Kitty Smith didn’t waste much time figuring out the secret to her brain surgery recovery process. If she wanted to regain the strength and skills that vanished when her brain tumor was removed, she had to focus on the small stuff.

Fixating on the big picture—how long and exhausting the journey would be—would defeat her before she could even get started, she found.

Small steps

“What helps me out is, just the littlest steps get you to the next point and you work up from there,” Smith said. “It’s almost like a game. Keep going to the next level, and the next level. …I’m able to do a lot more than I used to when I first had the surgery.”

Before Smith hit on this strategy, everything was hard, said Mae Dines, a friend who, with her partner, Denny Dowling, has taken Smith under her wing and into their home in the aftermath of the surgery.

“She wanted to come home and have it be exactly the way it was before,” Dines said. “Once she realized that it had to be by little steps, it made everything easier.”

Smith, 38, explained how it works: “Once I could do one thing I’d say, let’s see if I can do this. And if you keep up with that, you get that done, you try something else. So far, that’s how I’ve got everything done.”

A seismic change

Smith’s life today is a far cry from the way it used to be. A keenly independent person, she lived on her own and worked second shift as a press operator for an auto parts manufacturer in Ionia, Michigan.

Her morning routine included a 10-mile walk or an hour or more of swimming in Baldwin Lake.

Then at work one day in June 2014, a huge headache bowled her over. She went to a local hospital and received a shot that eased the pain.

A week later the same thing happened, but a CT scan showed nothing amiss.

After her third debilitating headache, she went to another local hospital, where she received a CT scan with contrast. This time something showed up: a tumor at the base of her brain.

“Right from there they sent me to Spectrum Health in Grand Rapids,” Smith said.

She came under the care of the Brain & Spine Tumor Center and Todd Vitaz, MD, a neurosurgical oncologist with the Spectrum Health Cancer Center. Dr. Vitaz did a surgical biopsy of the tumor, which was found to be an anaplastic astrocytoma, aggressive and cancerous.

A week later, Dr. Vitaz performed a second surgery, removing the entire 1-by-2-centimeter tumor with the help of intraoperative magnetic resonance imaging. iMRI technology lets the neurosurgeon see the brain or spine on-screen during the operation, Dr. Vitaz explained. Spectrum Health is the only hospital in West Michigan to offer iMRI technology.

“You get that radiographic feedback during the operation and then you can make decisions based on that,” he said. “You can say, ‘There’s residual tumor in there, I want to go back after it’—and go after it in the same setting. Or you can say, ‘No, I’ve obtained my results, I got everything, it looks good.’”

In Smith’s case, he said, “I could be very confident that I got control of the tumor without destroying or damaging the surrounding normal brain tissue.”

Setbacks and rebounds

Still, it wasn’t smooth sailing for Smith after the surgery. The event left her with a severe case of double vision, which she still deals with today.

What’s worse, an attack of meningitis landed her back at the hospital for further recovery and rehabilitation.

“I had to relearn how to move and do everything,” she said. “You can’t just get up and do things the way you used to.”

She returned to Dines and Dowling’s home in Montcalm County and began the next phase of recovery: commuting to the Lemmen-Holton Cancer Pavilion for eight weeks of radiation therapy to zap any cancer cells that might have survived surgery.

By Christmas, when the radiation treatments were finished, Smith had a follow-up MRI and received what may have been the most disheartening news yet: Despite the successful surgery and targeted radiation therapy, another tumor had developed, this one in a trickier part of the brain.

“The place the tumor is in, they can’t do surgery on it,” Smith said.

Undeterred, Dr. Vitaz and the multispecialty team worked together to develop a new plan for Smith.

It relies heavily on chemotherapy treatments ordered by Wendy Sherman, MD, West Michigan’s only neuro-oncologist—a doctor trained to provide specialized medications and chemotherapies in cases like Smith’s.

Dr. Sherman collaborates with the medical oncology team at the Spectrum Health Cancer Care Center at United Hospital, so Smith can receive the twice-monthly treatments closer to home. Every two months Smith returns to the Brain and Spine Tumor Center to discuss new MRI results. Depending on the results, Dr. Sherman may tweak the prescribed chemotherapy.

So far, the results of the chemo have been very encouraging—the treatments have done more than just stop the tumor’s growth.

Smith smiles, thinking about the moment she first heard this news.

“I’ve never seen Dr. Vitaz almost skipping into my room before,” she said.

“Doctors are usually serious, and when they first started chemo treatments they were keeping an eye on it, and then after the MRI appointment I went in—and I mean he came barreling into the room, with a huge smile. …Dr. Sherman was the same way. She came in, just—big smile. They were happy. They were like, ‘It shrunk!’”

“They call her their miracle patient,” Dines added.

Small dreams

Buoyed by the good news, Smith stays focused on her one-small-step-at-a-time strategy.

“It’s basically me getting up and moving around and figuring out what I have to do—it’s relearning everything,” she said, whether the job is setting the table or feeding the dogs.

To retrain her eyes, she does exercises for double vision. To build endurance and balance, she uses a stair stepper. For arm strength, she uses hand weights.

“I started out with 5-pound weights, and I couldn’t even lift it three times. But I started working my way up.” Now, she said, she’s ready for 15-pound weights.

When she came home from the hospital, she used a walker, a shower seat and a raised toilet seat. Now she doesn’t need those aids anymore.

“I might be a titch wobbly, but I can do it on my own and that’s all that matters to me,” she said.

Smith’s desire to regain her independence isn’t her only motivation. She also has three teenage sons and doesn’t “want to see them deal with losing their mom.”

So at this point, does Smith allow herself to dream about the future?

“Very small” dreams, she said. “I want to drive again. I want to be able to do stuff for myself, so I push myself.”

Despite her strong progress, Smith is understandably cautious. “I know it’s going good,” she said, “but at the same time, knowing what goes through my body—sorry to say it—it scares the hell out of me. Because I don’t know when the next tumor’s going to pop up. …But so far it’s going really good. So that’s my—kind of—hope.”

Dines and Dowling, who drive Smith to her chemo appointments and observe her daily ups and downs, said Smith’s presence in their lives has made life richer.

“She’s a very strong encouragement to us,” Dowling said.

“I’ve always said we’ve got two choices: It can make us better or it can make us bitter. Kitty has chosen to make it better.”

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