Christiana Grenoble – Pain Management

Christiana Grenoble remembers the exact moment she knew she had hurt her back. “It was during a Tai Chi class,” she says. “I was in the middle of one of the harder postures, already on one foot. As I twisted into the pose, I heard a pop in my back and that was it.”

It was November of 2010, and Christiana was hardly a novice. She’d been doing Tai Chi for 20 years, a martial art widely known for its sequences of graceful movements and even transitions, a moving combination of yoga and meditation. “That’s true,” she says, “but Tai Chi can also get pretty ‘out there,’ pretty rigorous.” She’s no stranger to rigorous activity, having been a practitioner of Kung Fu as well, and accustomed to exercising every day.

In her early 40s, Christiana was accustomed to the occasional backache after a strenuous workout, but they always resolved within a day or two. So when she felt the pop, she figured she’d be OK after taking it easy for a few days. In fact, she waited about six months, thinking – and then hoping – the problem would just go away. When it didn’t, she made an appointment with her family doctor. “I was in a lot of pain at that time,” Christiana remembers. “I couldn’t walk more than 50 or 100 feet without problems. And my foot was starting to go numb. I couldn’t manage – I couldn’t even do normal household activities anymore.” Knowing Christiana’s high threshold for pain, her doctor suggested that she go to physical therapy and see a pain management doctor. “She didn’t want to just give me a prescription for pain killers; she wanted me to see a specialist,” Christiana remembers.

To call her experience with the first pain management doctor unsuccessful is being charitable. “It was a nightmare,” Christiana says flatly. “He put me through a series of tests, first saying I had this condition and then that condition. And he kept giving me medications like oxycodone that were just way too strong, crazy stuff. I couldn’t sleep; I was edgy all the time. I thought that must be what methamphetamines felt like.” Distressed, and with worsening pain, she stopped seeing that doctor and weaned herself off the narcotic drugs.

She treated herself with over-the-counter Motrin while she looked for appropriate medical care. She was referred to various area orthopedists and chiropractors, who were stymied by her presentation – she was even briefly treated for a slipped disc, without success – and finally, it was suggested she see Dr. Sureja for pain management.

Based on her previous experience, she was skeptical, but made the appointment anyway. “He seemed awfully young, but I felt like he was genuinely interested in helping me,” Christiana recalls. Ever pragmatic, she added, “I figured it could take a while to figure out what was wrong, so I decided to give him two years.”

Dr. Sureja picks up the story. “Throughout the course of her previous treatments, she’d tried various anti-inflammatories, pain medications and non-specific steroid back injections, but they hadn’t helped,” he notes. “I conducted a thorough examination, and reviewed her imaging with her. I suspected her pain was coming from inflammation and arthritis within one of the facet joints, one of the very tiny stabilizing joints located between and behind adjacent vertebrae.” Dr. Sureja observed some swelling around the joint, which “…could have indicated that she might have stressed that area doing one of her Tai Chi exercise,” he says, “we just weren’t sure. Based on how she described her pain – where the findings were located on the MRI and what her physical exam showed – we thought it was probably coming from that tiny little facet joint.”

Dr. Sureja sought to prove his theory of Christiana’s pain, and performed a facet joint injection, a procedure that is done for both diagnostic and therapeutic reasons. Dr. Sureja explains, “Under x-rays, we placed an anesthetic into her joint to determine how much improvement she had over her usual pain. What we found by doing that was that she had significant and tremendous improvement.” Christiana recalls, “He basically found the spinal joint and re-created the pain. Literally, when he put the needle in me, it caused me exactly the pain I felt when I was standing up or walking.”

Once he confirmed that her pain was coming from that particular joint, Dr. Sureja then injected cortisone, which gave Christiana several months of relief. The next step was a medial branch block, another diagnostic procedure which temporarily interrupted the pain signal from the medial branch nerves to the facet joint. She remembers it well: “It was amazing. I had resigned myself to the fact that I was going to suffer the rest of my life, but when he found the nerves and put in the medicine to block them, I felt better immediately. I felt 75% better.”

And it will get better still for Christiana: Dr. Sureja plans to perform a radiofrequency ablation. “We’ll cauterize the nerves going to her joint to help block the painful impulses coming from the inflamed area,” he says, noting that “…it may need to be repeated at some point, especially for someone like Christiana who is extremely active and doesn’t want to continue getting cortisone – and who is adamant about avoiding narcotic pain medication.” But he adds that in some cases, patients who undergo the procedure have no return of pain. Radiofrequency ablation is safe, and performed in Dr. Sureja’s office without general anesthesia. She’ll even be able to return to her job as a computer programmer/engineer the next day.

Christiana is looking forward to the next step. She’s already regained a lot of her quality of life and function, because Dr. Sureja was able to specifically pinpoint where her pain was coming from, and diagnose it successfully. She’s lost 50 pounds and is anticipating a healthy, active lifestyle. Her goal – which she once believed unattainable – is now within her reach: “I want to be able to walk without suffering. I want to be out of pain, without having to take medication every day.”

