One Scar, Two Stories

March 8, 2019

At age 31, Katie Napoli has triumphed over two separate health crises. Today she helps others conquer the fear that comes with significant injury or disease. 

When professor Katie Napoli teaches her health behavior students about the fear response following a diagnosis, she speaks from experience. Katie, 31, has already felt the distress that comes with a life-threatening medical crisis—twice.

Her first battle began on an icy night in 2012. Driving home after dinner with a friend, Katie lost control of her car on a winding, dark road and hit a tree. Knocked unconscious immediately, she was soon in the care of emergency medical technicians.

“If the ambulance hadn’t come when it did, I would have been dead,” said Katie. “I was completely alone. They rushed me to Jersey Shore University Medical Center where I was immediately induced into a coma.”

Because Katie’s brain showed signs of swelling, Aasim Kazmi, M.D., a neurosurgeon at Jersey Shore’s Trauma Center, performed a craniectomy. Katie also received a tracheostomy, inserting a tube into her windpipe, to take over breathing for her.

“I wasn’t supposed to make it,” the Beachwood resident says. “I had gone into respiratory failure several times, and my injury was quite significant.” Odds said that if she lived, she would most likely be in a vegetative state.

But Katie beat the odds. She regained consciousness after nearly a month and was transferred to the Brain Trauma Unit at JFK Johnson Rehabilitation Institute. With occupational therapy, speech therapy, physical therapy and counseling, she recovered her short-term memory and her abilities to walk, talk, swallow, read and write.

“The staff was fantastic,” she says. Once recovered—and with a new perspective on life—Katie began working as a personal trainer and attending school to study physical education.

A New Battle

In 2017, during a physical, Katie’s doctor noticed her thyroid looked enlarged.

“I had felt something in my throat, and I just thought it was scar tissue from my tracheostomy,” Katie says. “My heart would also flutter out of nowhere. I ignored that too, but I also felt tired and exhausted.”

A scan and biopsy later, she found out she had thyroid cancer. “The radiologist called with the malignancy report and I didn’t really know what to say,” she says. “You feel like you’re going to faint.”

Katie was referred to Alexander Shifrin, M.D., the medical director of the Endocrine Oncology Program at Hackensack Meridian Health Cancer Care of Monmouth and Ocean counties and the director of The Center for Thyroid, Parathyroid and Adrenal Disease at Jersey Shore. He immediately confirmed the diagnosis and found that the cancer had spread to her lymph nodes. As part of Hackensack Meridian Health’s unique multidisciplinary approach, endocrinologist Danielle Lann, M.D., who subspecializes in endocrine oncology at Jersey Shore, was immediately brought in to help counsel and prepare Katie.

“The multidisciplinary approach allows all the physicians involved in the patient’s care to develop a plan pre-operatively together,” Dr. Lann says. “It’s best for the patient and they are more at ease knowing everyone on their medical team is on the same page.”

This all-hands-on-deck approach put Katie at ease. “I felt very informed because the team is so organized and strong,” she says.

Within a couple weeks, Dr. Shifrin performed the surgery, which proved to be extra challenging because of the scar tissue from Katie’s previous tracheostomy.

“I had to go through the scar in order to achieve the goal,” Dr. Shifrin says. He removed Katie’s thyroid gland and 22 lymph nodes on the right side of her neck, taking precautions to protect her vocal chords.

“Since her job was teaching and she needed her voice, I used special censors during the surgery to monitor the nerves responsible for voice functions, and it helped to preserve those nerves,” Dr. Shifrin says.

He also removed a great deal of the remaining scar tissue from Katie’s accident and made her scar less noticeable. The final step in her treatment was radioactive iodine therapy. The team reserves this treatment for select patients who are the most likely to benefit from it and to reduce the risk for recurrence, Dr. Lann says.

“Katie has a very good prognosis,” she says. “But because of the surgical pathology, some of the post-operative blood work and the fact that it spread to the lymph nodes, we decided radioactive iodine was necessary.”

Dr. Lann counseled Katie that after her surgery she must take thyroid hormone replacement for the rest of her life. Katie takes Synthroid (levothyroxine), a synthetic form of T4 thyroid hormone.

Life’s Calling

In the midst of cancer treatment, Katie graduated in May 2018 with her master’s degree and now works as an adjunct professor at Kean University in Union and a lecturer at Rowan University in Glassboro, where she teaches about health behavior theory.

“I finally feel that I’m doing what I’m supposed to do in this world,” she says. “And I don’t think I’d be where I am right now if this hadn’t happened to me, because it’s allowed people to see how strong and resilient I can be. I’m really thankful for the entire experience.”

Katie’s Tips for Overcoming Fear

Katie is pursuing her Ph.D. and hopes to further explore cancer survivorship and the fear and emotional struggles that follow.

“When a person is diagnosed with cancer, they immediately assume the worst and literally fear for their lives. It is not until the potential for survival is effectively understood that a person’s fear from a cancer diagnosis diminishes, even slightly,” she says.

To combat this strong emotion, Katie shares her expert—and personal—advice:

  • Remind yourself that you are supported by a strong medical team
  • Try to stay positive and calm
  • Continue doing what you would normally do

“Be stronger than your worry and overrule your fear. YOU are in control,” Katie says.