Happy Heavenly Birthday Cz , Today is April 5 your first birthday in heaven, you would be 54 today. I know you are celebrating with family and friends that passed on before us and the angels and our Lord, how happy you must be. Your body is healed and your soul is singing joyfully.
I am going to celebrate you today, yesterday I could not get you off my mind and Tom and I spoke and laughed about all the fun times we had. You introduced us just over 25 years ago. Man time flies by. I will be visiting your grave today and yes i will be bringing the coffee. I miss you so much and talking to you every day, but today isn’t about me it’s about you. And I know you would not want anyone sad on your birthday. So I am going to celebrate you and be grateful for the time I had you in my life, as we were more than cousins.
I cannot promise I won’t cry or miss you.
Some may find it hard to celebrate today you see we are selfish because we loved and are missing you so much. Like the other days that have gone by since you passed, this one hurt almost as much as the day you passed away. I woke up this morning positive my heart was going to feel a deep sadness , but you made sure that didn’t happen you visited me again last night.
This is your first birthday not here and there will be many firsts , it’s the first birthday in my entire life that I didn’t talk to or see you physically, or sharing a birthday coffee with, or seeing you open your gift and hearing you say oh Debbie you should have bought yourself something instead of spending money on me, then you would give me a big hug and kiss and tell me you love it and tell me you love me. So I will have to come visit your grave and just be grateful you were in my life and these flowers are my gift for you.
Do you know how much I miss you? How not a day goes by where I don’t think of you or talk to you ? Well we said it enough we were more than cousins we were also like sisters and we were best friends. I think you do, because you keep coming to me in my sleep and hugging me like you did last night, but last night was different you told me you need me to let others know you are with them too and they need to get on with living.
Every time you come to me we hug , give our hello smooch, then are sitting on this same beautiful rock in this amazing garden. I have never seen anything so pretty.
You say you are better than okay and then voice your concern about others who aren’t taking your passing so well. And you give me these messages to relay.
You tell me about a feather, the Angel feather, a sign of faith and protection and it comes via your Angel telling you that all loved ones in heaven are safe and well. Or that your family will keep seeing the same numbers over and over, it’s you letting them know you are more than okay you are healed and with always them. You tell me that you are using this as a way to tell everyone you are okay. And yes even the pennies from heaven are from our loved ones.
You want family to know your spiritual presence is always there. And to let go of the grief and stop stressing and live your lives to the best you can. And to take care of themselves , their health especially and not dwell on things that are not good.
You tell me how our loved ones do hear our thoughts feelings and emotion’s, its sent through energy. When we think of them they know it. And that’s why we will see the same yet different signs. We will even smell them suddenly , their cologne . Just respond hi I know it’s you, because are loved ones are near.
You stress that I already know these things because I am so smart haha and I have a long energy connection but others don’t understand because it’s new to them and I have to let them know .
So I promise I will write about it ,better and not as sloppy as i wrote all you said at 3am so everyone can read it. We are not to be sad any longer,or angry, we have to now work on moving past the grief and we must be encouraged and relaxed knowing that our loved ones are happy, healthy and with our Lord and there is nothing to fear and someday we will all be together again.
As you then try to explain the afterlife to me and the beauty you describe seems incredible, you tell me you all have jobs and that you cannot wait to get yours. You tell me how good my parents are and the rest of the family and they have amazing jobs. You mentioned lassie also greeting you when you arrived in heaven as did the entire family, and you keep saying you didn’t know why you was nervous to get there. You tell me one final thing that you need me to do and I tell you anything …. you say meningiomas and I ask what about them, you say to me do what i do best and you say I will figure it out. I say okay.
Then you tell me you must go now. We stand, hug , smooch and say I love you. And just like that I woke up.
I will celebrate your birthday today and I will be happy that you are in a place that’s of peace and love and beauty and no disease.
I Love You Cousin
Until We Meet Again
Love Your Cz
Songs we would listen to and play the air guitar to ❤
My cousin had reoccurring meningiomas she battled for 5 years every time the came back it was more aggressive
What You Should Know About Meningioma Brain Tumors
The tough outer layer is called the dura mater. A meningioma is a tumor that arises from the meninges — the membranes that surround your brain and spinal cord. Although not technically a brain tumor, it is included in this category because it may compress or squeeze the adjacent brain, nerves and vessels. Meningioma is the most common type of tumor that forms in the head
The words brain tumor sound scary to anyone. After all, we are talking about the most complex organ in the human body.
