A Herniated Disc While on Holiday: Patient Sought Advice and Assistance

THE DOCTOR

In his thirty years of practice, Dr. Hope has performed over ten thousand spinal surgeries, treating each patient with the stellar care and attention they expect. Dr. Hope's goal is to provide an unsurpassed level of care to every patient. 

Dr. Hope's primary concern is always the best outcome for his patients - and that does not always demand surgery. In fact, he only recommends surgery once all other non-operative treatments have been considered. 

THE PATIENT

Brian O’Rourke, a very active, athletic man in his mid-fifties, was a patient of Dr. Hope’s about twenty years ago when he required surgery on his L4-L5 disc. He experienced a full recovery and resumed all his usual activities. 

Last winter, Brian began to experience mild back and leg pain. By Spring, the pain in his lower back and legs worsened, but he attributed it to a pulled hamstring and believed that it would heal on its own. By Summer several months had passed, but the moderate pain continued. 

In July, Brian went to a resort in the Dominican Republic with his family and friends. Towards the end of his stay, Brian “did something” while rolling out of bed one morning. The pain in his back shot up from a 3 to a 10 in an instant. He needed immediate emergency care, but any and all movement was incredibly painful. With great difficulty, his wife was able to get him to a local hospital. 

CHALLENGES OF OVERSEAS CARE

After a very painful drive, Brian arrived at a local hospital. Getting admitted to a hospital emergency room, in a country where most of the doctors and nurses did not speak English, was challenging. Brian and his wife had no idea how they were going to get home without significant medical intervention. The pain was at a 10 and traveling seemed to be out of the question. 

Brian and his wife decided to consult with Dr. Hope via phone. Dr. Hope advised Brian to get an MRI. The hospital in the Dominican Republic shared the results with Dr. Hope and within 4 hours of the first call to Dr. Hope, he had access to the results and explained to Brian that he had a large herniation of the L5-S1 disc that would most definitely require surgery. 

On the positive side, the MRI showed that the L4-L5 was still in great condition - 20 years after his first back surgery. 

Although the doctors at the Dominican Republic hospital wanted to remove the herniation and put screws in Brian’s back, Dr. Hope advised that the screws were not necessary. Based on his trust in Dr. Hope and the fact that he was reluctant to have major surgery overseas, Brian made the decision to be airlifted back to the United States.

“DR. HOPE’S DILIGENCE PROBABLY SAVED MY LIFE”

It took a few days to make the arrangements for the medevac, but Dr. Hope communicated with Brian and his wife via phone throughout this time. Once the flight was arranged, Dr. Hope's office scheduled the surgery. Only 12 hours after landing at Dulles International Airport, Dr. Hope was performing Brian’s surgery at a hospital in Fairfax, VA. The surgery went very well.

Unfortunately, a few days after arriving home post-surgery, Brian experienced dull pain in his chest. Dr. Hope suspected the pain could be due blood clots. Between lying flat on his back for several days and the flight home, these actions could have easily contributed to the formation of blood clots. Brian was quickly readmitted to the hospital and put on blood thinners to alleviate the clotting. 

Around 11:00 pm Dr. Hope called Brian's wife to see how Brian was doing. She told him that Brian was on blood thinners and resting. Dr. Hope was not comfortable having a patient on blood thinners so soon after surgery knowing that it can have very harmful side effects. He did some additional research and then called a fellow surgeon to confirm his position. 

By 1:00 am, Dr. Hope called Brian's wife again and asked her to meet him and another surgeon at the hospital. 

The blood thinners were immediately discontinued and the doctors performed Interventional Radiology (IR), sometimes called pinhole surgery, to insert a filter that would catch any blood clots before they could get to Brian's heart or brain. This filter would remain in Brian's chest for several months until blood thinners could be safely administered. At that time, the filter would be removed. 

Brian credits Dr. Hope's late night diligence and follow up calls with saving his life, stating that "Dr. Hope led the way in getting me through the blood clot issues. I really believe that he saved my life and fixed my back." 

THE ROAD TO RECOVERY

Brian expressed that Dr. Hope's expertise in the operating room enabled him to get back to the quality of life he had held previously. 

Due to the large herniation that went untreated and sat on his nerves for several days, this recovery has been slower than Brian's previous experience. But Dr. Hope was with him all the way. Brian was amazed at the time - and the many phone calls - that Dr. Hope devoted to his care. His personal touch throughout the process was of great comfort and value to Brian and his family. 

Dr. Hope explained that this recovery could be slow, but Brian's pain went from a 10 to a 0 immediately following surgery. 

After three months of physical therapy, and a follow-up routine at home, Brian feels that he's 90% back. Nearly 8 months later, Brian still experiences some tingling and numbness in his left foot, but he is back to playing tennis and going to the gym where he is seeing continuous improvement. In Brian's words, he is forever grateful.