Case History of Lidia
When we first met Lidia in June 2007, she was a 49-year-old determined woman in search of answers. She had a history of progressive weakness in her legs, impairment in her bladder and bowel function, and pain that was worsening over a period of two years. She was diagnosed with and treated for several medical conditions over the two-year period and did not have relief of pain or improvement in her symptoms. In fact, she continued to worsen until she lost function of her lower extremities and was wheelchair-bound. Her weakness and pain started in her toes and progressed to her lower abdominal region. At an outside facility, she was diagnosed with a thoracic arteriovenous malformation (a cluster of abnormal blood vessels near her spinal cord) but was told it could not be treated and was referred to Dr. Neil Martin, a Neurovascular Specialist at UCLA. She presented to us with her husband and children hoping for assistance.
As her condition was progressively and rapidly worsening, we admitted Lidia directly to the hospital for a complete evaluation and for pain management. She had several diagnostic tests and a complete review of her angiogram. She did have an arteriovenous malformation (AVM) that was the likely cause of her symptoms. Dr. Martin discussed the findings in detail with Lidia and her husband and recommended surgery to remove the AVM. He discussed the possible outcomes including persistent pain, persistent paralysis, and the possibility of permanent loss of bowel and bladder function. She agreed to proceed with the operation and had surgery on June 13th. The nine hour operation was a success and the AVM was completely removed.
She continued to recover in the hospital and on the fifth day after surgery she was discharged home. She worked aggressively with physical and occupational therapy and was walking in the hallway with a walker before going home. She continued to have urinary dysfunction and needed to catheterize herself intermittently. Overall, she was extremely pleased with her progress and determined to continue improving.
We evaluated her in the office about six weeks following surgery. She made excellent recovery and was no longer requiring the assistance of the wheelchair. Her bowel and bladder function returned to normal and she no longer needed to catheterize herself. She was walking with a walker or cane and the assistance of leg braces.
At the end of September 2007 she was walking with the assistance of a cane and eager to return to work. She continues to work with physical therapy and is making dramatic improvements.
In addition to her duties as a full-time mother and wife, we received word in December 2007 that Lidia returned to work as a LVN (licensed vocational nurse) at a rehabilitation facility. We are extremely pleased with her progress, outcome, and determination to recover.
Jennifer Varma, NP