But what you might not know is that some brain tumors can be treated or even just monitored quite successfully with very positive outcomes.
And this is exactly the case with a specific type of brain tumor called a meningioma, which is a common tumor that forms within the outer three thin layers of tissue that cover the brain and spinal cord, called meninges.
Dr. Ravi Gandhi, neurosurgeon at Florida Hospital Orlando who specializes in brain tumors and minimally invasive brain surgery, explains more about meningiomas, and how many patients go on to live healthy, fulfilling lives under the care of a qualified neurosurgeon.
Meningiomas account for about 36 percent of all primary brain tumors and 20 percent of all brain tumors
Meningiomas are common types of tumors within the head, says Dr. Gandhi. In fact, this skilled neurosurgeon performs an average of two brain tumor surgeries per week, and about one meningioma-specific surgery per month.
Dr. Gandhi further explains that meningiomas can affect anyone, but 40 percent occur in adults over age 60.
Certain genetic mutations can cause people to have multiple meningiomas, or have these types of brain tumors run in their families, explains Dr. Gandhi.
Meningiomas are usually benign
The good news is that most meningiomas are usually benign and slow-growing, meaning they do not have cancerous cells that can spread to other parts of the body.
Meningiomas are the most common benign intracranial tumor. They originate from arachnoid cap cells, which are cells within the thin, spider web-like membrane that covers the brain and spinal cord. The arachnoid is one of three protective layers, collectively known as the meninges, surrounding the brain and the spinal cord. The meninges also include the dura mater and pia mater. Although the majority of meningiomas are benign, these tumors can grow slowly until they are very large if left undiscovered and, in some locations, can be severely disabling and life-threatening. Most patients develop a single meningioma; however, some patients may develop several tumors growing simultaneously in other parts of the brain or spinal cord.
Some meningiomas are found along the dural lining in the venous sinuses of the brain and skull base, locations where arachnoid cap cells are most abundant. The following subtypes are based on the location of the tumor.
- Cavernous Sinus Meningioma: Occurs near the area that drains deoxygenated blood to the heart from the brain.
- Cerebellopontine Angle Meningioma: Located near the margin of the cerebellum; acoustic neuromas (vestibular schwannoma) typically are found in this area.
- Cerebral Convexity Meningioma: Located on the upper surface of the brain cerebral convexity.
- Foramen Magnum Meningioma: Located near the opening at the base of the skull through which the lower portion of the brainstem passes.
- Intraorbital Meningioma: Located in or around eye sockets.
- Intraventricular Meningioma: Located in the chambers through which cerebrospinal fluid is carried throughout the brain.
- Olfactory Groove Meningioma: Located along the nerves connecting the nose to the brain.
- Parasagittal/Falx Meningioma: Located adjacent to the dural fold that separates the two brain hemispheres
- Petrous Ridge Meningioma: Portion of the temporal bone (which supports the temple) that contain sections of the organs that facilitate hearing.
- Posterior Fossa Meningioma: Occurs near the back of the brain.
- Sphenoid Meningioma: Located near the sphenoid bone behind the eyes.
- Spinal Meningioma: Located in the spine, in some cases against the spinal cord.
- Suprasellar Meningioma: Located near the area of the skull where the pituitary gland is found.
- Tentorium Meningioma: Located near where the brain connects to the brainstem, an area known as the tentorium cerebelli.
According to the Brain Science Foundation and the American Society of Clinical Oncology, meningiomas account for about 34 percent of all primary brain tumors and most often occur in people between the ages of 30 and 70. Malignant meningiomas account for about two to three percent of all meningiomas.
The World Health Organization (WHO) classification of brain tumors is the most widely utilized tool in grading tumor types. The WHO classification scheme recognizes 15 variations of meningiomas according to their cell type as seen under a microscope. These variations are called meningioma subtypes; the technical term for these cell variations is histological subtypes.
World Health Organization (WHO) Meningioma Classifications
|WHO Grade I — Benign||WHO Grade II — Atypical||WHO Grade III — Malignant|
|Fibrous (fibroblastic)||Clear Cell||Rhabdoid|
Atypical meningiomas (which account for seven to eight percent of meningioma cases) exhibit increased tissue and cell abnormalities. These tumors grow at a faster rate than benign meningiomas and can invade the brain. Atypical meningiomas have a higher likelihood of recurrence than benign meningiomas.
