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Thursday, September 10, 2020

One Step at a Time

Posted By: Advancing Care
Ameer Lester built back his strength slowly and has started returning to activities he loves. Photos by Kenneth Gabrielsen

After being diagnosed with a spinal tumor, an NYC teen receives advanced care to regain mobility and functionality.

By Lisa Cesarano
As seen in the December 2020 Issue of Advancing Care.

For 16-year-old Ameer Lester, the symptoms were subtle at first.
Ameer had complained about his left hand feeling cold, and he was unable to open jars, recalls his mom, Jennifer, an emergency room nurse. “We had attributed this to shoveling snow in the cold weather.”

Over time, however, the Bronx resident experienced symptoms that grew progressively worse: leg weakness, difficulty in walking and falls. “My leg would tilt to the left,” Ameer remembers, “so I could not walk properly or run.”

Then, last August, he began experiencing weakness on one side of his body. “This typically happens with stroke victims,” says Jennifer. “Something didn’t seem right.”

A Frightening Diagnosis

Jennifer immediately brought Ameer to his pediatrician, who then referred him to an orthopedist and a neurologist. A brain MRI revealed nothing remarkable. He then had a follow-up MRI of his cervical spine at Westchester Medical Center, the flagship of the Westchester Medical Center Health Network (WMCHealth). That’s when they found a tumor. “I knew something was wrong,” says Jennifer, “but I never would have imagined it was that.” 

The diagnosis was particularly difficult for the Lester family, as they were already facing a daunting health challenge: Jennifer was receiving treatment for Leukemia while caring for Ameer, his 11-year-old brother, Amaad, and 5-year-old sister, Mia.

Ameer’s MRI revealed a schwannoma, a tumor that grows off a nerve root in the neck, which was severely compressing his spine. “Schwann cells are support cells that surround nerve cells, like the insulation surrounding a wire,” explains Jared Pisapia, MD, a neurosurgeon at Maria Fareri Children’s Hospital, a member of WMCHealth. “The schwannoma impacted the nerve roots that feed from the spinal cord to his arms and legs.”

“If you are going through what I did, having patience is a very important thing. Dr. Pisapia made that easier; he has such a good energy, which made me feel so positive.”
– Ameer Lester, 16

While the tumor was noncancerous, “often in these situations, patients hit a tipping point, where symptoms begin to rapidly worsen, and Ameer seemed to have reached that point,” notes Dr. Pisapia. Ameer was admitted immediately and prepared for surgery.

Dr. Pisapia performed surgery to remove the tumor compressing Ameer’s spine. Guided by intraoperative neuromonitoring which safeguards the delicate nerves near the spine, he accessed the tumor by removing adjacent bone and opening the dura, a thin membrane that encloses the spinal cord, parts of the spinal nerves and the spinal fluid within the spinal canal. Finally, Dr. Pisapia placed several rods and screws into Ameer’s spine, to stabilize it.

“Ameer recovered his leg function and is able to walk normally, has no pain in his arm and, importantly, did not lose any hand function after surgery,” says Dr. Pisapia. While the surgery was a success, Ameer faces a long road to recovery, as it takes at least a year for the bones to grow back together.

“I never had any health issues, so this was very new and different and scary for me,” says Ameer. “But slowly, I started building back my strength, to move and walk correctly and even do some jogging.”

Ameer; his mom, Jennifer; his younger sister, Mia; and his younger brother Amaad, enjoyed the photo shoot at a local park. “They had so much fun,” says Jennifer. “Ameer’s confidence got bigger.”

‘Stay in the Moment’

While helping Ameer through his surgery and recovery, Jennifer continued to manage her own health concerns. “The way I have approached the past year and half is basically one step at a time,” says Jennifer. “You can drive yourself crazy. I have learned to stay in the moment and figure out what needs to be done now.”

For his part, Ameer took this experience as the opportunity to cultivate patience. “I waited a whole year for my bones to fuse together. I had to develop a good mindset. I had a lot of time to think when I was in the hospital recovering. It helped me get better insight and to look forward to things in life.”

Both Ameer and his mom were deeply grateful for the care he received. “Dr. Pisapia’s bedside manner was so amazing,” says Jennifer. “To be cared for by a surgeon of that caliber and then to essentially have him develop a friendship with Ameer was a godsend.”

Multidisciplinary Expertise: Maria Fareri Children’s Hospital Neuro-Oncology Program

Central nervous system tumors, including cancers of the brain and spinal cord, are the second-most-common malignancies in children. Successful treatment requires a coordinated team approach. 

The primary treatment program at Maria Fareri Children’s Hospital includes pediatric neurosurgery, pediatric neuro-oncology, pediatric radiation oncology and advanced practice nursing. These team members are assisted by specialists skilled in pediatric neuropathology, neuro-radiology, neurology, endocrinology and nursing. Dedicated psychology, neuropsychology, child life, physical therapy, occupational therapy, nutrition and social-services personnel also provide necessary support to patients.

To learn more about our pediatric neurosurgery services across the WMCHealth network, please call 914-775-5437 or visit mariafarerichildrens.org/neurosurgery.