ActivePaper Archive Medical missionary back on her feet - Chattanooga, 3/2/2006

Medical missionary back on her feet

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Nurse Anne Carter, left, who has received pain relief from her minimally invasive back surgery, and her husband, Dr. Louis Carter, a plastic surgeon, will leave for a medical mission trip Saturday.

On Saturday, Dr. Louis and Anne Carter of Lookout Mountain will leave for a medical mission in Jos, Nigeria. Mrs. Carter, a registered surgical nurse, said she expects to be in the operating room with her plastic-surgeon husband, who will be doing head and neck reconstruction. A year ago, that might not have been possible. An unstable spine had given Mrs. Carter pain in her legs, making standing and walking difficult. Working on medical missions, which she and her husband have done regularly since 1996, had become "a lot of just sucking it up," said Mrs. Carter, 66. Last May at Memphis University Hospital, she had minimally invasive spinal surgery, in which a new device that restores the disc space between the vertebrae to alleviate pain was implanted. The surgery realigned her spine and alleviated her pain. Most of the techniques used in the surgery are available in Chattanooga but were pioneered in Memphis, said Dr. Kevin Foley, Mrs. Carter’s surgeon. "These things become attractive to good surgeons," he said, "and they are adopting them in their practice." Mrs. Carter’s diagnosis, according to Dr. Foley, was spondylolisthesis, in which one vertebrae shifted forward on the vertebrae below it and pinched the nerve, and spinal stenosis, which is the narrowing of the lumbar spinal canal. When her condition began to worsen after a trip several years ago, she stayed in bed for six weeks in hopes of getting some relief. It didn’t help. "I don’t jump at surgery," Mrs. Carter said. More recently, the limitations kept her from picking pickup her grandson, Joseph Eldridge, now 2. "I could not lift him," Mrs. Carter said. "He had to learn how to crawl up into my lap. I wasn’t able to help my daughter." A neurosurgeon and longtime friend who was in their wedding recommended that she not have surgery until they saw Dr. Foley, a professor at the University of Tennessee Health Science Center in Memphis. Although the Carters have lived in the Chattanooga area since 1987, they consider the Memphis area home and have a son who lives there. "We did not consider that a hard thing (to have the surgery there)," Mrs. Carter said. The minimally invasive approach to her May 2005 surgery required two incisions in her lower back of less than an inch long and two slightly longer incisions above the first two, she said. Through those holes, Dr. Foley inserted a Capstone implant, a device he helped design that fits into the disc space to keep collapsed bones separated while new bone grows. Bone morphogenic protein, a protein that induces the formation of bone and cartilage, was inserted before four screws and two rods were added to fuse the spine. Dr. Carter noted that one of the beauties of minimally invasive surgery for his wife was that she lost only a couple of ounces of blood. "In the old surgery," he said, "you lose a lot of blood." While back surgery usually requires about two weeks of bed rest, patients after minimally invasive surgery typically spend one or two days in the hospital. Within six to eight weeks, they return to their normal daily activities. On her feet and moving the next day, Mrs. Carter said her husband helped her walk a quarter mile the day she came home from the hospital to stay with friends. Soon, she was making the walk twice a day. "It was hard," she said. "At first, I had to lean on (Dr. Carter)." However, she said, she felt none of the aching pain down her legs that she had before. Two-mile walks and twice-a-week water twicea-week aerobics have further strengthened her, she said. Mrs. Carter’s first major test came five months after her surgery on a medical mission trip to Kenya. "It was a trial balloon," she said, "but I worked just about every day. I hadn’t worked (there) in years." Following Nigeria, the Carters plan to make a longer team trip to Hauna village in Papua New Guinea in May. They also have made trips to other places in Africa, to Asia and to South America, where her husband teaches and operates and she assists him and trains operating room personnel. Mrs. Carter said she still gets tired and has a small amount of pain, but "it’s nothing, absolutely nothing, compared (to before)." Dr. Foley said his patient had "a combination of good things" going for her: "Minimally invasive surgery is a whole let less painful, and you recover faster; she was a motivated patient who helped a lot with her own recovery; and she had the good Lord looking after her." E-mail Clint Cooper at ccooper@timesfreepress.com