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This time she got through and doctors scanned Ava’s brain. Her cyst had ruptured, although it was unclear if it was due to her fall the month before.
Spinal fluid was being pumped into her skull, contorting her brain and causing double vision. The pressure could have led to blindness or, in an extreme case, death. But the trip to Milwaukee brought that to a halt.
A closer look
Assistant general manager, Utah Jazz
Age » 39
Past » NBPA certified agent for ASM Sports; agent at Mark Bartelstein & Associates
Education » Northwestern University, economics
Family » Wife Gina, daughters Ava (6) and Lucy (2), son Oskar (4)
Of note » First met agent Mark Bartelstein when he coached Josh Bartelstein’s sixth-grade team as a college job. Josh Bartelstein went on to play at Michigan, where he was a teammate of Jazz point guard Trey Burke.
Quotable » “I had always privately thought about being on the other side and working for an organization. I’d never advertised it. But then Dennis [Lindsey] called. The Utah Jazz are one of the top five organizations that I respect.”
The headaches could finally be explained. But how would doctors fix them?
Hoping for a happy ending • Justin Zanik sat in Section 109 at EnergySolutions Arena on Tuesday at the Jazz’s preseason opener against the Golden State Warriors. Beside him, Ava sat with her light brown bob haircut pushed back by a sequined pink headband. She plucked kernels of popcorn out of his cupped left hand. After it was gone, Ava tangled her fingers with his.A foul was called against the Jazz and boos began to rise inside the arena. Ava turned to her father and asked, "Can I boo?"
Justin looked at her and said, "No, everyone else can boo but you can’t." Then he reconsidered. "Once you can tell me what you’re booing I’ll let you boo."
Four surgeries later, the headaches are gone and Ava is, more or less, a normal little girl. She points proudly to a ridge on the left side of her head where a subdural shunt was placed under her skin. A tube through which the shunt pumps extra spinal fluid can be traced down her neck and to her stomach.
After doctors in Milwaukee determined Ava’s cyst had burst, they spent much of the summer trying to clear excess fluid out of her head. Spinal fluid is a river, constantly pumping in and out, but hers was pooling and not being reabsorbed into the spine.
On June 15, doctors drilled two burr holes into the top of Ava’s head and inserted tubes to help the fluid drain.
"Ava had brain surgery today," Gina wrote in her journal. Then, hopefully: "Her headaches improved immediately."
However, a week after surgery, the headaches returned.
The tubes were reinserted on June 25 and fluid drained for eight days. When Justin worked the NBA Draft on June 27, his daughter was connected to tubes in a hospital in Milwaukee.
The fluid continued to accumulate and Ava had headaches the same day the tubes were removed. On July 3, Lew performed a fenestration of the cyst, cutting a path through its other side to try to redirect flow.
Days later, it was clear that procedure had not worked either.
The subdural shunt was a last resort. While 100 percent effective, it comes with its own set of complications, namely that a gizmo would be in Ava’s body for her entire life.
"Why would I want to put something permanent in my daughter if I don’t have to?" Justin Zanik said.
On the Fourth of July, Ava was on morphine and slept through the firework shows that could be seen from her hospital room. Gina never left the hospital and encouraged Justin to spend nights either at home or in nearby Madison with her parents and their two other children, 4-year-old Oskar and 2-year-old Lucy. That night she listened to Pachelbel’s Canon in D and watched fireworks pop over the city. In her journal the next day she wrote, "This journey must have a happy ending. If a shunt takes her pain away, sign me up."
Settling in Utah • "The reason we don’t put a shunt in everybody up front," Lew, the Milwaukee neurosurgeon, explained, "is because usually we don’t need to."
He described the procedures as "trial and error" and "escalating treatment until one of them works."
The shunt went in on July 12, nearly a month after Gina insisted on a new brain scan in Milwaukee, and more than two months after the headaches had begun in earnest.Next Page >
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