a movie,” Crystal said. “It was a seven-minute flight, and I really have no memory of it.”
Around 2:15 am on Sept. 13, 2022, Jesse Skoch, MD, faculty neurosurgeon in the Division of Pediatric Neurosurgery, performed surgery to decrease the pressure the hemorrhage was causing on Isaac’s brain.
The tumor was roughly the size of a baseball, and appeared to be a high-grade glioma—a tumor that forms in the glial cells, which are cells found in the brain and spinal cord, Dr. Skoch said. Tumors that are “high grade” are fast-growing and spread quickly through brain tissue.
“His symptom of having a tumor that hemorrhaged is more common with highly aggressive, fast-growing lesions,” said Scott Raskin, DO, pediatric neuro-oncologist in the Division of Oncology. So was the location of Isaac’s tumor, which was in the temporal lobe, instead of the more common cerebellum. “When we saw those things on the scan, we were pretty concerned we were dealing with a high-grade tumor,” he added.
Dr. Skoch and Dr. Raskin recommended complete surgical removal of the tumor, which Dr. Skoch performed on Sept. 26.
After the surgery, Dr. Raskin prepared Crystal for the probability that Isaac would need radiation therapy. “The diagnosis wasn’t clear for several weeks,” he said. “We had to do specialized testing that took time to get back, but we were really concerned this was a high-grade tumor, so we were planning radiation while waiting on testing results. It was a lot of ups and downs and twists and turns. But we wanted to take the right steps to make sure we were delivering the right treatment."
The diagnosis came on Nov. 3: It was a low-grade, slow-growing glioma—specifically a pilocytic astrocytoma, which is a brain tumor that develops in the brain’s neuron-supporting star-shaped cells, called astrocytes, a type of glial cell.
“When we got that testing back that grouped Isaac’s tumor with lower-grade tumors, we literally last-minute aborted the radiation plan and said let’s just watch him and treat him with nothing but surgery,” Dr. Raskin said.
For Crystal, it was a miracle. “Everything pointed to us going down a really ugly, dark path,” she said, “and then it just completely changed directions.”
Today, one year later, Isaac is fully recovered and back to life as a typical 6th grade boy. He’s playing basketball and golf, riding roller coasters and playing the drums—activities he’s always loved. “It’s like nothing happened,” Crystal said. “It’s amazing. He’s back to being my lively, give-me-a-run-for-my-money kind of kid.”
He’s also running a nonprofit called Claw Machines for a Cause, an organization he started in 2021, when he was in 4th grade and his friend passed away from sudden unexplained death in childhood (SUDC). Claw Machines for a Cause raises money for local charities by purchasing claw machines and placing them in popular restaurants and breweries, filling them with donated prizes and then donating the proceeds.
Since his surgery last year, Isaac has added brain tumor research at Cincinnati Children’s as one of the areas his organization supports.
“I’m very pleased with how quickly and successfully and completely Isaac has recovered,” Dr. Skoch said. “It’s very easy for kids to become apathetic and a little checked out during their recovery, especially because it can be painful and distressing, but he was really cooperative with everything and took everything in stride. It’s not surprising he’s the kind of kid who runs fundraisers. It’s just his personality. He’s clearly a pretty special kid.”
Crystal said she and her family were “blown away” by the care they received, but according to Dr. Skoch, the care is standard at Cincinnati Children’s.
“Even though Isaac’s case was pretty rare, the way he was treated was pretty formulaic,” he said. “He came in really sick and needed ICU-level care. Our ICU is very familiar with decompressing patients’ brains, putting pressure monitors in, putting in external drains. That’s routine for them. There aren’t a lot of places where that’s a routine thing. Then there’s our oncology team who are used to seeing common tumors, like Isaac’s, in uncommon spots. And then, from a neurosurgical standpoint, even though each of the neurosurgeons on our team has different specialty niches, we can all treat these types of cases emergently. These are some of our strengths.”
Crystal plans to use the strength of Isaac’s story to help other families in similar situations.
“Anything I can do to help somebody have some hope in these dark, dark days, I’m all for,” she said.
(Published October 2023)
3333 Burnet Avenue, Cincinnati, Ohio 45229-3026
© 1999-2024 Cincinnati Children's Hospital Medical Center. All rights reserved.
