By JOE KENNEDY
THE ROANOKE TIMES

SETH M. GITNER/THE ROANOKE TIMES

Jacob keeps his mind preoccupied as his body is wrapped in plaster of Paris to make a mold for a brace to help him sit upright.

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   CHARLOTTESVILLE - Jean Tyree and her husband, Jerry, faced a decision no parents ever want to face. Should they allow surgeons to remove a cancerous portion of their son's spinal cord? It could save his life, but it would leave him partially paralyzed.

    Even harder were the questions that came from friends and doctors before the surgery.

    "What if they find a cure in six months?" the second-guessers asked. And, "How can you do it?"

    For more than a year, Jacob had suffered with an astrocytoma, a fast-growing, malignant tumor entwined in his spinal cord. By last spring, Jacob already had had surgery and 23 radiation treatments.

    Initially, his condition improved. Wearing splints on his legs, he played sandlot baseball last summer. Then Jacob spent a week at church camp in early June.

    "He had a great time, but he was physically fatigued when I picked him up," his mother said. His clumsiness increased, muscle spasms wracked his back and pain ruined his days.

    Pain is "a fearful item to deal with," said Jean Tyree, a rehabilitation nurse at Lewis-Gale Hospital in Salem. Jacob had "the fear of having to live with it the rest of his life."

    Jacob tried rest, heat, massage and medication, but the symptoms remained. Later in the summer, the family took a trip to Florida.

    Jacob felt weak. He could go into the ocean, but only with help. Upon the family's return, he had an MRI.

    "The tumor was larger," Tyree said.

    Dr. John Jane, Jacob's neurosurgeon at the University of Virginia Medical Center, read the results. The tumor needed, in medical parlance, "debulking," Tyree said. "I was shocked."

    Jane performed the second operation in August. But that didn't solve the problem. Follow-up studies showed the cancer cells had mutated, demanding aggressive treatment.

    Thinking of Jacob's continuous pain and of ways to keep him alive, Tyree asked the surgeon, "'Do you ever go in and remove the cord?' And he said, 'Yes, we do, in extreme situations.'"

    This situation qualified as extreme, Jane said. Already, Jacob was almost paralyzed.

    Again, Tyree considered options, including chemotherapy. But there is scant evidence that that works at all for astrocytoma, she said.

    She talked frankly with Jacob and described the radical surgery she and Jane had discussed.

    "That means I'll be a permanent paraplegic, Mom," Jacob said.

    "I just had to say, 'That's right,'" his mother recalled.

    Jacob thought for a moment and said, "I want to walk."

    They were sitting outside, talking about something most would consider unthinkable.

    "Could this tumor kill me?" Jacob asked.

    "I said, 'Yes,'" his mother said. "He looked me straight in the eye and said, 'Mom, this tumor is not going to kill me.'"

    They decided to remove the malignant portion of Jacob's spinal column.

    "It was our only opportunity to save Jacob," she said last week.

    Surgery took place Sept. 23, 10 days after Jacob's 10th birthday.

    "Jacob is such a brave little boy that he understood when we did this that it was going to save his life - I hope it's going to save his life - but that he'd be paralyzed," Jane said.

    "After the surgery, Jacob said, 'Well, Mom, they were right. I can't feel a thing.'"

    He has a color photograph of the 6- to 8-inch piece of spinal cord that Jane removed. At the Kluge Children's Rehabilitation Center in Charlottesville, he has mastered new skills he needs. He swims, using just his upper body, an exercise that's great for his confidence. He slides himself in and out of the family's van.

    He roars around the hallways in his bright blue Little Dipper wheelchair, asks knowledgeable questions and charms all who know him.

    Recently he lay on a table as plaster of Paris was wrapped around him. It will be used to mold a brace to help him sit upright.

    "I feel like a mummy," he said.

    Thursday, he will come home to the Bradshaw area of Roanoke County. Monday, he will begin spending a few hours a day as a fifth-grader at Mason Cove Elementary School.

    For Jerry Tyree and the couple's younger son, Cooper, it will be a relief to have the family together again.

    Once Jacob is well-rested, his parents will give him a cookout and sleepover for his birthday. Piles of presents await him.

    Throughout this process, Jean Tyree sent countless updates to friends, expressing her belief that God would protect Jacob and her willingness to go with God's plan.

    A follow-up MRI and pathology report have been inconclusive as to whether the doctors got all of the tumor.

    "There were just a few cells we were worried about," Jane said. "I just had to tell her [Jean Tyree] I was still concerned," though not greatly.

    Medical options include more radiation now, as a preventive measure, or later, if his condition worsens. Or his parents could let the disease take its course and, in Jean's words, "Release him to the Lord."

    Jacob has told his mother that God wants him to be a messenger. He's a 10-year-old kid with a quick mind, an unquenchable spirit and a community that can't wait to see him again.

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