Rick Larsen - After the Brain Tumor: Back on his Bike

Trim and 6’3”, 54-year old Rick Larsen is as athletic as he looks. He surfs, skis and hikes, but his daily workout is mountain biking on a trail he helped build, at the Camp Camarancho Boy Scout Preserve in Fairfax. Watching him zip down the hill on his bike, it’s hard to believe that in January of 2015, Rick was a repeat patient at Marin General Hospital, including three visits to the Emergency Department, surgery, and overnight stays in the Intensive Care Unit (ICU), Step-Down Care Unit (SCU), and Cardiac Unit

On January 7, 2015, Rick was carrying the family Christmas tree out to the curb when he felt numbness and tingling in his right arm. Rick and his wife Alison are both in the health care technology field, and they felt they knew enough not to worry: A quick search on the internet convinced him it was just a pinched nerve. Over the next few days, the numbness and tingling spread down Rick’s side to his leg. When his doctor couldn’t squeeze him in, he went to an urgent care clinic. They referred him to Marin General Hospital's Emergency Department, where an MRI revealed a growth at the base of Rick’s brain. The hospital called in neurosurgeon, Dr. Tarun Arora, who suspected the lesion was a brain tumor called a hemangioblastoma. Rick was admitted to the SCU and stayed in the hospital for two days to have detailed imaging of the tumor. While Dr. Arora believed the tumor was likely benign, the tumor was compressing and invading vital parts of the brain that, if not relieved, would eventually leave Rick paralyzed.

Rick and Alison knew about UCSF’s world renowned neurosurgery program and wondered whether to go there for Rick’s surgery. That’s when Dr. Arora explained that he, and all the other neurosurgeons on staff at Marin General Hospital, are full-time UCSF faculty who treat patients at both institutions as part of a unique program that UCSF Neurosurgery and Marin General Hospital started four years prior. As a result of this strong alliance, patients are able to receive UCSF neurosurgical care without leaving Marin and their local support network of family and friends. He suggested that Rick stay close to home at Marin General Hospital for his brain tumor surgery, near his wife and teenage son and daughter. By then, Rick and Alison had formed a very positive opinion of the Marin General Hospitalstaff. They readily agreed.

Rick was sent home with a prescription for steroids to shrink the swelling from the tumor as much as possible for surgery scheduled one week later. Despite the steroids, his symptoms continued to worsen and the numbness spread to his face. He also developed persistent hiccups due to pressure on a critical part of his brain. Dr. Arora was attending a conference out of town, but he had given Rick his cell phone number. After hearing from Rick and discussing the situation, Dr. Arora arranged to move Rick’s surgery up by two days and agreed to come back early from the conference to perform the operation.

The morning of the surgery, all members of the surgical team introduced themselves to Rick and Alison and explained their individual roles in Rick’s procedure. The Larsens were impressed. As Alison puts it, “We knew we were dealing with the A-team. They were all so dedicated, and such great communicators.” Anesthesiologist Andrew Solomon shared mountain biking stories to put Rick at ease. Sheila Habib, the OR Nurse, promised to update Alison every hour, by text or in person – and did. As a result, Alison says she “knew what was going on at every step, which was huge” as she waited anxiously with a group of supportive friends outside the OR. Later that evening, Dr. Arora explained that the surgery was a success. The entire tumor was removed and Rick was awake, talking, and moving everything normally.

Rick was discharged the next week, with detailed instructions for slowly stepping down the steroids to avoid rebound swelling in the area of the tumor. A few days later, the debilitating hiccups came back, and kept Rick awake all night. Dr. Arora increased the steroids for Rick but the hiccups wouldn’t subside. Rick returned to the Emergency Department (ED) for another MRI which was thankfully normal--a relief to everyone. His hiccups were most likely from slight swelling and he was released with a new prescription. When the Larsens stopped by the drug store to fill it, Rick passed out in the parking lot, hitting his head on the asphalt. He was rushed back to the ED, this time by ambulance.

Dr. Arora met them at the ED. Fortunately, testing determined that the fall had not impacted the surgical area in Rick’s brain, but despite being normal just an hour before, his blood pressure was alarmingly low. Rick was admitted, this time to the Cardiac Unit, where it was determined the blood pressure issues were an atypical reaction due from the steroids. His blood pressure soon returned to normal and Rick was able to head home to continue his recovery.

Today, Rick is back to work and once again doing the activities he loves, mountain biking and kite boarding. He has nothing but good things to say about Marin General Hospital. “I’ve been on every floor of the hospital. The expertise, communication and academic caliber of the staff, and the way they worked together – it was the perfect combination. You don’t have to go to the city and get lost in the shuffle.

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