Onward and Upward: Dr. Kaiser’s Patient Tommy

Tommy Javenes Story

March 20th, 2018 on Giant Mountain in the Adirondacks
Tommy happy to be on the mountain again after surgery.

“I used to run 50K races—then I couldn’t walk 200 feet,” says Tommy Javenes, who estimates that he was functioning at maybe 3 or 4 percent of his previous physical capacity when he first met neurosurgeon Dr. Michael Kaiser, Associate Director of The Spine Hospital at the Neurological Institute of New York.

Just two months earlier, Tommy had been an avid hiker and skier in peak physical condition. Then, one summer night, he took a fall while descending Anthony’s Nose, a mountain in New York’s Lower Hudson Valley. The fall injured his neck, spinal cord and nerve roots (nerves that exit the spinal cord to branch out to the rest of the body).

Tommy fell while he was making his third trip up and down the mountain in 24 hours. He had long enjoyed climbing this particular mountain, especially to watch the sun set. He relished the fresh air, beautiful view and opportunity for vigorous exercise. “For most people, it’s about a 40-minute climb up,” says Tommy. He could do it in 18.

Tommy had hiked that mountain a lot, a way of coping through the years of his wife’s illness with brain cancer. That night, just six months after her death, he depended perhaps even more on the outdoor air, the breathtaking view and the exercise. Watching the sun set from the top of the mountain, he chatted with four hikers who’d set up camp as they made their way along the Adirondack Trail. He heard them fretting about how little water they had.

“I’ve got plenty of water down in my car,” he told them. “I’ll bring it up.” They protested, but he insisted it was no problem. He jogged down to his car, loaded up his backpack with eight big bottles of water, put on his headlamp and made his second quick climb up in the dark. The hikers were thrilled. Tommy was happy as he made his second descent.

Tommy (far right) two months before his fall.

Then he headed off to work as usual. The restaurant he owns, the Fireside Steak Pub, is only a short drive from Anthony’s Nose. During the night, Tommy found himself chatting about the hikers up on that peak. He got what he calls a “bright idea”: He would really surprise them with a couple pizzas and some cold drinks. So after he closed the restaurant, he loaded up the pizzas, drinks and a bag of ice, and he headed for the mountain again.

He climbed up for the third time and remembers that the hikers were amazed and jubilant. “They were like, ‘Holy… ! That’s amazing!’ ”

Smiling, he headed back down the mountain in the dark. But, he says, “I wasn’t paying enough attention. I was just walking across a real narrow, steep section, and I stepped on a rock the size of a golf ball and I started falling to the left. There was nothing to grab on to… I fell 40 feet total.”

Tommy came to rest facedown, his lower legs dangling off a ledge. He could move his right foot a little bit and his left upper arm a little bit. That was about it. He thought to himself, “Okay, I’m not totally paralyzed. I just gotta stay awake, and hopefully someone will hike up here soon.’

Stuck on the ledge, Tommy thought a lot about his wife, who had gone through so much during the years of her illness and treatment. “They originally told her she had probably three to six months to live, and she lived nine and a half years,” he says. Over those years, she had three surgeries and went through a lot of ups and downs. Tommy remembered being at her side through all that and thought of what might be a long ordeal ahead for him. “I figured that even if I couldn’t walk again or whatever, at least from being with my wife, I knew how to deal with it: day-by-day.”

Eventually the sun rose. Tommy was still on the ledge. It got hot. Bugs started crawling on his face, and Tommy could not move his arms to brush them away. Every few minutes he shouted for help.

Finally, his calls were answered. A hiker heard him and called 911. A medical team rushed to the site, strapped Tommy to a rigid stretcher and carried him to a location where he could be airlifted by helicopter to a nearby hospital.

Tommy in recovery

Tommy was in bed in that hospital for nine days. He had no broken limbs or internal bleeding, but the bones and discs in his neck were damaged, and his spinal cord and nerve roots were compressed. He couldn’t stand or walk and could barely move his hands. He would likely need surgery but was deemed too unstable for it yet.

In the meantime, Tommy was moved to an inpatient rehabilitation center that focuses on spinal cord injury, brain injury and stroke. “There were no promises of me walking or anything like that,” he remembers. Gradually, the trauma-related swelling around Tommy’s spinal cord receded, and he regained some function. He was able to walk “a little bit—but not well.”

