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Best and worst of times: New mom undergoes brain surgery while awake

5 min read
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Anne Wilmus Photography

Jonette and Dan McClelland of Marianna are shown with their newborn daughter, Sophia, in April 2017. A tumor was found on Jonette’s brain just five days after Sophia was born.

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Celeste Van Kirk/Observer-Reporter

Jonette McClelland holds the hands of her daughter, Sophia, 14 months old, as they walk on the sidewalk at their home in Marianna last week.

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Celeste Van Kirk/Observer-Reporter

Jonette McClelland holds her daughter, Sophia, 14 months old, at their home in Marianna.

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jonnettemcclelland

Celeste Van Kirk/Observer-Reporter

Celeste Van Kirk/Observer-Reporter

Jonette McClelland, a nurse practitioner from Marianna, was found to have a brain tumor days after giving birth to Sophia, now 14 months old. McClelland was kept awake during the surgery to remove the tumor.

Jonette and Dan McClelland of Marianna were elated when they became parents in April 2017. Daughter Sophia was healthy and so was mom.

That all changed five days after Jonette’s cesarean section. She was at home and suddenly suffered a seizure.

“That was our first warning that something was going on,” said Jonette, 34, a pediatric nurse practitioner. “Luckily, my husband was home and witnessed the seizure and called the ambulance.”

At the hospital, doctors did a CT-scan of Jonette’s head and delivered the shocking news that she had a brain tumor. She was immediately transported to Allegheny General Hospital in Pittsburgh, where a biopsy revealed the tumor was malignant. Doctors scheduled surgery to remove it just six weeks after Jonette had given birth.

“Looking back, there really weren’t any symptoms,” said Jonette. “Maybe I was more tired, but I chalked that up to being pregnant. I was excessively tired. That was really the only thing until the seizure.”

Jonette’s plans to breastfeed baby Sophia were drastically changed.

“I think at first I was kind of in shock because, obviously, that’s not what you expect, especially right after a baby,” she said. “Then I was kind of like, we have to just get done whatever needs to be done. I just went on autopilot for the first couple of months, for sure.”

Fortunately, both Jonette’s and Dan’s families jumped right in and cared for both her and the baby.

“We had a lot of support and a lot of people helping us out,” she said.

Brain cancer is tough to treat because removing a tumor surgically can put a patient at risk of losing brain functions located near the mass. That’s why Dr. Jody Leonardo with Allegheny Health Network’s Neuroscience Institute performed the surgery while Jonette was awake. That’s right – Jonette was awake while doctors were operating on her brain.

“I said you have to do whatever you have to do,” said Jonette. “I was actually fine with it. It was kind of interesting to me, just because I’m in the healthcare field.”

Leonardo said that the process helps her test areas of the brain to avoid problems.

“We performed the procedure with her awake so that we would understand in advance the areas that we would need to stay away from, versus the areas where we could resect the tumor from,” said Leonardo. “If we noticed any change in her speech or motor function, we would preserve that area.”

At first, the idea gave Jonette pause, but then she agreed.

“We talked about all of that, and I said I definitely wanted to be awake for it, and even though it was intimidating, I wanted to know what was going on and wanted to make sure that my functioning was going to be OK,” Jonette said.

Jonette was sedated while a part of her skull was removed to access the tumor. Then doctors woke her up to check on her during the removal. They put her in special restraints because it was crucial that she remain motionless during the procedure.

“Her brain tumor occurred in her dominant hemisphere of the brain, in between the areas which controlled her speech, motor function, her ability to understand, and her ability to see the full field of vision of both of her eyes,” said Leonardo. “In addition, it was a type of tumor that does not look different than normal brain – most tumors appear different in color and texture than normal brain, making it easier to remove them as they looked different than normal brain tissue.”

One of the doctors held Jonette’s hand through the entire procedure – not just for support but also to test her strength. Jonette said it was comforting.

“He had to make sure I had strength on my right side still, and he showed me pictures on flash cards and asked me questions like ‘What state are we in?’ Stuff like that,” said Jonette.

She described the experience as being uncomfortable, but said she felt no pain at all. The surgery took hours and wasn’t without risk.

“There are risks of seizures during the procedure,” said Leonardo, “Hemorrhage, damage to normal brain tissue which could result in inability to speak, see, or communicate.”

The surgery took more than eight hours and Jonette was awake for most of it.

Doctors removed as much of the tumor as possible and Jonette started radiation soon after. She’s now finishing her sixth and final round of chemotherapy.

Brain cancer usually does not spread to other parts of the body and her doctors aren’t worried about the tumor regenerating for many years.

“Jonette is one of the most remarkable and one of the strongest people I have ever met in my life,” said Leonardo. “Her determination, her drive, her love for her family, and her bravery is resounding.”

A scan in a few months will give Jonette a prognosis and she and her family are hoping for positive news.

“I’m less tired now than I was for several years before I knew that I had the tumor. So I am guessing that was my only symptom,” she said.

She’s using that renewed energy to care for Sophia, who is now a toddler, and to return to work part-time.

McClelland’s family and friends will take part in the fifth annual Brain Cancer Awareness 5K Walk on Aug. 18 at White Oak Park. Proceeds benefit research at the University of Pittsburgh Cancer Institute. To participate or make a donation, visit www.facebook.com/braincancerawareness5K.

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