Pam Nelson's Story
Pam Nelson lives life with gusto.
She drives a Harley, rides horses, works out and skis. She owns Foothills Toyota in Skagit Valley and breeds horses on her 100-acre farm. She’s accustomed to taking charge and being in control. But in the spring of 2006, at age 55, she began suffering so much agonizing pain that a workout left her in tears.
A local physician discovered what looked like a tumor on her spine. Pam called her sister, an active volunteer in the Seattle health-care community, for advice on finding the best neurosurgeon in the region. A few phone calls later, she was under the care of a team at Harborview, led by two internationally renowned physicians:
Dr. Richard Ellenbogen, chair of the UW Department of Neurological Surgery and president of the Congress of Neurological Surgeons, and
Dr. Randall Chesnut, UW associate professor of neurological surgery and director of neurotrauma and neurosurgical spine services at Harborview.
“I really didn’t know much about Harborview beyond the fact that it’s a great trauma center,” Pam recalled. “I didn’t realize all the other things they do there.” According to Ellenbogen, Pam had a very aggressive looking spinal nerve sheath tumor, and it was unclear from pre-surgery tests whether it was benign or malignant.
“Pam’s case also was uncommon because of the tumor’s location on her spine,” he said. “We assembled a team of surgeons and were prepared for anything we would find.”
Pam faced a battery of tests and a delicate and complicated seven-hour surgery.
“If you have an unusual case, as Pam did, you want to go to a place where unusual cases are an everyday occurrence,” Chesnut said. “Harborview is accustomed to getting people out of trouble. We deal with complex, life and death conditions so our surgeons are able to work calmly through a situation even if things don’t go as expected.”
Pam was prepared, too. She put her affairs in order and gathered her family. They cried, they talked, and then she checked into Harborview. “Your emotions run the gamut from fear that you are going to die to ‘let’s get this over with’,” Pam said.
Before her surgery, Ellenbogen came to her room with a rolling skeleton to show Pam and her family the location of the tumor. Each physician on the team came to talk with her, reassure her and answer all her questions. Then it was off to the operating room.
Based on extensive tests and consultations, the team decided to operate from her back, the safest course for protecting her nerves and making sure she could walk after surgery. If the tumor turned out to be malignant, they would have to close her up, turn her over and remove the entire tumor from the front. Although it was the size of a peach, the tumor was benign. Ellenbogen was able to reach most of the tumor and cut off its future blood supply.
“The tumor was adjacent to nerves, arteries and veins, making her spine very unstable,” he said. “It was an unusual tumor to find in an adult. “Once the tumor was removed, it was Chesnut’s turn to operate. He fused the bottom two lumbar and sacral bones that had been damaged by the tumor, temporarily stabilizing them with titanium screws and rods.
“We expected a lot of her back to have eroded,” he said. “Bones are alive, and Pam’s bones kept remodeling to accommodate the tumor.”
Pam was impressed with every aspect of her experience at Harborview. Care was provided with efficiency, expertise and compassion. She appreciated both her remarkable team of surgeons and her attentive team of nurses. “They would double check everything to make sure there were no errors,” she said. “Their bedside manner is so gentle, and they are with you whenever you need them.” A month after surgery, Pam returned to work but not to business as usual.
“I’m going to take more time with my family and myself than I did before,” she said. Her future looks bright and her pain is gone. If she needs hospital care in the future, she knows where to go.
“I would tell anyone who needs surgery - go to Harborview,” she said.
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