April 19, 2012
Teamwork between a John C. Lincoln neurologist and neurosurgeon has helped one patient achieve a miraculous recovery, leading to a high-stepping celebration in the Intensive Care Unit.
High-stepping patient James Bolger, left, and John C. Lincoln neurosurgeon Igor Yusupov, MD
It's not every day the Intensive Care nurses see one of their patients high-stepping, especially not the day after surgery. It's no wonder they clapped and cheered.
Neurologist Eric Foltz, MD, and neurosurgeon Igor Yusupov, MD, were equally enthusiastic. Thanks to their effective teamwork, their patient's mobility was a lot better than either expected.
The amazing patient is James Bolger, a 49-year-old City of Phoenix construction worker, who is now doing well and going to physical therapy three times a week.
"I am very grateful for all the help I've had from the doctors, nurses and physical therapists who assisted in my care at both John C. Lincoln Hospitals," he said.
But today's joy is polar opposite of the Oct. 10 morning when Bolger woke up feeling lightheaded and confused.
"I had no warning," he said. "I had extremely poor balance. I thought I was having a stroke."
Neurosurgical patient James Bolger, left, looks at a medical image of his cervical spine (neck) with John C. Lincoln neurosurgeon Igor Yusupov, MD.
Bolger's wife took him to the Emergency Department at John C. Lincoln Deer Valley Hospital, where they whisked him to the MRI for a brain scan. Oddly, it showed clear tissue, no blood clots, no bleeding and no signs of stroke. Yet Bolger's lightheadedness and balance problems were getting worse.
The ER admitted him to the hospital and called for an immediate neurological consult. Dr. Foltz evaluated Bolger and ordered another MRI, one of his neck and upper spine.
Symptoms continued to worsen. On the second morning in the hospital, Bolger could no longer walk. "My legs would no longer obey my brain," he said. "When I tried to stand, my legs wouldn't function."
"You can imagine how scary that must have been," Dr. Yusupov said. "If he'd had a desk job, and was suddenly facing life in a wheelchair, it would be traumatic enough. But Jim physically works for a living. Without full physical ability, there's a real question whether he could support his family."
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If there could be any good news, Dr. Foltz said, it was that the problem came on suddenly. "The MRI showed compression in his spinal cord, caused by bulging discs."
It was important to surgically relieve pressure on the spinal cord before it caused permanent damage. Dr. Foltz transferred Bolger to John C. Lincoln North Mountain Hospital and called Dr. Yusupov.
"Dr. Foltz did an excellent diagnostic workup, great investigative work," Dr. Yusupov said.
Dr. Yusupov met Bolger and his wife, Gina, that night. "He assured us the problem was correctable," Bolger said, "but he said I needed to have the surgery first thing in the morning."
"The earlier the intervention, the better," Dr. Yusupov said. "The cord wasn't permanently damaged yet, but the longer we waited, the greater the risk."
Dr. Yusupov removed the bulging disc that was compressing Bolger's spinal cord, replaced it with a prosthetic plug and used plates and screws to stabilize the spine.
As soon as Bolger woke up in ICU, he asked if he could try to walk. Within two hours, with the help of a physical therapist, he was moving carefully with a walker.
By the next morning, he was high-stepping around the unit to the sounds of the nursing staff's applause and cheers.
Learn more about Neurosciences at John C. Lincoln.
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