After a harrowing surgery, incredible success
In late 2010, at the urging of his then-fianceé, Gregory Daily visited his family doctor to get checked out for snoring. He left with a problem far worse than a lousy night’s sleep. When his doctor peered into the back of Daily’s throat, he noticed that structures there appeared as if they’d been shoved to the left. Even though Daily didn’t have any trouble speaking or swallowing and didn’t have a sore throat, his doctor sent him for a CT scan anyway.
His films revealed a softball-sized skull-base tumor wrapped precariously around his carotid artery and other crucial structures, including additional blood vessels and important nerves, and dangerously narrowing his airway—results that threw the young patient headlong into a medical journey lasting more than a year.
“The neuroradiologist said it was one of the largest tumors of its kind he’d ever seen,” Richmon says.
“It’s one of those cases where everyone looks at the scan and gulps,” Carey adds. Complicating the scenario further, he explains, additional examinations showed that the tumor was full of blood vessels, making removing it especially dangerous.
But Richmon, Carey and their colleagues all agreed that the tumor had to be removed. It would only continue to grow, eventually leading to a host of deficits.
The doctors scheduled Daily’s surgery, then discovered weeks later that he was a candidate for a new clinical trial that had the potential to shrink his tumor. Daily underwent two treatments with radioactive iodine, but the therapy didn’t have a significant effect.
Returning to the original plan, Richmon, Carey and their colleagues, including Hopkins neurosurgeon Gary Gallia, prepared their patient for surgery in October 2011. It was a task no one on the team took lightly.
“There’s only a handful of cases that keep me up at night, and this was one of them,” Richmon recalls. Because of the tumor’s location, size and other characteristics, removing it had enormous risks, including the potential for stroke, facial paralysis, breathing and eating problems necessitating permanent breathing and feeding tubes, and excessive blood loss.
After developing a comprehensive plan for Daily’s surgery, the team commenced work on Oct. 7. They took a tag-team approach, with Richmon, Carey and their colleagues trading off repeatedly over the course of the operation.
Twenty-six hours later, Daily’s surgery was finished, but his journey to recovery had just begun. Over the next few months, he worked with physical and occupational therapists to work on swallowing and other basic skills and had numerous follow-ups with both surgeons and other care providers. Within just a few weeks, Daily returned to his job as a tax examiner with the Pennsylvania Department of Revenue. In a few months, he was back at the gym resuming his regular workouts.
Today, Daily is enjoying life with his new wife, whom he married in April. Besides some lingering weakness with his tongue, voice and right hand, which he’ll likely overcome with time, the 27-year-old has had none of the serious functional deficits that his doctors were so concerned about. “Besides my scar,” Daily says, “there’s really nothing you could see if you looked at me that would tell you what I’ve been through.”
For Richmon and Carey, seeing Daily’s success is a reminder of the incredible promise of medicine. “I’m very proud of our team, and Greg as well. He worked very hard on rehab to get to where he is now,” Richmon says. “It reminds me of why we all go into this profession. It’s such a great joy and reward to have patients like this do so well.”