After three weeks, Tommy was discharged from inpatient rehab and began outpatient therapy. He also looked for a surgeon who could help to decompress and stabilize his spine.

Tommy already knew about Columbia University Irving Medical Center/NewYork-Presbyterian Hospital and its neurosurgery department: That’s where his wife received care for her brain cancer. “I was there hundreds of times, for nine and a half years with my wife. [Columbia neurosurgeon] Dr. Jeffrey Bruce did her three surgeries, and he was absolutely amazing.”

On one hand, Tommy was very happy with his care at the hospital where he was airlifted following the accident. But ultimately, “I was like, ‘You know what? [Columbia is] just such a great hospital, I’d rather be somewhere where I know the care is so great.’ ”

Having also gotten a recommendation from a fellow hiker, Tommy went to see neurosurgeon Dr. Kaiser at the Spine Hospital. When Tommy met Dr. Kaiser, he could tell that the fit was, in fact, great. “He was very easy to talk to.”

Tommy was hoping for the best, but Dr. Kaiser made it very clear that the surgical goals weren’t to get Tommy hiking or skiing—things he might never do again. The surgical goals were to relieve compression on the spinal cord and nerve roots, stabilize Tommy’s spine and help the bones heal in a new, stable position. (The technical terms for these goals are decompression, stabilization and fusion.) In other words, the surgery could prevent things from getting worse, but it couldn’t undo the damage that had been done in the fall. Tommy understood.

Dr. Kaiser described what he would do during the surgery. First he would remove the vertebrae in the neck that were putting the most pressure on the spinal cord. He would also remove the spongy discs between these vertebrae. (These procedures are called corpectomy and discectomy.) He would clear plenty of room for the spinal cord and nerve roots. Then he would use medical hardware to fix the remaining vertebrae in a good position, and use bone that was removed to help fuse the remaining vertebrae together.

The surgery was scheduled, and soon the day arrived. “I kind of limped in there the best I could, with my mother and my brother. I went to the prep area. I felt comfortable there because I remembered how good they were with my wife. Dr. Kaiser talked to me—I felt confident about it all. They wheeled me in, and the next thing you know I woke up.”

The surgery had gone well.

Shortly after, Tommy went back into physical therapy. “I was doing rehab for another year and a half. At first my feet were on fire, my balance was terrible, but it was getting better. I was walking every day, then I started hiking every day. And the pain I was in, when I was hiking, was ridiculous.” But he fought through it.Tommy started doing more challenging hikes. He even started hiking up Anthony’s Nose, the same mountain he had fallen down. “I was doing three-mile, five-mile hikes,” he says. “I just kept getting better and better.”

Then he signed up for a 50K (31 mile) race.

Yes, people thought he was crazy, but he had done the same 50K twice before his accident, and he thought, “Let me sign up for this race and just see how far I can get. They have aid stations every four miles, so I figured… you can bow out at any point.” Tommy planned to walk at least to the first station.

He began the race with about 500 other athletes. “Within two minutes, I couldn’t even see the last person in front of me.” As Tommy limped along, “everybody else was running.” About a mile into the race, someone approached from behind: Iron Pete, the Sweeper.

The Sweeper in a race sticks with the last person, making sure everyone in the pack finishes the race or bows out safely. In this race, the Sweeper was going to stick with Tommy.

“So I get to the first station, and he’s like, ‘How you doing, Tommy?’ I’m like, ‘I’m doing okay for now… let’s get to the next one.’ ” That was at mile four. One by one the miles passed, and he finished the race.

The next time Tommy saw Dr. Kaiser, “I showed him pictures on my phone that showed I had done the 50K race.” Dr. Kaiser could hardly believe what Tommy had achieved. Since then Dr. Kaiser and his nurse, Rosemary, have enjoyed continued updates from Tommy with pictures of his hikes, races—even snowshoe and ski trips.

“I always keep working and pushing myself,” says Tommy, but at the same time, “I owe Dr. Kaiser everything. It’s been three years, and it’s still getting better.”

Learn more about Dr. Michael Kaiser  on his bio page here.

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