Irene Downing’s always had back pain, but this was something completely different from anything she experienced before.
“It was like a 20 on a scale of 10,” Irene says.
At its onset, she saw her primary care doctor and said she felt like she’d had a stroke. She was prescribed pain medication, which, she says, had little effect. Over the next few weeks, Irene visited a chiropractor and then an acupuncturist. Nothing helped.
By the time she saw her pain management doctor, Irene was practically paralyzed on her right side. She could no longer write and she was able to walk only by supporting herself on the nearest piece of furniture. Her pain management doctor ordered MRIs and told her to see a neurologist.
The neurologist gave Irene a steroid pack to hold her over until the MRI results became available, so she was feeling her first bit of relief in weeks. Two days later, a nurse from the neurologist’s office called and told her to get to an ER as soon as she could manage it. Irene was suffering from what the nurse described as a “critical compression” of her spinal cord.
A new concern
That night, at Virtua Memorial Hospital in Mt. Holly, New Jersey, Penn Medicine neurosurgeon Patrick J. Connolly, MD, told her she’d need surgery after the swelling subsided in a couple of days. She was diagnosed with cervical spondylotic myelopathy.
“Basically, bone spurs in her cervical spine were pressing on her spinal cord, causing it to not function properly,” Dr. Connolly says. “When the spinal cord’s pinched like that, there’s not really any good way to treat it that isn’t surgery, especially with the severity of Irene’s symptoms.”
Irene’s first thought: But I’m getting married on September 29.
It was the first week of August, which would leave her about seven weeks to recover. The typical recovery time for a surgery like this is 12 to 18 months, but there was hope that Irene would be strong enough to walk down the aisle on her own.
“Surgery, it’s necessary, but it’s not like waving a magic wand. The spinal cord has a pretty complex internal structure, so it takes a while for that to heal,” Dr. Connolly says. “But that’s an important point: It actually does heal a lot of the time. Twenty years ago, it was sort of medical dogma that nervous tissue didn’t really improve and you had what you had, but we’re seeing that these patients can get better.”
The beginning of the end
Five years earlier, Irene had undergone spinal fusion. She did well for a while. But when some of the vertebrae are joined together, the others are forced to pick up the slack, and, gradually, that seemed to accelerate the arthritis in Irene’s unfused vertebrae.
“She had a good fusion,” Dr. Connolly says, “but her disease just progressed to the point that she began having pretty significant symptoms.”
This time around, Irene underwent a posterior cervical laminectomy. Dr. Connolly alleviated the pressure on her spine and extended her fusion nearly to the top of her neck. This should be her last spinal surgery. The top of the cervical spine, the only part of Irene’s that remains unfused, usually isn’t affected by arthritis, Dr. Connolly says.
Here comes the bride
Irene says she felt “immediate relief” from her pain when she woke from the surgery—which freed her mind to focus on the last of the wedding preparations.
“I wasn’t going to change my date. I was determined to walk on September 29,” she says. “The show must go on.”
Back at home, an in-home nurse looked after Irene and she worked with an occupational therapist. A couple weeks before the wedding, Irene shed her neck brace with Dr. Connolly’s blessing. She needed a cane to get around, but she was still walking on her own. That’s what mattered most to her.
The wedding went on as planned. The honeymoon was a low-key affair in North Wildwood. As soon as the couple returned home, Irene began working with a physical therapist.
“Just last week,” she says in early April, eight months removed from her surgery, “my therapist said she wants to discuss putting me in a regular gym program.” She says her level of pain most days now is about a three on a scale of 10. Some days it may run around five. “And I can live with that. I crushed my spinal cord,” Irene says. “It’s been a rough road, but Dr. Connolly got me down the aisle.”
Dr. Connolly defers back to Irene. “It’s her,” he says. “She has a great spirit, and she’s been super-motivated through all of this.”