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Journey to Pain Relief

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(5/31/10) - "Carley had been complaining of her back hurting," said Shelby Gauthier, Carley's Mother. "She was 13-years-old, so my husband Arthur and I attributed it to growing pains. When the pain continued to worsen, we became concerned."
The Gauthiers sought medical assistance from their pediatrician, who referred them to a spine specialist. X-rays were performed to help determine why Carley was having so much physical distress. There was simply no answer.

In an attempt to help ease the discomfort and strengthen Carley's back, a physician recommended physical therapy. However, it did not help and the family was still without an answer as to why the pain was occurring. "The pain was excruciating," said Carley. "It was constant and my back felt stiff. In school, I could not think clearly for long, because my mind kept going back to the pain. I was also not able to do all of the fun things I enjoyed." Numerous visits with physicians, physical therapy appointments, and X-rays, led to no conclusion regarding a cause for Carley's pain. "We were not sure what was wrong with Carley, so we kept her active," said Shelby. "She would ride her bike, take long walks and on lazy days, we made her get up and move. We had no idea that something serious was wrong with her."

A visit to an emergency room for unrelated leg pain changed everything. "While the emergency room doctors were caring for Carley she again complained of her back hurting," said Shelby. "For that reason they also took an X-ray of her spine. These X-rays revealed a tumor."

The Gauthiers were immediately referred to Pediatric Orthopedic Surgeon Dr. Al Gilpin of McLeod Orthopaedics in Florence to discuss the next steps.

According to Shelby, Dr. Gilpin took one look at Carley's X-rays and said she needed to see a Neurosurgeon. He referred the family to Dr. William Naso of Florence Neurosurgery and Spine. Dr. Naso specializes in minimally invasive spine surgery and tumor surgery.

"Carley was suffering from an aneurismal bone cyst – a blood-filled tumor," explained Dr. Naso. "These tumors usually occur in the second decade of life. Carley had a tumor located on the spine at the fourth and fifth levels. It had eroded through nearly half of her lumbar vertebrae. The tumor was causing severe pressure on the nerves. A major concern with this tumor is that it can result in severe weakness or paralysis."

According to Dr. Naso, Carley was fortunate that she had little neurologic damage given the size and extensive destructive nature of this tumor. She was already experiencing weakness in her leg and some sensory loss.

"This was an extremely vascular tumor. Therefore, prior to performing surgery to remove the tumor we decided to embolize the tumor. This procedure, performed by McLeod Interventional Radiologist Dr. Greg Cleveland, is done by catheterizing the blood vessels leading to the tumor. Dr. Cleveland placed metal coils in the feeding vessels which reduced the blood supply of the tumor, making the surgery much safer.

"The embolization procedure is not performed in many hospitals because of how difficult and dangerous it can be," continued Dr. Naso. "If the coils are put in the wrong place, it can actually cause paralysis."

During the surgery to remove the tumor, Dr. Naso, assisted by Dr. James Brennan, also of Florence Neurosurgery and Spine, exposed Carley's spine through an incision in her back. Once the tumor was removed under the microscope, they stabilized the spine with titanium screws and rods.

"Although these tumors are generally benign and cured by surgery, they can reoccur," continued Dr. Naso. "In addition, if left untreated, a blood-filled tumor can lead to complete paralysis of the lower extremities and incontinence of the bowel and bladder. Carley was extremely fortunate the tumor was discovered and able to be removed through surgery."

Following surgery, Carley was a patient of the McLeod Pediatric Intensive Care Unit (PICU), where she was cared for by Pediatric Intensivists Dr. Carl Chelen and Dr. Judith Ugale.

Carley spent a total of nine days in McLeod Children's Hospital. "The staff was so good to us," commented Shelby. "Carley was not an easy patient for the first couple of days after surgery because she was in such great pain. But, Dr. Naso and the hospital staff gave her exceptional care."

While Carley was a patient, her parents were able to stay close by at the McLeod Guest House. "We liked having the option of staying near the hospital and not traveling back and forth to Surfside everyday," said Shelby. "The Guest House being right across the street from the hospital also made Carley's stay in the hospital less stressful for us."

Following the surgery, Carley wore a back brace for three months, in order to have extra support when walking, moving, or performing everyday activities. Today, Carley continues to be seen by Dr. Naso for follow-up MRI's to ensure that the tumor has not recurred.

"The most frightening feeling was not knowing if the cyst was cancerous," said Shelby. "We were also very afraid that she was not going to be able to walk after the surgery. Carley is our whole life. We wanted her to be all right.

"It eases our minds that McLeod has specialists available to take care of the physical problems experienced by Carley," said Shelby. "We are blessed by the care she received and that the hospital is close by if anything happens in the future."

"Since recovering from the surgery I feel great," Carley said with a big smile. "Right now, I am still not able to ride roller coasters or take part in strenuous activity, but one day I will. I am also very thankful for the McLeod staff because I do not know what would have happened to me without all of them."

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