Denise Buro initially chalked it up to pandemic stress, business setbacks and depression when her husband started acting different.
The 50-year-old founder and CEO of a database marketing company, Jason Buro had always been a go-getter, problem-solver, the life of the party. Then, little by little last year, that all changed. Jason turned argumentative, then withdrawn and indifferent, even letting the lawn he once faithfully tended grow wild all summer long. His wife of 28 years knew something was seriously off.
"He literally would just sit in the dark on TikTok — all day long," Denise recalled. "You’d ask him a question and he’d just kind of grunt. And that was very, very odd. And if you did become confrontational, or combative, with him, he would just look away — and that is not him."
On the rare days when Jason did go to his Jamestown, North Carolina, office, colleagues noticed changes too. Among other things, a co-worker told Denise that Jason had had two headaches so severe, he had stretched out on the floor in search of relief.
But repeated doctor visits brought no explanations, and his family was scared. So, in early March, they staged an intervention — forcing an unwilling Jason to go to the emergency room at Novant Health Kernersville Medical Center for a brain scan. What it revealed was devastating.
"The doctor sat me down and started going through the MRI … and I see this big potato, and say, 'OK, that’s my brain,' " Jason recalled. "And he’s like, 'No sir, that’s the largest brain tumor I’ve ever seen.' "
And before he knew it, Jason Buro was in an ambulance on his way to the skilled neurosurgeons who could give him his life back.
Novant Health surgeons are readyAct now
Almost too late
"I think if his family had waited, you know, a week or two more, it would have rapidly gone downhill," said Dr. Rashid Janjua, the neurosurgeon who oversaw Jason’s care at Novant Health Forsyth Medical Center in Winston-Salem. He practices at Novant Health Brain and Spine Surgery - Kimel Park.
Janjua quickly ordered another MRI as well as angiogram to size up the full extent of the problem.
Jason Buro’s "big potato" was a giant atypical olfactory groove meningioma. Janjua suspects the grapefruit-sized tumor had been growing for a year or more. It filled a quarter of Jason’s skull, pushing his brain up and back inside his head.
Its position behind the forehead, where it pressed on the brain’s frontal lobes, accounted for Jason’s out-of-character behavior. The frontal lobes are involved with thinking, memory and personality — the things that make us who we are.
"My concern was: This man is the CEO of a company. How do I get him back to making sound judgments for his company?" Janjua said. "But bigger than that is … that this is somebody’s husband, somebody’s dad. And every minute of the operation, you’re thinking, 'OK, I need to get this man back to his children and his wife.'"
It would take close to 18 hours of surgery over two days to accomplish that mission and return the old, familiar Jason to his loved ones.
Though Novant Health Forsyth is a busy tumor center, its surgeons see only a handful of tumors of this size in a typical year, Janjua said.
Meningiomas begin in the layers of tissue surrounding the brain and spinal cord. The American Society of Clinical Oncology estimates that 34,840 will be diagnosed in the United States this year. The risk increases with age.
Risky at every step
To remove Jason’s tumor, Janjua performed a procedure called a craniotomy in which the top of the skull was opened. Then, working through a smaller hole to avoid exposing healthy brain tissue, he used an ultrasonic tool to "nibble away" at the tumor and remove it, piece by piece.
All the while, computer navigation pinpointed the location of blood vessels, nerves and healthy tissue — guiding the operation much the same way GPS guides a road trip. But even with that high-tech equipment and the assistance of neurosurgeon Dr. Michaux Kilpatrick, removing a meningioma is tricky business.
"Every single aspect of the surgery has risks associated with it, from the time you cut the skin to the time you put him back together," Janjua said.
On a grand scale, there’s the potential for lasting brain damage, seizure, stroke and even death. If nearby sinuses are breached, spinal fluid can leak from the nose during a sinus infection and meningitis can result. And the nerves that are responsible for smell and taste can be damaged or destroyed.
But Janjua could tell soon afterward that the surgery had been a success. Unlike other operations, where patients come to in the recovery room, those who have brain surgery wake up in the operating room. The reason is simple: It allows doctors to swiftly assess their functioning and undertake immediate follow-up surgery, if needed.
Jason not only did well on his post-op function tests, he was up around the morning after each surgery. And within 10 days of entering the hospital, he was back at his Winston-Salem home to finish his recuperation.
Taking nothing for granted these days
By early May, Janjua gave him the OK to drive and Jason returned to the helm of his company, Valurity Analytics. He even started mowing the lawn again.
Best of all, he was around to celebrate a pair of important family milestones: daughter Sydney’s graduation from Appalachian State University and son Logan’s high school commencement. Logan — who played a big part in the intervention — plans to follow his dad’s footsteps and join the U.S. Navy.
Denise is grateful to have her motivated, high-energy husband back — which she considers nothing short of a miracle.
"I really think he wouldn’t have made it much longer," she said in mid-May.
In hindsight, Jason suspects Denise is right. He said he owes his life not only to Janjua’s skill but also to his wife’s persistence.
"She’s my angel," he said.
The experience has truly been life-altering for Jason Buro.
Before his tumor, Jason hadn’t seen a doctor for a dozen years. But his health will now be closely monitored. The type of tumor he had — not cancerous, but not benign either — could grow back, so he will have brain scans every few months just in case.
And during the many months of medical detective work, doctors made two more significant discoveries: that Jason has Type 2 diabetes, which runs in his family, as well as a form of leukemia. For now, he said, doctors plan to manage the leukemia with a wait-and-see approach.
One thing is sure, Jason said: He won’t take his health for granted any more.
Denise Buro will always be glad she refused to take no for an answer.
She and Janjua agree that it’s critical, when family members think a loved one’s health is in peril, to do something about it. You know your loved one better than anyone else.
"If I hadn’t pushed, you know, he might not have gotten that MRI in time," Denise said. "And don’t let your spouse bully you: If they’re saying no and you know something’s wrong, stand your ground. Persistence is what saved his life."