Malignant meningiomas show increased cellular abnormalities, and grow at a faster rate than benign and atypical meningiomas. Malignant meningiomas are the most likely to invade the brain, spread to other organs in the body and recur more often than the other two types.
As noted earlier, meningiomas most often occur in people between the ages of 30 and 70. Children are not as likely as adults to develop meningioma.
Women are more than two times as likely as men to develop a meningioma. Malignant meningioma diagnoses are three times as likely in men. Spinal meningiomas occur 10 times more frequently in women than in men.
Exposure to ionizing radiation, especially high doses, has been associated with a higher incidence of intracranial tumors, particularly meningiomas. There also is evidence indicating a connection between meningiomas and low doses of radiation. The most well-known case involves children in Israel who were given radiation for scale ringworm between 1948 and 1960. Within the U.S., dental X-rays are the most common form of exposure to ionizing radiation. A number of studies have linked the number of full mouth dental radiographs to increased risk of meningioma.
The genetic disorder Neurofibromatosis type 2 (NF2) is believed to put people at a higher risk of developing meningioma. Patients with NF2 also may be more likely to develop malignant or multiple meningiomas.
Per the Brain Science Foundation, a number of studies have suggested a correlation between meningiomas and hormones. Such findings include the following:
- Increased occurrence of meningioma in women
- The detection of such hormones as estrogen, progesterone and androgen in some meningiomas
- A link between breast cancer and meningioma
- A connection between meningioma growth, menstrual cycles and pregnancy
Researchers are beginning to explore the possible connection between meningioma risk and the use of oral contraceptives and hormone-replacement therapy procedures.
Because meningiomas commonly are slow-growing tumors, they often do not cause noticeable symptoms until they are quite large. Some meningiomas may remain asymptomatic for a patient’s lifetime or be detected unexpectedly when a patient has a brain scan for unrelated symptoms. Presenting signs and symptoms depend on the size and location of the tumor. Symptoms of meningiomas may include any of the following:
- Change in personality or behavior
- Progressive focal neurologic deficit
- Hearing loss or ringing in the ears
- Muscle weakness
- Nausea or vomiting
- Visual disorders
Symptoms can be related more specifically to the location of the meningioma. Examples include the following:
- Falx and Parasagittal: Impaired levels of brain functioning such as reasoning and memory. If located in the middle section, it would likely cause leg weakness/numbness or seizures.
- Convexity: May cause seizures, headaches and neurological deficits.
- Sphenoid: Vision problems, loss of sensation in the face or facial numbness and seizures
- Olfactory Groove: Loss of smell due to compression of the nerves that run between the brain and the nose. If the tumor grows large enough, vision problems may occur due to compression of the optic nerve.
- Suprasellar: Vision problems due to compression of the optic nerves/chiasm.
- Posterior Fossa: Facial symptoms or loss of hearing due to compression of cranial nerves, unsteady gait and problems with coordination.
- Intraventricular: May block the flow of cerebrospinal fluid, resulting in (obstructive hydrocephalus), potentially leading to headaches, lightheadedness and changes in mental function.
- Intraorbital: Buildup of pressure in the eyes, leading to a bulging appearance and potential loss of vision.
- Spinal: Back pain or pain in the limbs caused by compression of the nerves which run into the spinal cord.
It can be difficult to diagnose meningiomas for several reasons. Because the majority of meningiomas are slow-growing tumors and primarily affect adults, symptoms may be so subtle that the patient and/or doctor may attribute them to the normal signs of aging. Adding to the confusion is that some of the symptoms associated with meningiomas can also be due to other medical conditions. Misdiagnosis is not uncommon and, in fact, may take several years to diagnosis correctly.
When a patient presents slowly increasing signs of mental dysfunction, new seizures or persistent headaches or if there is evidence of pressure inside the skull (e.g. vomiting, swelling of the optic nerve head in the back of the eye), the first step should be a thorough neurological evaluation, followed by radiological studies, if needed.
