Phylis Esposito: Back in Action

Phylis Esposito, 66, is not one to sit still for too long. Retired from a successful career in investment banking and financial services, she prefers to be on the go: enjoying Manhattan, traveling, and cheering for her beloved New York Yankees. She also considered herself healthy — until she learned, she had a brain tumor.

Her symptoms began in 2016 during a family road trip to Gettysburg, when she experienced severe dizziness. "The room was spinning for two days," she remembers. She decided to visit an Ear, Nose and Throat physician, who was a friend. While he did not uncover an issue, he did refer her for a CT scan. It revealed a golf-ball-sized mass on the right side of her brain that was shifting the tissue of her brain toward the left side in the posterior fossa. These tumors arise from the meninges, the membranes around the brain and spinal cord, and they are typically benign (noncancerous).

Physicians monitored the tumor with CT scanning over the next year and determined that it had to be removed. It was growing and impinging on critical structures in her brain: the venous sinuses, major vessels that drain blood from the brain; the right temporal lobe, responsible for learning and memory; the cerebellum, which coordinates movement and balance; the brain stem, which regulates vital functions such as breathing, swallowing, and heart rate; and cranial nerves that are involved in facial movement and hearing, for example.

She sought opinions from multiple neurosurgeons — one recommended an approach that required two surgeries. However, when Mount Sinai’s Joshua B. Bederson, MD, said he could probably remove it in one operation; she decided to have the surgery with him. Dr. Bederson is the Leonard I. Malis, MD/Corinne and Joseph Graber Professor of Neurosurgery and Chair of the Department of Neurosurgery for the Mount Sinai Health System

When she met with Dr. Bederson and Leslie Schlachter, PA-C, Chief Physician Assistant and Clinical Director in the Department of Neurosurgery, she was reassured. Especially helpful to Ms. Esposito was the ability “to travel digitally through her own brain” with the Virtual Reality (VR) Brain Tumor Simulator. Ms. Schlachter was the expert guide as Ms. Esposito put on VR goggles that allowed her to see, in vivid color, the vasculature of her brain. "I thought it was terrific. It helped me see just how much room the tumor was taking up in my brain," she says. "I remember thinking, 'Oh my God is that in my head?' It helped me fully understand what needed to be done."

The virtual reality tool was also vital for Dr. Bederson and his team to plan Ms. Esposito's highly complex surgery, which required extraordinary precision. Armed with data from the MRI and CT scans, they could map out the surgical approach. Using augmented reality tools not available in many centers, he and his team were able to practice the surgery virtually, using special eyepieces to direct him through the blood vessels of the brain and better understand the challenges they would face during the actual procedure. The team rehearsed it multiple times so by the time they stepped into the OR, they knew exactly what they were facing and how to tackle it.

Ms. Esposito was facing another challenge. Her 101-year-old mother, who had lived with her in midtown Manhattan, required care and passed away two months before Ms. Esposito's scheduled surgery in July 2018. "It was a grieving period, and I relied heavily on my faith," says Ms. Esposito. "I was raised Roman Catholic and come from a family of great faith. Religion has been there for me my whole life, especially during this time."

On July 17, 2018, Ms. Esposito — after having received the Catholic sacrament of Anointing of the Sick — had the surgery. The tumor was very dense and challenging to remove, but Dr. Bederson was able to do so. Every move he made carried a potential risk of damage. During a six-hour operation, he followed every step he had rehearsed virtually, gingerly navigating through Ms. Esposito's brain to free the tumor without harming nearby critical structures.

She recovered in the Neurosciences Intensive Care Unit after surgery, proceeding to a step-down unit after one day. For years, her brain had adapted to the slow-growing tumor, but with it removed in a single day, her brain swelled as it readjusted to the new space. She spent a week receiving physical therapy in Mount Sinai Rehabilitation Center before going home and continued with physical therapy as an outpatient for the next six months.

As is typical with brain surgery, one of the toughest things was how tired Ms. Esposito felt as her body healed during the months after surgery. As she recovered, she was challenged to do daily tasks in the way she had become accustomed — taking care of her apartment, preparing food, and so forth — and often needed to take lengthy naps. Her best friend moved in with her after she came home to help her with meals and support her recovery until Ms. Esposito could care for herself.

There were initially some effects of the surgery on the optic nerve to her right eye, which resulted in vision impairment and balance problems, but they have since improved. "My vision was significantly impacted by the surgery — double vision, blurred vision, lack of depth perception, imbalance, and dizziness," Ms. Esposito explains. "Dr. Bederson told me to be patient and suggested there was a possibility that as my brain healed, it might self-correct — which indeed it did, with much help from various therapy professionals. In fact, my vision today is better than before surgery — my right eye needs no correction, and my left eye has a weaker correction than before."

One year following the surgery, she celebrated her birthday — July 28, 2019 — aboard the Queen Mary 2, sailing to London and fully enjoying the trip with her family members. In October 2019, a follow-up scan showed everything was fine and the tumor had not come back. "I feel great now and am in very, very good health," says Ms. Esposito. "I feel that I am back to the way I was before." Reflecting on the ordeal, she says, "When you hear the words 'brain surgery,' you know how serious it is — that there is a possibility that you can lose your sight or hearing. I feel very blessed, and I have the utmost appreciation and respect for everyone who has treated me."