Jason Stadstad

March 16, 2004, was to be a dream 16th birthday for Jason Stadstad of Manvel, N.D. — spring mountain skiing in Montana with his family.

Few people thought Jason would live to be 16, never mind ski the back bowls and black diamonds of the Rocky Mountains. When he was diagnosed with brain cancer, he was expected to have three months to a year to live. More than once his parents were told to take him home from the hospital to say goodbye.

From August 2003 to March 2004, Jason spent more than 100 days in the hospital. He bravely endured misdiagnoses; multiple infections and surgeries; chemotherapy; radiation treatments; pneumonia. He spent days in a coma or unconscious. After his hometown doctors referred him to Mayo Clinic for advanced care, Jason was transported to Mayo three times by air ambulance for emergency treatment.

That Jason was even able to consider the ski trip is testament to his strength, optimism, support from family and friends, and the outstanding care of his Mayo Clinic medical team.

"Jason's case is really the best example I can cite about the importance of the pediatric patient/parent/caregiver alliance. It takes everybody — all sorts of people — pulling together to get an outstanding result like this. And it's really gratifying to be part of it," says his Mayo Clinic doctor, Cynthia Wetmore, M.D., Ph.D., in Rochester, Minn. "We're still not really sure why he has done so well. There's just so much we do not yet know about pediatric brain tumors. But we do know that cases like his usually don't have good outcomes."

Heading for the ski slopes in March 2004, Jason was feeling the best he had in 18 months. Yet his path to health still held some hazards. And he would come to rely on the partnership of his parents and his Mayo team to pull him through more perilous turns.

Detours along the way

Jason's cancer was a stage IV astrocytoma, also called glioblastoma multiforme, a brain cancer that arises from cells known as astrocytes. In children, many of the brain tumors that arise from astrocytes are slow- growing. Jason's was a more aggressive cancer — the kind that can quickly grow out of control before it is diagnosed.

Jason's symptoms of nausea, fatigue and a tingling on his right side that progressed to paralysis were typical of the symptoms of astrocytomas. Just as typical was the fact that his brain tumor was not immediately diagnosed. Originally it was thought to be an aneurysm, an abnormal swelling of brain blood vessels. Then it was thought to be encephalitis, an infection of the brain. With each undiagnosed day, the cancer grew, to the point where it could not be safely removed surgically.

It was finally diagnosed when Jason came to Mayo Clinic in October 2003. Radiation and chemotherapy schedules were set, and Jason's treatment began. The Stadstads lived in a Rochester motel Mondays through Fridays, and they drove home to North Dakota on the weekends.

Cynthia Wetmore, M.D., Ph.D.

One weekend that fall, Jason developed an infection in his brain and required a surgical shunt to relieve the pressure. Then, just as he was to begin chemotherapy in January 2004, a fluid buildup in the brain signaled the fact that the shunt was infected and had to be removed. Another shunt was put in, and Jason spent 26 more days in a Grand Forks, N.D., hospital recovering.

Once again, Jason healed — just in time for the annual ski trip to Montana. "At this point, we still believed we only would have Jason for a year," Jason's mother, Michelle Stadstad, says. They thought, if this was to be Jason's last birthday, let it be on the mountain. Let it be with family. Let it be.

"I felt strongly that Jason should go skiing if that's what he wanted to do, and he felt well enough to do it," says Dr. Wetmore, who is the only pediatric neuro-oncologist in the five-state area around Rochester. "I would never tell someone not to follow a dream — dreams are life-giving."

With Dr. Wetmore's cautious support — she gave them her cell phone number, just in case — Lee and Michelle Stadstad took Jason and his two younger brothers, Jared, 15, and Justin, 12, on the annual family ski trip with an extended family of about 25 others. Lee and Michelle strongly value close family, community and continuity of tradition. "If we didn't have all these great people are part of our survival team, we wouldn't have made it," Lee says.

Gregory Schears, M.D.

March 15, 2004 — Fortified by family, friends and medical team, the Stadstad ski convoy set out on the afternoon of Monday, March 15, 2004. When the car phone rang about 150 miles into the trip, Michelle remembers hearing the nurse from their local clinic on the other end say: "Jason's platelet count dropped. You need to get Jason right away to a hospital and have a platelet transfusion. He has to have it — now."

The Stadstads reacted to this information as they have to every other twist in Jason's path to health: They floored it. They called Dr. Wetmore, hunkered down and headed into the wind together once more in the direction Dr. Wetmore pointed: Hospital, fast.

March 16, 2004 — Jason spent his 16th birthday in a Bozeman, Mont. , emergency room. With a low platelet count, a fall while skiing and injury to an internal organ could cause life-threatening uncontrolled bleeding. The transfusion helped protect him from this. Says Michelle: "We celebrated though, and Jason never once complained that he spent most of his birthday in the ER. That's how he is. "Adds Jason: "You just do what you have to do and hope for the best."

March 17, 2004-- The next day, March 17, Jason bounced back and seemed ready for action. He made two runs down the mountain before a headache came on, and he began vomiting. He spent the rest of the next two days resting and sleeping in the condo. At night, he felt well enough to join in the usual family fun of communal meals, guitar playing and singing, and soaking in the condo's hot tub.

March 19, 2004 — In the early morning hours of Friday, March 19, Jason awoke in the night to get a drink of water. He was feverish, having difficulty swallowing, and becoming incoherent. "We packed up fast and headed for home. We just needed to be home," says Michelle.

