When Melissa Martin was at her lowest point, she couldn’t even pull on her own socks and needed her fiancé to assist with that arduous task. She couldn’t walk her dog, unload the dishwasher, or vacuum, let alone attend yoga or her rigorous black belt karate classes. Melissa’s week revolved around dragging herself to her job as a veterinary nurse, and attending acupuncture, chiropractic, massage therapy and counseling appointments.
“Laying hurt, sitting hurt, standing hurt,” recalls Melissa, 33, of Worcester, who injured her back as she helped her fiancé carry a couch. “I had days where my leg was numb and tingly and I’d have a pronounced step. I kept going to doctors and had x-rays that didn’t show anything. Because I couldn’t do anything, I went on antidepressants and went to therapy a couple times per week. For about a year, I was the most miserable person. Every ounce of strength I could muster I used for work, but it was horribly painful…it is mentally exhausting to be in pain all the time.”
Thanks to Timothy R. Smith, MD, PhD, MPH, and Milford Regional’s partnership with Brigham & Women’s Department of Neurosurgery, Melissa can now do karate, rock climbing, kayaking and much more–all without pain. Brigham and Women’s Neurosurgery of Milford, located on the second floor of the Health Hill Center on Milford Regional’s campus, have offered weekly clinics since last spring. Drs. Smith, Hasan Zaidi and, the newest member of the team, Dr. Omar Arnaout, see patients on Tuesdays and Wednesdays. They treat the full spectrum of brain and spine disease including herniated discs, spinal stenosis and complex spinal reconstruction for tumors and deformity, as well as brain tumors and vascular disease as well.
Brigham and Women’s Neurosurgery of Milford got Melissa an appointment in two weeks. “They believed me when I said I was in excruciating pain and had to be seen quickly,” she recalls. “The second I met Dr. Smith, I knew he was my surgeon. He was comforting and confident at the same time. He’s like one of those TV doctors with a bedside manner. You meet him and he instantly makes you comfortable.”
Melissa brought an MRI that her primary care doctor had recently ordered, and to her relief, Dr. Smith gave her the long-awaited diagnosis–a herniated disc. Since she was a teenager, Melissa had endured an unusual amount of back soreness for her age and moving the furniture put her pain over the edge.
“The most common thing we see is degenerative changes related to time,” explains Dr. Smith. “Younger people tend to get herniated discs, and for older folks, it tends to be changes related to arthritis. The human spine is made up of multiple levels, and in between the bones at each level there is a large soft cushion that is the disc which acts like a shock absorber. It absorbs a lot of stress and over time, it can wear down. It has a thick, fibrous outer-ring like rubber and an inner component that is soft like jelly. When a weakness develops in the fibrous wall, some of the jelly can leak out, causing a herniated disc.”
Dr. Smith routinely recommends holding off on surgery as many patients heal on their own, but Melissa had already tried noninvasive treatments such as pain medication, steroid pills and steroid injection. He will advise surgery based upon the failure of medical treatment, the correlation of what the MRI shows and how the patient describes the pain, and the patient’s overall health. He and Melissa agreed that in her case, surgery was the best solution.
Relieved to have answers, Melissa underwent minimally invasive lumbar micro-discectomy at Milford Regional this past June. During this procedure, part of the damaged disc is removed easing the pressure on the nerve roots. Dr. Smith had told Melissa that he would make a small incision, insert a small tube the size of a highlighter and put small tools through the tube, including a camera and light. “This produces minimal discomfort to patients as there is so little soft tissue disruption,” he says. “We have to find the fragment that is pushing against the nerves. Once we remove it, the nerve root is once again free and unencumbered. Prior to that, it’s lodged up against the nerve root compressing it. It doesn’t have to be big to cause immense pain. Generally, the fragments are only 1-2 centimeters wide.”
Patients go home the same day and typically stay out of work a couple weeks adhering to lifting restrictions until the wound heals. Follow-up visits are scheduled for two weeks and two months after the operation. Melissa recalls how after surgery, she could feel her leg again and got up and walked without pain.
“I had instant relief,” she marvels. “On the way home we stopped by my karate place and said hi to everyone and they said they would never guess I’d just had surgery. It was glorious to have a thirty-minute drive to Milford for surgery instead of a two-hour drive in and out of Boston. The nurses were also fantastic, checking on me every ten minutes and they let my fiancé come sit with me while I was getting the prep done so that I wasn’t lonely or nervous.”
Melissa stopped taking pain medications within a couple of days. She resumed her active lifestyle including a pain-free and joyous wedding in October. “I was very pleased at how quick the recovery was and how great I felt afterward,” she says. “Dr. Smith is a genius. Truthfully, he gave me my life back. He truly saved my life. Right after the surgery, there was hope, and now I’m the happiest I’ve ever been.”
To schedule an appointment with Dr. Smith at Brigham and Women’s Neurosurgery of Milford, call 508-244-5500.