Misty Gans

The year 2020 will be remembered as a difficult year for many across the globe, but it was especially strange for Eagle resident Misty Gans. In early summer, Misty, an active, adventure-loving 40-something, started experiencing unusual symptoms. It began when she realized she was having increasing difficulty reading from her cell phone. She made an appointment to have her eyes checked but her optometrist dismissed concerns, chalking it up to the normal changes a woman in her mid-40s would expect. But then Misty started having trouble deciphering computer screens at work as well. Misty was working as waitress at a local diner, and when inputting orders, she often had trouble reading the screen, especially when it flipped from one page to the next. “People were telling me ‘you’re just stressed; weird things happen when you’re stressed,’” Misty recalls. “I was going through a difficult divorce at the time so I assumed they must be right.”

Things get weird: A fall and more severe vision changes

Then, in mid-September 2020, Misty took a nasty fall at work. “I remember feeling woozy, but I knew I hadn’t eaten much and thought I’d probably just had too much coffee,” Misty explains. “After that, I don’t remember anything — I just opened my eyes and I was on the ground with firefighters helping me. Apparently, the cook found me unconscious in the back and had called for help.” The fall left her with a large hematoma and a concussion, so she took the week off from work to rest. By the next weekend, she made plans to meet friends for breakfast. But when she started driving, things got weird. “I kept seeing these bright flashes on my right side and old memories were appearing before my eyes,” Misty remembers. “I was literally driving down a highway and I could only see half the cars; the whole right side was gone.” She was able to stay focused on the car in front of her and safely get into a parking lot where she called a paramedic friend for help. “My friends thought I was having a panic attack, but I knew it wasn’t. Something was wrong and my head hurt so bad.”

After this frightening incident, Misty’s doctors diagnosed anxiety and migraines. But, knowing these answers just didn’t feel right, Misty continued to advocate for herself and kept pushing for more information. Finally, a physician ordered an MRI scan. Four days after the test, she received a call asking her to come in to discuss the results as soon as possible.

“Initially the doctors found a spot on my brain, but they didn’t think it presented the way a glioblastoma (a type of brain tumor) should,” Misty explains. “They wanted to take a ‘wait and see’ approach, but I still wasn’t satisfied.”

Misty finds hope in Dr. Tsvankin at Swedish

Meanwhile, Misty’s condition continued to worsen. She started having difficulty speaking and was unable to form complete sentences clearly. Her sister came from out of state to help her find the appropriate care. A chance referral from a friend lead Misty to the Sarah Cannon Cancer Institute at HCA HealthONE Swedish and Vadim ‘Eddie’ Tsvankin, M.D. From the start, it was clear that Misty found what she needed in (whom she affectionally calls) ‘Dr. Eddie,’ — someone who would help her find what was wrong and get it taken care of. “He went over everything with me and helped to coordinate all of my care. He understood that we needed to get this thing out and he kept assuring me ‘we got this,’” Misty recalls.

Dr. Vadim 'Eddie' Tsvankin is a neurosurgeon at the Sarah Cannon Cancer Institute at Swedish in Englewood, Colorado. When he went over Misty’s symptoms, scans and pathology, he suggested performing an advanced procedure called an awake craniotomy. In an awake craniotomy, the surgeon ‘maps’ the brain during surgery to identify and preserve brain function while removing tumor tissue. “Anybody can remove a brain tumor,” says Dr. Tsvankin. “The question is, can you remove a brain tumor while preserving all the essential brain structures? Some of the structures that may be infiltrated by the tumor, make the patient who they are, or that allow them to derive joy from life. Removing the tumor isn’t enough. The metric for success isn’t just a clean MRI after surgery — it’s the quality of life our patients enjoy after our job is done.” While it seemed a scary prospect to Misty, she was ready to partner with her Dr. Eddie and get her symptoms resolved.

‘Her speech improved in real time’

The team began the surgery by sedating Misty while Dr. Tsvankin accessed her brain. Misty was then brought back to consciousness to interact with the team during the procedure. They asked her questions and had her perform simple tasks while Dr. Tsvankin used specialized electrodes to stimulate brain structures. This allowed him to create a personalized map of her brain and remove the irregular tissue invading critical brain structures.  “We saw the changes in Misty during the surgery,” Dr. Tsvankin explains. “Her speech improved in real time.”

The procedure was extremely effective, and Misty’s bravery was lauded. “I’m sure I owe Dr. Eddie’s assistant quite a bit of money for hand surgery — I squeezed her hand really hard during the surgery,” she joked. “But I knew then, and I know now that God was with me and He was writing this story for His glory. He wasn’t done with me yet.”

 “An awake craniotomy is not a trivial surgery, and you need a highly-trained and experienced team like the one I have at Swedish to perform it safely,” says Dr. Tsvankin. “But the most important member of that team is the patient — in this case, Misty. Each surgery for me is a stream of tiny, critical decisions. Misty had to be brave and strong to literally be alert and provide the input that guided each of our decisions. Her input is what gave us the best information for an excellent outcome.”

Pure joy for the future

With her speech and cognition greatly improved, Misty now is receiving radiation and chemotherapy to complete her treatment. She is still experiencing some difficulty in reading from a screen but expects that to resolve as she continues to heal. Recently, she was even feeling well enough to take a few runs on the nearby ski slopes — only a few weeks after the surgery. She is so grateful for the experience and expertise of Dr. Tsvankin’s team who helped her through such a demanding procedure.

“Online, I often go by Misty Pure Joy. People ask if it’s my last name. It’s not, but it is my life,” Misty explains. “No matter happens, I know God has got me, and I can continue to live with that pure joy no matter what comes my way.”

HCA HealthONE Swedish ranks among the nation’s top neuroscience programs and was designated as a Neuroscience Center of Excellence (COE). A leader in the field of neurology and neurosciences and the treatment of stroke, the program at Swedish combines state-of-the-art technology with an outstanding team of staff and physicians who have extensive experience and expertise in treating nearly all forms of neurological disease. Learn more about the Neuroscience Center of Excellence at HCA HealthONE Swedish.