Cyclist Swiftly Back to Biking After Spinal Surgery
An avid cyclist and photographer, John was used to intense physical activity, twisting, lifting and associated aches and pains. So in February 2009 when he began to experience extreme pain in his legs and buttocks, it was easy to assume it was a pulled muscle. But over the next few days as the pain continued to intensify, John went to the emergency room at a local hospital. Doctors there concurred that he had likely suffered a muscle strain and that it should improve with time and rest.
"The pain was unrelenting to the point it woke me up in the middle of the night," says John. "But I'm the guy with a high tolerance for pain who never sees a doctor. It became exhausting and on a scale of one to 10, 10 being the worst pain imaginable, mine was a nine."
That's when John finally went to the emergency room at Memorial Hospital Miramar.
"When I arrived at the emergency room at Memorial Hospital Miramar, I could barely walk and needed a wheelchair," says John. "I was relying on pain medication just to get through the day. I turned to Memorial for their experts and experience."
Emergency room physicians at Memorial Hospital Miramar ordered an MRI. The results confirmed a herniated disc in John's spine and he was referred to Memorial Neuroscience Center and Greg Zorman, MD, Chief of Neurosurgery for Memorial Healthcare System.
Located at Memorial Regional Hospital and Memorial Hospital West, Memorial Neuroscience Center in South Florida is dedicated to the diagnosis and treatment of a wide range of neurological disorders and injuries in adults and children.
Counting on Experience
During his first visit with Dr. Zorman, John learned that the herniated disk was compressing the nerve root resulting in sciatica. He would need spinal surgery.
"As soon as he said 'surgery,' I was in so much pain, I said, 'let's go!'" says John. "I could have gone anywhere, but I chose Memorial. If someone was going to operate on my spine, I wanted it to be a physician who has done it a thousand times. Not to mention, Dr. Zorman has a calm and reassuring bedside manner. I knew I was in great hands."
John underwent a laminotomy, which required only a small surgical incision in his back to remove the herniated portion of the disc and leave the muscles intact.
"For cases like John's that are severe enough to require an operation, fortunately there are new surgical techniques that offer fewer complications, reduced postoperative pain and a faster recovery period," says Dr. Zorman. "Not only was it my goal to fix his herniated disc and relieve his pain, but I also wanted to give him back the ability to return to riding his bike as if nothing had ever happened."
The day after his spinal surgery, John was up and walking, without pain. He spent just one night in the hospital, and was released.
"After surgery, it was like a switch had turned off my pain," says John. "I walked out of the hospital the next day and into the sunlight, realizing that I had lost a month of my life to my injury, but extremely grateful that Dr. Zorman and the Memorial team were able to give me my old life back."
During the next month, John went to Memorial Hospital West for rehabilitation therapy several times per week. After two weeks, John returned to work.
"I've not taken a pain pill since my release from the hospital," says John. "Three months later, I had recovered fully and returned to cycling. Most importantly, I'm pain-free and enjoying my life again."
A Young Teacher's 'Miraculous' Recovery From Brain Injury at Memorial
Her morning started like any other, and Jennifer was less than a mile from the school where she works as a teacher when the car crash occurred.
Rushed by ambulance to Memorial Regional Hospital, 27-year-old Jennifer had suffered a broken neck, internal injuries and bleeding and swelling in her brain. Her condition was life-threatening.
When Jennifer's family arrived at Memorial Regional Hospital, they were quickly updated and offered the support and compassion they needed to help them cope with her prognosis.
Most critical was Jennifer's brain injury. Doctors put her on a ventilator and placed Jennifer in a medically induced coma to help control and monitor the bleeding and swelling in her brain. Next, Greg Zorman, MD, FACS, Chief of Neurosurgery, Memorial Neuroscience Center, performed a ventriculostomy, drilling directly into Jennifer's skull to relieve and monitor the pressure.
Jennifer's mother, Pat, says, "As a mother, I wanted to talk to her and hold her. But as the nurses so gently explained, any stimulation could cause the swelling in her brain to increase. It was torture for me but I knew in my heart that Jennifer would make it."
Jennifer's husband, Derek, and her stepfather, John, also remained by her side. The next 24 hours were critical as the family waited for news.
Living with Hope
"The nurses prepared us for the worst but at the same time, gave us so much hope," says Derek. "The nursing staff was amazing and so compassionate, even bringing us a special bag for families of patients with brain injuries filled with books, pillows, blankets and food — everything we needed so we could be with her."
After several days, when the swelling in her brain had not resolved, Jennifer's family grew more concerned.
"We were anxious for them to wean her off the ventilator and medications," says Pat. "Dr. Zorman placed a temporary probe in her brain to monitor and relieve the pressure, reassuring us that she needed more time. He was experienced, confident and we trusted him implicitly."
After more than two weeks in a coma, the swelling subsided and Jennifer's condition improved. Soon she was taken off of the ventilator and her tracheotomy was removed.
