Charlotte’s Story of Hope
By Dr. Bryan Oh
When most people think about a herniated disc, they don’t often associate it with the life-altering complications that can accompany the condition, especially when it isn’t well managed. But the story of my patient Charlotte is a great example of hope and healing after surgery to correct the herniated disc in her spine that led to some of the most severe complications I have ever seen as a result. Here is her story.
Charlotte’s health had been deteriorating steadily for an entire year. It began with back and leg pain that got progressively worse. Then the leg pain gave way to extreme weakness. She had been getting epidural steroid injections from a pain doctor, but Charlotte experienced little pain relief as a result. Her pain doctor at the time told her that her condition was “inoperable” and there wasn’t much more that could be done. Charlotte’s symptoms worsened and next, she could no longer control her bladder. Then one day, she lost the ability to walk altogether. She also lost all sensation in both legs. While she was not completely paralyzed, she was only able to twitch both feet. Not knowing what else to do, she went to the hospital. She underwent an MRI of the spine and it revealed a large herniated disc in her lumbar spine (low back). The disc fragment was so big that it was pressing on her spinal nerves and was the cause of a majority of her painful and debilitating symptoms.
When I first saw Charlotte, I knew something had to be done. But given the fact that she had already lost her ability to walk for more than one week, I was very skeptical about her outcome if we were to perform surgery. I told her that while we recommended a lumbar laminectomy procedure to remove the large disc fragment, there were no guarantees that it would alleviate her symptoms that had progressed so significantly. But I wanted us both to remain hopeful so I told her that my dream would be for her to dance with me in the office one day. But before taking her to surgery, I re-iterated to her that my hope was most likely just a pipe dream. She agreed, but she essentially told me that she had nothing to lose.
We went to surgery and the procedure lasted about an hour. During the operation, I performed a laminectomy procedure and removed a large herniated disc fragment that was putting significant pressure on Charlotte’s spinal nerves. While the surgery was satisfying in that we were able to successfully remove the herniated disc fragment, I didn’t expect that Charlotte would have a great functional outcome. In the recovery room, there was no appreciable change in her condition. When I saw her the following morning, there was no significant improvement in her ability to move her legs. Then, on the second post-op day, I saw her bend her right knee. This was real progress and her medical team and her loved ones were thrilled! Clearly, this movement was not something Charlotte had not been able to do before surgery and it gave all of us hope.
For the next week, however, nothing else really changed. While Charlotte was still able to bend her knee, she certainly wasn’t able to bear weight on her legs. She remained unable to walk. Finally, a decision was made to transfer her from the hospital to a rehabilitation facility. While we weren’t completely dejected, nobody on her team seemed really optimistic. The initial glimmer of hope was blunted. Almost three months passed.
Then a few weeks ago, I walked down the hallway toward my office when I saw Charlotte’s daughter. She greeted me warmly. I had gotten to know her pretty well before the surgery and in the immediate post-operative period. Out of the corner of my eye, I saw Charlotte walking with a front-wheel walker. I was thrilled and amazed. This outcome was something beyond my wildest dreams. Trying to downplay the situation, I approached Charlotte. I told her that while walking with a walker was great progress, dancing with me (as we had originally discussed before the herniated disc surgery) would require that she lose the walker. To my surprise, she walked away from the walker completely on her own. She told me that she was using it only for precautionary reasons. She told me that she had started to dance recently and wanted to prove it to me! It didn’t take long for me to see that she was holding up her end of the bargain and we danced together around the office for a bit.
Practicing medicine and neurosurgery specifically is challenging. In today’s complex health care environment, sometimes it feels like victories are few and far between. But being privileged enough to be part of Charlotte’s story reminded me how gratifying medicine can be. She told me that she felt she had regained her life again. Her process to healing continues. She still goes to therapy. Her bladder still isn’t perfect. But her life is moving forward once again. Charlotte’s story of hope just goes to show that even after the most debilitating and disabling of spine injuries (a severely herniated disc in this case), the promise of a life free from pain is never impossible.