At the first gas stop, Jason got out of the car and col- lapsed on the pavement. His dad, brothers and the gas station attendants helped pick him up and steady him. Michelle called Dr. Wetmore, at home in Rochester on her day off. Dr. Wetmore advised them to get to the nearest hospital, in Miles City, Mont., and called the hospital to prepare for Jason's arrival there.

Once the Stadstad's got to Miles City, Dr. Wetmore worked with the staff there by telephone to try to stabilize Jason. She also briefed her colleague in Rochester, Mayo Clinic Critical Care Physician Gregory Schears, M.D., and began to make arrangements to send out Mayo's emergency transport team to bring Jason back to Rochester.

Dr. Schears leads the 12 nurses and 15 respiratory therapists who make up Mayo Clinic's Pediatric Transport Team. Every day, Mayo Clinic Pediatric Transport Team members are speeding toward a child somewhere in the world in a fixed-wing aircraft referred to as MayoMed Air, an emergency medical helicopter known as Mayo One, or by ground ambulance.

Shortly after talking by telephone with Dr. Wetmore and the Miles City hospital staff on Friday, March 19, Dr. Schears made the decision to dispatch MayoMed Air at 6:10 p.m. to bring Jason to Mayo Clinic. "With Jason's history of chemotherapy, his fever and the low blood pressure, the risk for sepsis (blood infection)was such that we knew we had to act," Dr. Schears explains.

Scott Feigal was the pediatric intensive care nurse on duty who responded to the call. By talking with Dr. Schears on the phone during the plane ride, he had a good idea of what to expect on the ground. By 10:45 p.m., Scott Feigal was in the Montana hospital with Jason, Mayo Clinic medical equipment in tow. "Our pediatric transport team is like a mobile mini-ICU," he says. "By taking specialty equipment with us, we're sure we have what we need to do the job."

Scott Feigal, Mitch Nelson and Sara Nelson, Pediatric Transport Team

March 20, 2004 — Jason had no pulse when Feigal arrived. Working with the local medical team and Dr. Schears by phone, Feigal was able to stabilize Jason. Less than two hours later, at 12:30 a m., Saturday, March 20, Jason and his mother were on MayoMed Air headed for Rochester.

Intensive care

Back in Rochester at the Intensive Care Unit, the medical team determined why Jason's path had taken yet another precipitous turn: He had indeed contracted a blood infection, as Drs. Wetmore and Schears had initially suspected.

Jason spent two weeks in the ICU clearing both the infection and pneumonia, a complication he was especially vulnerable to because of the weakening effect of chemotherapy on his immune system. He was discharged on his father's birthday, March 31, 2004.

"I tell you, there were so many chaotic things happening healthwise that sometimes we forgot he had cancer," says Michelle. "We had prayer chains around the world pulling for us, there were so many times we thought we'd lose him."

Instead, Jason kept getting better, and his life deeper, richer. In October 2004, Jason was elected high school Homecoming King. He resumed workouts with the junior varsity hockey team. He maintains a 4.0 average, and looks forward to starting his freshman year at the University of North Dakota next fall.

He hasn't spent a single night in the hospital since March 31, 2004. That, says Dr. Wetmore, is, "Amazing. Just amazing."

Through it all, Jason has surprised and inspired those who meet him with the quiet persistence with which he treads cancer to move steadily toward life. Says Jason: "It sounds funny, I know, but the only thing I really think about is keeping going. I never really dwell on how sick I am or if I feel bad. I always have faith, and my family."

Five-year survival from glioblastoma multiforme is less than 2 percent. Even so, the family and Dr. Wetmore continue to believe in Jason's recovery. "I am cautiously optimistic that Jason may be in the very small percentage of patients that beat this tumor" Dr. Wetmore says. "I have been very thankful to have come to know Jason and this family. I will miss seeing them every month, but that's the good news!"

Says Michelle Stadstad: "It takes trust, hope, prayer and phenomenal talent and commitment like Dr. Wetmore's to get where we are. She is just awesome." Adds Jason: "It takes family, I know that much. And Dr. Wetmore felt like family to us from the beginning."

Back to normal

On Dec. 14, 2004, Lee, Michelle, Lee's sister Lynne Hoverson and Jason visited Dr. Wetmore for a checkup. "Everything looks so great!" Dr. Wetmore says as she scans his blood tests, tests his arm strength and balance.

The facial paralysis the tumor induced caused a slight droop on the right side that results in an asymmetrical smile — but the nerves are coming back.

"Jason's MRI scan will never be 'normal' in the traditional sense, because there is a significant amount of scarring in areas of his brain and still some very small areas of questionable-looking tissue," Dr. Wetmore tells the family. "But I am extremely pleased to tell you that the MRI scan shows continued resolution and healing, and there is no indication of progressive tumor growth."

Jason learned to count on his family when the chips were down.

Then Dr. Wetmore dispenses ordinary health tips as she would to any teenager. "Wear a helmet, drink skim milk, get enough sleep, eat your vegetables." She continues down the list. "I'm saying normal things to you because that's how you are now: normal! And really, I mean it, always wear a helmet when you play hockey!"

Jason laughs and nods.

The Spring 2005 ski trip was a record-setter, even by Stadstad standards. Says Michelle: "We really have something to celebrate this year."

Once again, the Stadstads' extended-family convoy headed west — uncles, , aunts, grandma, cousins, friends, guitars and skis — with Jason in the lead vehicle, , barreling into the night. Come morning, they would be on the mountain.