Makayla is an academic achiever who has been dancing since she was 2, competing since she was 6. "I do all the genres," she says. "I'm very competitive by nature. I do ballet, tap, jazz, contemporary, hip-hop."
A member of the National Honor Society and the HOSA Future Health Professionals, was powering her way through high school when, in the spring of 2016, she began to experience dizzy spells. An endocrinologist found that she had very low blood sugar. "I was nauseated all the time, and I started passing out," Makayla says.
Her condition worsened, and around Thanksgiving of that year she began having headaches that lasted weeks at a time. "No one could figure out what the problem was," says her mother, Misty. "We threw our hands in the air and decided to see our primary doctor because she woke up in the middle of night with excruciating pain in her head."
The primary care physician, concerned about some of Makayla's blood levels, referred her to a pediatric neurologist, who chalked up the problem to migraines and possibly an inner ear problem. A vertigo test came back positive.
"My daughter has been a competitive dancer for 16 years, so for her to have a balance issue didn't make sense to me," Misty recalls. "So I begged and pleaded with the neurologist to do an MRI. She said, 'We don't need to do this.' I begged and pleaded some more, and I told her we had met our deductible. She finally agreed, and on Christmas Eve she called me. She said, 'We've got something here we did not expect.'"
Taking a conservative route
Makayla was diagnosed with a prolactinoma, a benign tumor of the pituitary gland that produces the hormone prolactin. It is the most common type of pituitary tumor. A pediatric physician prescribed tumor-shrinking drugs, but Makayla did not tolerate them well, ending up in the emergency room four times. Then she began to have vision problems. "At this point I got frustrated," Misty says. "She had gone from being able to dance 20-plus hours a week to barely being able to get out of bed to go to school. I wanted a second opinion."
Misty took Makayla to an adult endocrinologist, who then referred Makayla to a prominent skull base tumor team: Dr. Norberto Andaluz, a neurosurgeon with Mayfield Brain & Spine, and Dr. Lee Zimmer, a prominent ear, nose and throat surgeon. Drs. Andaluz and Zimmer discussed Makayla's situation and agreed that she needed surgery as soon as possible because her symptoms were worsening and her quality of life was poor.
Makayla met first with Dr. Zimmer, who chatted with her about her condition and her activities, then examined her nasal passages. Sitting down, Dr. Zimmer addressed Makayla and her mother in a calm, even manner. The tumor, about the size of a marble, was precariously close to Makayla's optic nerve, threatening her eyesight. Surgery wasn't merely an option, it was a necessity. "We need to do this," Dr. Zimmer said.
The tumor in her brain would be removed through her nose.
Makayla processed the news with maturity. "I thought it was a little odd at first – that they would get to my brain through my nose," she says. "I didn't really understand the anatomy. When he explained it to me, it made a lot more sense. I also felt relief when I found out they wouldn't have to crack my skull open to get it out."
Two days before her surgery, Makayla met Dr. Andaluz. "I would trust Dr. Andaluz to do any type of surgery again," she says. "He does a great job of explaining everything and how and why it's done."
On March 31, six months after her symptoms began, Drs. Zimmer and Andaluz operated together in a minimally invasive procedure called endoscopic transsphenoidal surgery. During the procedure, Dr. Zimmer began by making a small incision at the back of the nasal cavity. He then worked through the nostrils with a tiny camera and light called an endoscope. Once the pituitary was exposed, Dr. Andaluz removed the tumor.
"After surgery I wasn't in too much pain," Makayla recalls. "I felt more pressure than anything. I had stents in my nose to keep it from closing off. Those kind of hurt, and they put a lot of pressure around my sinuses. But overall, I was not in too much pain. I had a little headache here and there, and they said that was normal. It wasn't anything over the top that I couldn't handle."
The restrictions she faced were perhaps the bigger challenge. Makayla was instructed not to bend over, not to lift anything heavier than a gallon of milk, and not to drink through a straw. She was not to engage in rigorous physical activity for 8 weeks. And she was taught how to cough with her mouth open in the event that she felt a sneeze coming on. She spent 3 nights in the hospital, and a few weeks after the surgery, Dr. Zimmer numbed her nasal passageways and removed the 4-inch stents from her nose. "I thought it was going to hurt, but they numbed the area," Makayla says. "It felt like a little tug, and then it was gone."
And now, back to senior year
Makayla's surgery was a success. She had no scarring and no permanent deficits. Nevertheless, she did have disappointments, missing out on her senior year of dance. Although Dr. Andaluz did not recommend it, she attended a university scholarship dinner just a week after her surgery. A month after surgery she attended her senior prom and took her Advanced Placement exams, passing all of them with 4's and 5's. "She's a trooper," Misty says. "Within a month she went from being so sick – which is how I would describe it -- to almost being back to herself."
Makayla began dancing again 8 weeks after surgery, but other priorities were now looming. After considering a career in dance, she had come to the conclusion that a path in show business might not be realistic. Today, a collegiate honors student on a full academic scholarship, she aspires to join the healthcare profession as an athletic trainer.
~ Cindy Starr
Hope Story Disclaimer -"Makayla's Story" is about one patient's health-care experience. Please bear in mind that because every patient is unique, individual patients may respond to treatment in different ways. Results are influenced by many factors and may vary from patient to patient.