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Monday, July 8, 2013

A Positive Mindset For Brain Surgery

Lyle Nalli was surprised when his hearing went out after he hopped out of workout one day.

"I just couldn't hear with my left ear," said the 53-year-old podiatrist from Huntington Beach, California. "I got out of the pool and thought there was water in my ear. "It would not go away. I thought there was wax in the ear, but there was nothing. I took a hearing test that showed a loss of hearing, but the doctors did not know why."

After consulting his colleagues in the medical community, he went in for an MRI. "It was positive for acoustic neuroma (AN), a swelling of the nerve," he recalls. The tumor was 3 mm in diameter and located inside his cranium between the inner ear and his brain stem. "After consultation, there were 3 options: just observe and let it be, gamma knive, and a surgery to excise it. I decided on surgery at the House Ear Clinic in Los Angeles with Dr. Slattery who I cannot say enough positive things about." He decided on an immediate surgery because he felt he was healthy enough to get through the surgery, there was no chance of coming back after excision, and he could eliminate the worry for the rest of his life that the tumor was not getting bigger.

For a man who has been training and racing all his life as a competitive pool and open water swimmer, health was not an issue. Not only has Lyle been a regular at local events, he has placed at World Masters Championships and was on the current record-setting Catalina Channel relay with his Long Beach Swim Focus training teammates. "The nurses and staff nicknamed me The Athlete because my resting heart rate was so low. In the Intensive Care Unit (ICU), my resting pulse of 38 beats per minute kept on tripping the alarm."

Like his open water swims, Nalli knew the inherent risks, but he had prepared himself as best he could and left the preparations and guidance up to Dr. Slattery. "In surgery, he cut into my skill about the size of a quarter (24 mm) behind my ear. He drilled into my skull and then gave me a spinal tap and drained out the cerebral spinal fluid (CSF). This caused my brain to recede and gave the doctor some slack to work with. Then he made a cut to excise the tumor around the brain stem where the facial nerves, hearing nerves, and balance nerves are located. He cut out the balance nerves and then shaved off a bit of the hearing nerve in order to save my hearing. Six hours later, the benign, slow-growing tumor was out and he patched me all up."

Nalli's story now becomes one of inspiration and shows the advantages of staying in shape as one ages.

"I was in ICU for 3 days and then I stayed in the hospital for a week total. For the first day and a half, I went in and out of sleep I had a throbbing headache and a sick, sour taste in my stomach for 4 days. It was hard to sleep and I had this strong sense of smell of cat urine and burnt eggs. This taste and smell did not go away for days and I immediately lost 15 pounds while I was in ICU. I lost my sense of balance and my head felt like it was spinning when I did things like try to walk or read or watch TV. Patience and time were what was needed. Even after 7 days, I wasn't able to walk upstairs and listening to music and reading was just tiring. I learned patience."

Fortunately, his healthy body built up over the decades through swimming got about to start healing itself quickly. "I just go around to waiting and watching. This was exactly the opposite from all my experiences in athletics and swimming. Imagine in swimming if a coach asked you to just do nothing in order to get better? But that is what I did."

But time means different things to different people. And Nalli was definitely different.

3 days in ICU, 7 days in the hospital, and on the 18th day after 6 hours of brain surgery, Nalli ventured back to the pool. "After 2 weeks, Dr. Slattery was surprised at my recovery, but I still had to have help to walk and keep my balance. Once I got back in the pool, I was so elated to even kick. I was very happy to be able to do 25 yards of freestyle, but I mostly did kicking. I was careful and couldn't do flip turns and even breathing side to side was tough. But day by day, I got better. I started out doing 500 yards, then 1100 yards, then 1800 yards."

Remarkably, less than 4 weeks from his skull being cut open with a drill, Nalli had gradually upped his distance to 5000 yards.

"I just got in today and decided to do a 500. Once I was able to do that, I decided to do 10 total. It is just progression. I am ecstatic and happy that I was healthy before the surgery. The wobbling is getting less intense and the dizziness is going away sooner. I entered U.S. Masters Swimming Nationals less than a month from now and want to do the 400 IM and distance frees."

Looking at his sparkling blue eyes and wide smile, his joy in swimming again is clearly evident and a credit to his positive mindset and a long life of healthful living.

Copyright © 2013 by World Open Water Swimming Association

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