"I’ve thankfully always been very healthy,” Iowa Clinic patient, Bobi Hilgemann said. That changed when persistent pressure behind her eyes accompanied by cluster headaches led to a diagnosis of pituitary macroadenoma, a brain tumor on her pituitary gland, requiring complex surgical care. She turned to Iowa Clinic Neurosurgeon Dr. Scott Seaman, whose advanced training made it possible to remove the tumor safely and close to home.
Bobi Hilgemann, a 33-year-old South Dakota native, has called Des Moines home for more than a decade. Now a vascular sonographer at Methodist Hospital, she never imagined that moving to Des Moines would not only lead her to her career, husband, and best friend, but also to The Iowa Clinic’s Dr. Scott Seaman, the neurosurgeon who would play a pivotal role in her care.
The symptoms that couldn't be ignored.
What started as mild, occasional pressure behind her eyes eventually became impossible to ignore. Over time, Bobi experienced persistent fatigue, worsening vision in her left eye, and a drooping eye lid that became more pronounced.
“It started with a constant light head pressure behind my eyes, especially my left side,” Bobi said. “I didn’t even have a primary care doctor until I just needed a physical one year.” In December 2024, she mentioned her symptoms to her new PCP. Expecting a simple follow-up plan, she was surprised when he ordered a CT scan right away.
“I’m very thankful my PCP listened to me,” she shared. “That’s when we found I had a tumor.”
Additional MRIs and bloodwork followed, confirming a diagnosis: a pituitary macroadenoma pressing on her optic chiasm. Though benign, the tumor was large, hormone-producing, and wrapped around her internal carotid artery, making removal extremely complex and risky. Bloodwork also confirmed acromegaly, a rare hormonal disorder caused by excess growth hormone.
Expert care, close to home.
Bobi was referred to The Iowa Clinic’s Neurosurgeon, Dr. Scott Seaman. Having recently relocated to Des Moines from MD Anderson Cancer Center in Houston, Dr. Seaman brought with him advanced training in complex cranial and skull base microsurgery. His arrival marked a major shift in the region's ability to treat tumors like Bobi’s locally.
“There’s not a lot of folks, certainly not in the Midwest, that have the skill set to tackle these complex tumors invading into these compartments,” Dr. Seaman explained.
In years past, a case like Bobi’s would likely have required referral to a distant medical center, but Dr. Seaman’s expertise made it possible for her, and others like her, to receive world-class neurosurgical care in Central Iowa.
To safely access Bobi’s tumor, a transsphenoidal approach was planned. This minimally invasive technique, performed entirely through the nasal cavity, allows surgeons to reach the pituitary gland without opening the skull. The tumor’s location in the cavernous sinus and its proximity to major blood vessels raised the stakes.
“Dr. Seaman used the word ‘safe,’ and that’s my favorite word he used,” Bobi said. “He kept saying that he would only do what is safe for me and my specific case.”
Her surgery took place in March 2025. Though nervous, Bobi went in feeling confident in her care team and grateful the option was available nearby.
“I didn’t want to be a patient, but I had to change my mindset,” she said. “I’m blessed that I get to have the surgery...we can improve things and make it a better quality of life.”
Recovery, gratitude, and a new outlook.
She awoke with minimal swelling and bruising and was amazed by how normal she looked. Although a small portion of the tumor remains inaccessibly positioned behind Bobi’s carotid artery, Dr. Seaman and his team developed a careful monitoring plan involving bloodwork and follow-up MRIs. Since surgery, Bobi’s symptoms have significantly improved, and her energy and senses of taste and smell have returned.
“I’m honestly doing wonderful,” she said. “I’m doing better now than I was before surgery.” The experience shifted Bobi’s outlook. “I have a whole different outlook of being thankful,” she added. “I definitely feel happier to wake up and go to work…I also have a new, refreshed mindset on what it’s like to be a patient.”
For Dr. Seaman, Bobi’s case reflects exactly why he came to The Iowa Clinic: to provide leading-edge care, close to home, for patients who would otherwise have to travel hours away for it.
“She’s one of those patients you gravitate toward,” he said. “She’s a remarkable person.”
Bobi encourages others to listen to their bodies and seek help when something feels off. She’s grateful for the team-based, coordinated care she received across specialties, from her PCP and ENT to endocrinology and neurosurgery.
“I would recommend Dr. Seaman and his team to everyone,” she said. “He’s just so knowledgeable, skilled, and very thorough. I was in great hands.”