One morning Lisa Reive woke up and could not turn her head. She went to her regular doctor, who diagnosed her with several herniated discs in her neck. Lisa got treatment and went back to her job as a medical assistant.
She thought that would be the end of the story, but after she returned to work she noticed that her leg felt heavy.
“It was just an odd feeling” she says. “My leg felt heavy, and you shouldn’t even be aware that you HAVE a leg, and it was painful when attempting stairs or walking up an incline.”
A co-worker suggested that Lisa see a neurologist. The neurologist gave her test after test, but nothing explained Lisa’s leg weakness. It was a mystery.
Then one day, about six months later, Lisa was checking her husband’s blood pressure. Feeling a bit tired herself, she decided to check her own blood pressure and found that it was very low.
Wondering if this could be connected to the weakness in her leg, Lisa reached out to Dr. Robert Solomon, Chairman of the Neurosurgery Department at Columbia University Medical Center/NewYork-Presbyterian Hospital. Dr. Solomon suspected she had dysautonomia, a condition in which the autonomic nervous system (which controls your blood pressure and heart rate, among other things) is not working correctly. He sent Lisa to Columbia neurologist Dr. Rebecca Traub to be evaluated for the condition.
Dr. Traub had the idea to examine the thoracic region of Lisa’s spine (middle of the back, below the neck). Up until then doctors had focused on her cervical spine, the part in her neck, because of the herniated discs. No one had looked at the thoracic region.
There Dr. Traub found an arteriovenous fistula (AVF), an area where an artery and a vein are connected to each other in an abnormal way. This abnormal connection means that blood is not flowing through the surrounding area like it’s supposed to. An AVF in the spine causes the spinal cord to swell. If left untreated, this swelling can lead to paralysis of the legs.
Dr. Traub sent Lisa to Dr. Philip Meyers at the Endovascular Center for an angiogram. An angiogram uses X-rays and a special dye injected into a blood vessel to let the doctor see how blood is flowing inside vessels. Dr. Meyers was able to pinpoint the location of the AVF and get information about its formation. It was clear now that Lisa was going to need surgery to correct the fistula or risk paralysis, and the information Dr. Meyers was able to get with the angiogram would help the surgeon operate more quickly and effectively. Through it all, Lisa was thankful to have Dr. Meyers answer her questions and explain the procedure. “Dr. Meyers was extremely sensitive to my need to really ask a lot of questions and to voice my concerns,” she says.
With the information from the angiogram, Dr. Meyers sent Lisa to Dr. Alfred Ogden, from the The Spine Hospital at the Neurological Institute of New York, for surgery. Lisa says she was impressed by how patient, understanding and informative Dr. Ogden was. The surgery promised to be a complicated one, as Dr. Ogden had to first perform a laminectomy, a procedure to remove the back part of the spine that covers the spinal canal.
“I went in with firm confidence that I had the best doctors in the world,” says Lisa. “People come from all over the world to have these doctors operate on them, and I was fortunate enough to have them for me and was very grateful.”
Dr. Ogden not only repaired Lisa’s arteriovenous fistula, but he discovered two additional areas where arteries and veins had become tangled, called arteriovenous malformations, and repaired those as well.
“Had Dr. Traub not looked under that rock and had Dr. Ogden not done the surgery successfully, at some point in my life I would have been viewing the world from a wheelchair,” Lisa says.
Today Lisa is grateful to be walking and on the road to recovery. She has been seeing Dr. Traub since being released from Dr Ogden’s care and says she is “amazing.” All of our neurosurgeons collaborate closely with their Columbia colleagues for the best possible outcomes for their patients.
Lisa credits the doctors at Columbia for not only their medical and surgical expertise, but also their care for her as a person. “I think the most important thing I would want people to know [about] the team at Columbia is they’re amazing people. They do amazing things, but there’s a very human aspect to the process that I felt fortunate to be a part of.”
Images courtesy of Lisa Reive.