"We were reading books about the long term effects of brain injuries," said Pat. "I had great faith in the Memorial physicians and great faith in God. Jennifer is my only child and my greatest blessing."
"We didn't know if she would be able to care for herself or ever walk again but we were so grateful that Jennifer was alive," Derek says.
Initially, Jennifer suffered some memory loss. The young teacher was frustrated, but determined.
"I'd forgotten how to walk, talk and eat and had to relearn the simplest tasks all over again," said Jennifer. "As a teacher, I found that especially frustrating but the nurses, doctors and therapists were so patient and encouraging. They gave me the support I needed."
Very quickly, her family saw signs that the old Jennifer was back.
"I kept seeing little glimpses of her personality coming through and suddenly, it was like a light bulb went on inside her head and everything just clicked," said Derek. "Our Jennifer came back — it was miraculous."
After nearly a month in the intensive care unit followed by rehabilitative therapy, Jennifer returned home. Soon she was back in the classroom with some valuable new lessons to share with her students.
"Having overcome so many obstacles myself, I share in their accomplishments and I have a greater appreciation for learning and life," says Jennifer. "I recall very little of my time in the ICU, but this much I know — I am alive today because of Memorial."
Thanks to Memorial, Teen With Spinal Cord Injury is Walking Again
After Phillip accidentally dove into a sandbar off Dania Beach last year, the 18-year-old was left paralyzed with a broken neck. His family feared the worst.
Seven weeks later, following treatment at Memorial Regional Hospital in Hollywood, Phillip walked out of the hospital on his own two feet.
"I was lucky," says Phillip, whose treatment at Memorial included spinal cord surgery and intensive physical therapy. "The care was above and beyond anything I could have asked for."
The traumatic spinal cord injury presented many challenges, says Greg Zorman, MD, Chief of Neurosurgery for Memorial Healthcare System, who treated Phillip in the emergency room and performed spinal cord surgery the next morning.
"The immediate challenge was to temporarily stabilize his spine in head tongs and a Rotorest bed to prevent any further damage to the cord by aligning the fractured bones in his neck," Dr. Zorman says.
During surgery, Dr. Zorman used a piece of cadaver forearm bone as a graft to replace the shattered C-7 vertebra at the base of Phillip's neck. The C-6 vertebra just above had a minimal fracture. The surgery was successful.
"Dr. Zorman saved my life," Phillip says. "He absolutely saved my life."
Still, it was unclear whether Phillip would walk again. Initially, he had no motor function. He couldn't feed himself or lift a fork, says Alan Novick, MD, Medical Director of Rehabilitative Services for Memorial Healthcare System.
"At first, their goal at the hospital was to have him functional using a wheelchair," says Elisa, Phillip's mother.
With hard work and encouragement from his physical therapist, Phillip pushed himself during rehabilitation. Within weeks, he took his first steps using the parallel bars.
"Sometimes if I wanted to sleep or I didn't want to go to rehab, they'd wake me up and encourage me along," Phillip says. "By the time I left the hospital, I actually felt they were good friends of mine. They made the best of a bad situation. They made it feel like home."
The staff helped his family throw a party for Phillip in the hospital on his 18th birthday.
"These were big things because it helped motivate him," Elisa says.
Today, life is "almost completely back to normal," says Phillip, who began his freshman year of college this fall.
"His recovery was remarkable given the severity of the injury and his initial dense paralysis," says Dr. Zorman, who outlined the options and helped support the family through a very frightening time. "I always try to give the family the feeling that if there is only a 30 percent chance of recovery, they are the ones who are going to be in that 30 percent."
Says Scott, Phillip's father: "There's no question his recovery exceeded expectations. If it wasn't for his physical therapist and the doctors we had there, I don't think we'd have the same story. Dr. Zorman did a great job with the surgery. And Dr. Novick was the upbeat guy. The positive approach rubbed off on us as well."
Ken is Walking Thanks to Memorial's Extraordinary Neuroscience Center Team
When Ken first experienced numbness and tingling in his toes, it was easy for the active, 52-year-old business owner to rationalize the symptoms. "It started with a tingling feeling in my left baby toe," says Ken. "I was healthy and active so I thought it would pass."
But when Ken's symptoms progressed, he made an appointment to see his physician. "Our family physician suspected that his blood pressure medication was the cause of his symptoms," says Ken's wife, Barbara. "When the medication changes didn't result in improvement, we suspected a pinched nerve."
Searching for Answers
Soon, Ken's condition became more serious. "My legs became weaker and I had trouble walking," says Ken. "At that point, my wife suggested we get a second opinion at the Neuroscience Center at Memorial Regional Hospital, where she is employed as administrative director of nursing support services."
Ken underwent a thorough evaluation and a series of MRI scans to rule out multiple sclerosis, cancer, and other neurological conditions. Eventually, the MRIs and a spinal angiography led the Memorial neurologists to a definitive diagnosis of spinal cord arteriovenous malformation (AVM), a congenital disorder of the circulatory system in which a complex, tangled web of arteries and veins negatively affects the spinal cord blood supply.
