CentraState - Healthy Directions

"I'm happy that you don't have to go far for this type of surgery. I had my family all around for support." —Nilda Lopez www.centrastate.com Winter 2015 11 tissues have matured. Nilda was at the right age for a Chiari malformation to cause problems, some of which could be severe. According to Dr. Ghobriel, "Chiari malformations can be disabling. In extreme cases, it can be life-threatening." As suspected, an MRI confirmed a Chiari malformation; yet Nilda's symptoms were far more severe than the grade-one Chiari indicated by the MRI. Dr. Ghobriel explains the different findings this way: "We had to respect her symptoms, not just the grading. We always say that in pain management—in medicine in general—we have to respect the patient's symptoms, not just what the test or the textbook says." Nilda was swiftly referred to Mark McLaughlin, MD, a board-certified neurosurgeon specializing in cranial conditions, medical director of Princeton Brain & Spine Care and on staff at CentraState. Dr. McLaughlin says that, "a Chiari malformation isn't a rare condition for a neurosurgeon," which Nilda found comforting. "Sometimes, we'll just observe the patients if their cases are mild," Dr. McLaughlin says, "Then, there are some people who have more progressive symptoms like Nilda and need surgery to make more room for the spinal canal and for the back of the head." Surgery would relieve the compression of the nerves, which were contributing to Nilda's dizziness, neck stiffness and headaches. The alternative could have been the loss of driving privileges and mobility, as her symptoms would not improve with time. "I didn't want to wait because I was passing out too many times," Nilda says. "I felt like fluids were running through my arms. I was more scared of passing out while I was driving or walking than I was of the operation." Nilda adds, "I was so relieved that there was a reason for my symptoms. You know your own body and I had never felt these symptoms before." So, she readily agreed to surgery. A CURATIVE SURGERY Dr. McLaughlin performed surgery on Nilda in May 2014 to widen the bone structure at the base of her brain so the brain would sit comfortably atop the spinal column, and to relieve any nerves that were being compressed. The surgery was a success and, according to Dr. McLaughlin, "was essentially curative. We'll see her over the course of a year as she recovers, but I anticipate her to have a full recovery." To help with Nilda's recovery, Dr. McLaughlin recommended physical therapy through CentraState's Outpatient Rehabilitation Department. According to Marc Plawner, MS, physical therapist, "Nilda and I have worked continuously since mid-June on functional mobility, which has involved getting her back to the activities of daily living, such as showering, washing hair, getting out of bed, and, eventually, the physical transition back to work." Marc adds, "After major surgery, the body takes about a year to normalize. Symptoms of a Chiari Malformation: • Headaches that get worse with exertion • Neck pain or stiffness • Dizziness or vertigo • Decreased strength or sensation in the arms and legs • Unsteady gait • Difficulty swallowing • Vision problems • Ringing in ears Physical therapy expedites the patient's recovery by getting him or her back to normal function as quickly as possible in a very safe and responsible way. Nilda has a great attitude; she has created her own exercise program for home and works at it. As a result, she has significantly improved." It has been a long journey for Nilda, but she returned to work at CentraState in September, performing light duties initially. Now that she is healthy and strong, Nilda resumed full-time work in December as a patient care technician. Nilda credits her physicians with her return to health. "They are awesome," she exclaims. "There are no words to describe them. I'm so happy that they are in the community." In the end, Nilda is thrilled that she decided to have surgery. "I feel like this is a new beginning in my life, so I look for what is positive," she says. "It has given me a new perspective: that doctors are there that you can trust." The neuroscience programs at CentraState offer comprehensive care for brain, spine and nervous system conditions. For more information, visit www.centrastate.com/neuroscience or call 866-CENTRA7 (866-236-8727). HD

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