Winter 2012 Issue

With Our Help, A Brain Tumor And Spinal Cyst
Didn't Stop This Couple From Smiling

Last year was one that internationally known cosmetic dentist Ross Nash, DDS, and his wife, Debra Engelhardt-Nash, will never forget. They each overcame medical challenges that threatened their professional livelihoods and their future quality of life.

As Debra faced the diagnosis of a critical brain tumor, her husband was suffering from debilitating pain in his right leg that jeopardized his successful practice and educational institute.

An Unexpected Recovery
In the spring of 2011, Debra Engelhart-Nash noticed a weakness and started to walk with a slight limp. "I thought that perhaps I'd had a ministroke," said Debra, who is a nationally known practice management consultant.

"I went to my doctor, and I'll never forget the moment he told me my symptoms could indicate something catastrophic." An MRI revealed a posterior frontal falcine meningioma (brain tumor) on Debra"s left side. She was told to stop taking daily baby aspirin, because surgery would likely be needed very soon.

Prior to Debra’s surgery, an MRI revealed a posterior frontal falcine meningioma. Because of the size and location of her tumor, permanent neurologic deficit was expected.
A post-op MRI indicated that 98% of Debra’s tumor was removed. She still has no residual effects eight months after surgery.

Debra was referred to Carolina Neurosurgery & Spine Associates. Our surgeons determined her outlook was uncertain at best. "Because of the size and location of her tumor and difficulty with weakness in her leg, I was concerned that she may have a permanent neurologic deficit," said practice neurosurgeon Hunter Dyer, MD.

While Debra was very comfortable with Dr. Dyer's bedside manner, as the reality of her potential situation began to sink in, she nearly fainted in the exam room. Surgery was scheduled for the Monday after Easter. Debra was told to prepare for post-op care that might include two days in a medically induced coma, five additional days in the hospital, and three to four weeks of inpatient rehabilitation. It was also likely that her limp would be permanent.

"I got my affairs in order, and became very upset right before surgery," said Debra. "My husband, daughters, and pastor were all there with me. Before the surgery, the doctors and staff in the room all circled my bed and prayed with us. It was a very profound moment. I knew they did that because it was important to me."

The surgery was scheduled for two hours. It took six, but the results were better than expected. The post-op medically induced coma was not necessary and Debra only spent four total days in the hospital. "Dr. Dyer came to see me every morning with words of encouragement," said Debra.

When she was transferred to Carolinas Rehabilitation, Debra was still afraid of what was ahead. "We had promised our grandkids a trip to Disney World, and I was determined that I wasn't going there in a wheelchair," she said.

Debra spent just 11 days in rehab, not the expected three to four weeks. She surprised everyone with her incredible recovery. "It was completely amazing to see her walk with a normal gait within weeks of surgery," said Dr. Dyer. "She came through a large, technically difficult surgery as if it were nothing!"

Not only was she walking without a limp, she danced at her stepdaughter's wedding just weeks later. Today, she still has no residual effects, and an MRI indicated that 98% of her tumor was removed. "Dr. Dyer said I was his poster child," explained Debra.

Three Years Of Severe Pain Ended With 45 Minutes Of Outpatient Surgery
As a specialist in cosmetic dentistry, Dr. Nash spends most of his day standing and leaning over patients. He has also earned the reputation as a highly regarded speaker at dentistry conferences around the nation. The debilitating pain and constant numbness he was experiencing in his right leg and foot was a huge obstacle in his hectic routine and his profession.

"For three years, I had significant sciatic pain that was controlled by anti-inflammatory medication. When that stopped working, it became very difficult to walk," said Dr. Nash.

He was referred to neurosurgeon Vinay Deshmukh, MD, at Carolina Neurosurgery & Spine Associates, and an MRI indicated a spinal cyst was present at the L4 and L5 vertebrae. "He was suffering from neurogenic caudication and radiculopathy caused by spinal stenosis and related to a synovial cyst," said Dr. Deshmukh.

A sagittal MRI shows the cyst and stenosis at the L4 and L5 vertebrae. The cyst was removed endoscopically as an outpatient procedure.

Surgery was scheduled three days later, just two months after his wife, Debra, had undergone significant brain tumor surgery.

"We performed the surgery endoscopically on an outpatient basis to resect the cyst. No fusion was necessary," said Dr. Deshmukh.

"I went home hours after surgery and the pain was gone," said Dr. Nash. "It was like a miracle!"

"The care that we both received at Carolina Neurosurgery & Spine Associates was seamless from our first visit through follow-up care. They made a difficult situation as positive as it could be. I told them they should offer our family the frequent customer discount," said Debra.

A New Outlook And A Bright Future
According to the couple, it's impossible to measure the stress, uncertainty, and fear that they faced together, but the outcome is undeniable. "It was life changing," said Debra. "Each of our crises happened at a time in our lives when we could put our priorities in order. Things that we used to think were essential don't seem so important anymore."

Fortunately, thanks to the expertise of our physicians, they conquered their conditions and found a new focus for their lives..

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