"Because of the abnormal exchange of blood and oxygen, patients with spinal cord AVM are at risk of hemorrhage, paralysis and even death," says neurosurgeon Luis Rodriguez, MD, FACS, Memorial Healthcare System. "In Ken's case, our goal was to preserve his mobility and prevent further damage to his spinal cord and nerves."
Making Surgical History
AVM cases are relatively rare, affecting approximately 300,000 Americans. Most AVMs occur in the brain or spine.
"Treatment protocols are decided on a case-by-case basis," says Dr. Rodriguez. "In the past, we have treated AVM patients with minimally invasive procedures. However, we took a team approach and consulted with our interventional neuroradiologists. Due to the size and location of Ken's AVM, we recommended an open, conventional repair — a surgical first at Memorial Regional Hospital."
For Ken and Barb, the choice was clear.
"After exploring our options, we chose to have the surgery done at Memorial Regional Hospital," Ken says. "We had complete faith in their abilities and resources to perform the surgery."
After a five-hour operation performed by Dr. Rodriguez and his colleague, Greg Zorman, MD, FACS, Chief of Neurosurgery, Memorial Healthcare System, Ken's AVM was successfully repaired. A follow-up MRI scan confirmed the veins surrounding Ken's spinal cord had returned to normal.
"A heartfelt thank you goes out to everyone involved in Ken's care," says Barb. "Talk about patient and family-centered care! As a family member, I felt cared for, involved and informed."
While some permanent nerve damage can result with AVM, Ken has returned to work and is grateful to the Memorial Regional Hospital neurosurgery team for his preserved mobility.
"I'm indebted to the neurosurgery team and everyone behind the scenes," says Ken. "From the physicians to all the support departments that make Memorial Regional Hospital so special, we could not have received better care anywhere else."
Relief for Immobilizing Back Pain at Memorial Neuroscience Center
A caregiver by nature and profession, it was a bit ironic to Valerie that she would be the one to fall down the stairs while caring for an elderly woman.
"Statistically, she was at a higher risk of falling than I," says Valerie, who is a bereavement counselor. "But after tumbling down the stairs, I was prepared to wake up sore and black and blue. I had no reason to believe there was any cause for concern or medical attention."
Over the next few weeks, Valerie's back pain did not subside. In fact, it became immobilizing. After a visit to her primary care physician, Valerie continued to try anti-inflammatory pills and pain medication, convinced that her back pain would soon improve.
"Nothing seemed to help and I found myself unable to get out of bed," says Valerie. "I was fearful at the thought that something could be really wrong and that I might need surgery. I convinced myself that I just needed medication and rest."
When neither relieved her pain, Valerie contacted a family friend who is also a physician at Joe DiMaggio Children's Hospital. The physician referred Valerie to Memorial Neuroscience Center and Greg Zorman, MD, Chief of Neurosurgery for Memorial Healthcare System.
"Memorial was already a part of my family," says Valerie. "We live within a couple of miles of Memorial Regional Hospital and my family owns a business nearby. Not to mention the fact that I was born at Memorial Regional Hospital and gave birth to my two children there as well. I consider Memorial my family, my friend and neighbor."
When Valerie met with Dr. Zorman for a consultation and exam, she was frightened at the thought of surgery. But four months had passed since her fall and her back pain was excruciating.
Finding a Solution
"I was no longer able to work," says Valerie. "Simple tasks like making breakfast for my children seemed impossible. I wear many hats as a mother, a wife and a bereavement counselor. People count on me and I need to be there for them."
Following an MRI, Dr. Zorman sat down with Valerie and explained that during her fall, she suffered a herniated disc which was compressing a nearby nerve and causing her back pain. Dr. Zorman recommended spinal surgery to remove the herniated disc. He cautioned Valerie that if she did not have surgery, she was at risk of permanent nerve damage and could lose the use of her legs.
"Like many patients, Valerie was fearful and reluctant to undergo surgery," says Dr. Zorman. "Fortunately, at Memorial Neuroscience Center our caring team of physicians, nurses and staff is experienced in performing a high volume of surgeries while at the same time, addressing the emotional needs of patients and families. It's the combination of university-level services in a community hospital atmosphere that gives us the edge."
While the idea of undergoing spinal surgery weighed heavy on her mind, Valerie was scheduled to speak at a national nursing convention and did not want to miss the opportunity to share her message about the importance of grief counseling. She realized that given her back pain, there was no way she could travel and stand before an audience to give her lecture.
"Dr. Zorman gave me the reassurance that I needed and I finally agreed to surgery," says Valerie. "When I woke up, I was amazed to find that the pain was gone. The next day, I was up and walking again, pain-free."
After a short hospital stay, Valerie went home. She returned to Memorial three times per week over the course of three months for rehabilitative therapy.
"Just as Dr. Zorman predicted, my pain was gone and I was able to travel to the nursing convention," says Valerie. "I guess you could say that Memorial mended my body so I could continue mending hearts. I am forever grateful to Dr. Zorman and my Memorial family."