Sophisticated imaging techniques can help diagnose meningiomas. Diagnostic tools include computed tomography (CT or CAT scan) and magnetic resonance imaging (MRI). Intraoperative MRI also is used during surgery to guide tissue biopsies and tumor removal. Magnetic resonance spectroscopy (MRS) is used to examine the tumor’s chemical profile and determine the nature of the lesions seen on the MRI.
Sometimes, the only way to make a definitive diagnosis of the meningioma is through a biopsy. The neurosurgeon performs the biopsy, and the pathologist makes the final diagnosis, determining whether the tumor appears benign or malignant, and grading it accordingly.
Meningiomas primarily are benign tumors, frequently with defined borders and often enabling complete surgical removal, which offers the best chance for a cure. The neurosurgeon opens the skull through a craniotomy to enable full access to the meningioma. The goal of surgery is to remove the meningioma completely, including the fibers that attach it to the coverings of the brain and bone. However, complete removal can carry potential risks that may be significant, especially when the tumor has invaded brain tissue or surrounding veins.
Although the goal of surgery is to remove the tumor, the first priority is to preserve or improve the patient’s neurological functions. With patients for whom total removal of the tumor carries significant risk of morbidity (any side effect that can cause decreased quality of life), it may be better to leave some of the tumor in place and observe future growth with regular imaging studies. In such cases, the patient will be observed over a period of time with regular examinations and MRIs, while for other patients, radiation therapy may be deemed the best approach. It is common for patients to undergo preoperative embolization of the tumor to ensure safety during the surgical procedure. The embolization procedure is similar to a cerebral angiogram except that the surgeon fills the blood vessels in the tumor with glue to stop blood supply to the tumor.
Observation over a period of time may be the appropriate course of action in patients who meet the following criteria:
- Patients with few symptoms and little or no swelling in the adjacent brain areas
- Patients with mild or minimal symptoms who have a long history of tumors without much negative effect on their quality of life
- Older patients with very slow-progressing symptoms
- Patients for whom treatment carries a significant risk
- Patients who choose not to have surgery after being offered alternate treatment options
Radiation therapy uses high-energy X-rays to kill cancer cells and abnormal brain cells, and to shrink tumors. Radiation therapy may be an option if the tumor cannot be treated effectively through surgery.
- Standard External Beam Radiotherapy uses a variety of radiation beams to create a conformal coverage of the tumor while limiting the dose to surrounding normal structures. The risk of long-term radiation injury with modern delivery methods is very low. Newer techniques of delivery aside from 3-dimensional conformal radiotherapy (3DCRT) include intensity-modulated radiotherapy (IMRT).
- Proton Beam Treatment employs a specific type of radiation in which protons, a form of radioactivity, are directed specifically to the tumor. The advantage is that less tissue surrounding the tumor incurs damage.
- Stereotactic Radiosurgery (such as Gamma Knife, Novalis and Cyberknife) is a technique that focuses the radiation with many different beams on the target tissue. This treatment tends to incur less damage to tissues adjacent to the tumor. Currently, there is no data to suggest one delivery system is superior to another in terms of clinical outcome. Each has its advantages and disadvantages.
Chemotherapy is rarely used to treat meningioma, except in atypical or malignant subtypes that cannot be adequately treated with surgery and/or radiation therapy.
In adults, the patient’s age at the time of diagnosis is one of the most powerful predictors of outcome. In general, the younger the adult, the better his or her prognosis tends to be.
There generally is a better outcome if the entire tumor is surgically removed. However, this is not always possible due to the location of the tumor.
Data from the American Society of Clinical Oncology indicates an overall five-year survival rate for meningioma of 69 percent. Individuals with benign meningiomas have an overall five-year survival rate of 70 percent, while those with malignant meningiomas have an overall five-year survival rate of 55 percent.
These websites offer additional helpful information on meningiomas, including treatment options, support and more. (Note: These sites are not under the auspice of the AANS, and their listing here should not be seen as an endorsement of these sites or their content.)
The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon” online tool.
All tumors are evaluated and given a specific stage, from grade 1 being the least aggressive to grade 4 being most aggressive; 90 percent of meningiomas are grade 1 (or completely benign), a handful are grade 2, and a grade of 3 to 4 meningioma is very rare, confirms Dr. Gandhi.
Meningiomas are often found inadvertently
70 to 80 percent of meningiomas are found incidentally, meaning patients have no symptoms and they are identified through a CAT scan or MRI for an unrelated reason, says Dr. Gandhi.
He adds, For the remaining 20 to 30 percent of patients, meningiomas cause symptoms that bring them in to see a doctor for evaluation and more specific diagnostic testing.
Meningioma symptoms depend on its location in the brain
Meningiomas are often asymptomatic until they get to a certain size or affect a specific location in the brain, location is everything, points out Dr. Gandhi.
Meningiomas tend to grow inward, which can eventually can cause pressure on the brain or spinal cord.
When the tumor begins to put pressure on the brain, symptoms might begin.
Dr. Gandhi explains that common meningioma symptoms can include chronic:
- Neurologic difficulties
- Problems with speech
- Difficulty hearing
- Facial weakness and/or pain
- Disturbances in vision
Not all meningiomas need surgery
Meningiomas most commonly occur in specific locations and are classified as convexity (over the surface of the brain) or skull-based.
Every patient is unique, presenting with different tumor sizes and locations, symptoms, growth rate, age, medical history, etc., so the treatments that we recommend consider many factors, explains Dr. Gandhi.
Dr. Gandhi explains that treatment generally falls into three options: observation, surgery to remove the meningioma, and/or radiation.
Dr. Gandhi notes, Many patients with meningiomas just need observation, where depending on the size and location, we check the meningioma through an MRI in one years time to see if it is changing.
If its found that the meningioma reaches a specific size or the patient is experiencing symptoms, surgery is often the first line of treatment.
Surgery often brings positive outcomes for patients with meningiomas
If you’ve been diagnosed with a meningioma and you’re being told that you need surgery, it becomes important to have surgery from neurosurgeon that specializes in these types of tumors, Dr. Gandhi thoughtfully explains.
He adds, When your neurosurgeon has adequate experience, the risk of complications and difficulties after surgery to remove a meningioma are relatively low, but just like any surgery, there are always risks, which rise as a tumor gets larger or is located in a more challenging part of the brain.
After surgery, according to Dr. Gandhi, patients can expect to spend about one day in the ICU for close monitoring, and then another one to two days in the hospital before returning home. Once home, patients are advised to take it easy, and are able to do most daily activities with restrictions on vigorous activity for a few weeks.
We see patients for frequent follow-ups after surgery to make sure they are healing, and once we confirm that they are doing well, patients generally come for check-ups only once a year, says Dr. Gandhi.
Meningiomas can reoccur
Just like any tumor, meningiomas can reoccur after surgery. Dr. Gandhi clarifies, The rate of reoccurrence depends on how much of the tumor tissue and surrounding cells are removed during surgery if the entire tumor has been taken out with all affected tissue, reoccurrence is much less likely.
Gandhi adds, Sometimes, due to the location and position of the tumor (if it is too close to an artery or particular nerves), part of the tumor or affected tissue cant always be removed, and the chance of reoccurrence is higher, but since meningiomas are usually slow-growing tumors, we can often control their growth with radiation.
There is no proven cause of meningiomas
There is no proven cause of meningiomas, but there are two important risk factors to consider: radiation exposure and a genetic condition called neurofibromatosis type 2.
Weve also identified that some meningiomas have estrogen and progesterone receptors, so they can grow faster in stages of hormone changes that occur throughout pregnancy, or during certain treatments for breast cancer. This is a correlation and does not mean that these things are a cause of meningiomas., notes Dr. Gandhi.
Dr. Gandhi adds, Its also important to point out that there is no proven association between meningiomas or any type of brain tumor and cell phone usage.
Extending hope for all
From helping patients with meningiomas to those with many other neurological conditions and traumas, Dr. Gandhi shares his love for what he does as a neurosurgeon.
Dr. Gandhi reflects:
When I wake up every day, I feel lucky that I get to help people as a neurosurgeon being a neurosurgeon is something that I dreamt about since childhood. I decided I wanted to be a neurosurgeon in fourth grade, and after having a grandfather experience a stroke and learning more about how someone who can treat diseases of the brain can change a person/familys lives, my commitment to making this dream come true was even more solidified.
The reality of my childhood dream is just how I always imagined it would be I talk to patients and their families, sometimes at their worst, and provide some hope and comfort. And I get to work within a hospital that has some of the most advanced technology available in the field that supports me in providing safer and better surgery for my patients. Its what I was meant to do.
Learn more about the Florida Hospital Neuroscience Institute