For patients like Christiana, Dr. Sureja knows, chronic pain is debilitating above and beyond the physical stress it imposes. “For many people, there are psychosocial changes that can occur with pain and loss of function – depression, anxiety, a sense that their self-worth has decreased,” he notes. “But with improvement in x-rays and diagnostic imaging like MRI, we’re able to see the structures in the spine more clearly. We’re able to pinpoint the pain and treat that specifically, rather than simply masking it or putting somebody on opiates for the rest of their lives.”

As for Christiana, she considers herself lucky to have medical insurance that will cover the costs of her treatment. But, she adds, “Even if I didn’t, I’d save the money to have these procedures. It’s very exciting.”

Beverly Williams – Reverse Shoulder Replacement Surgery

The first time Beverly Williams saw Dr. Coleman, she was in a wheelchair. “I was having tremendous pain in my left ankle,” she says, but that’s not why she sought care at OSC. Only in her 40s, Beverly has suffered from debilitating rheumatoid arthritis since the late eighties, so she attributed her ankle pain to RA. “I assumed it was part of the joint breaking down,” she says. It was a natural assumption: she’d already had all but one of her joints replaced – all but her left hip.

A former reporter with The Daily Press, Beverly had worked in the field for years, covering the courts, criminal and civil, in both Hampton and Newport News. She suffered the effects of RA, undergoing several joint replacement surgeries throughout her journalism career, until she ultimately took a less strenuous job with the communications department at Ferguson Enterprises.

It was in 2009 that her reporter’s keen eye caught a notice in the paper announcing one of OSC’s community lectures: Dr. Coleman was speaking about new modalities in rotator cuff repair and shoulder replacement. She’d had surgery on her right shoulder in 2000 in Richmond, and “…swore that I’d never go through that again, because they cut through my rotator muscle to get to the joint. That recuperation – the physical therapy – was so painful.” But her left shoulder had started to break down, and she was in constant pain. “I knew something needed to be done. Pain is something you remember, and I wasn’t sure I wanted to go through that again. But I knew I couldn’t keep going the way I was. It was hurting to get dressed – I started wearing cardigans because I couldn’t get clothes over my head.”

With her reporter’s curiosity, she was also intrigued by the new technology. She attended the lecture and subsequently made an appointment with Dr. Coleman.

After examining her and reviewing her x-rays, Dr. Coleman remembers, “Beverly’s joint was destroyed and she literally had no rotator cuff. Ten years ago, when people like Beverly came to see us, we’d have to say, ‘sorry, we can’t help you, we can’t make you better.’ We would give them cortisone shots and they’d keep suffering.” He told her that a conventional replacement – putting a ball where the ball was and a socket where the socket was – could give her some pain relief but no function. She’d be unable to lift her arm, and worse, the repair could quickly fall apart, leaving her back where she started.

But that was ten years ago, he assured her, and then described the new procedure: a reverse total shoulder replacement, which relies on different muscles to move the arm. “The very clever French researchers who discovered this particular device realized that if you put it in basically backwards – that is, if you put a ball where the socket was and a socket where the ball was – then the outside muscle, the deltoid muscle, can do the work that the cuff used to have to do,” Dr. Coleman explained, noting that “It’s a mechanical issue; it has to do with the lever arm being better with that arrangement.”

At the time, Dr. Coleman had been doing the reverse total shoulder replacement procedure for about six years. “It was the Holy Grail of shoulder surgery,” he says. “Everybody had been looking for something like this. They’d tried dozens of different techniques – all kinds of things trying to solve the problem – but the French figured it out and it’s become the standard. Everybody now generally agrees this is the best way to solve a problem like Beverly’s.”

Shoulders are Dr. Coleman’s real focus, and he had adopted the procedure early on because he recognized its value, especially since he knew it would offer relief from pain as well as improving range of motion. They booked the surgery.

Of the post operative period, Beverly says, “It was totally different from the right shoulder. Instead of cutting through the muscle, Dr. Coleman was able to just move it out of the way to do the replacement. My healing time and physical therapy were so much better.” Today, she says, “I have more range of motion with my left shoulder, the shoulder Dr. Coleman did.” Naturally right-handed, she’s even begun doing some things with her left hand. She still protects her left hip, but realizes that it too might ultimately break down because of RA. “After the seminar and meeting with Dr. Coleman, I felt I was in good hands, really comfortable,” she says, and “after the surgery and the physical therapy at OSC, there was no doubt I was in the right place. If my hip becomes an issue, OSC would be my first option because of the treatment I received there.”

For someone who had suffered so much and for so long, such a good result would have been remarkable. But that’s not the end of the story, and not why Beverly remains grateful to Dr. Coleman and to OSC. Recalling her eighteen months in the wheelchair, Beverly explains: “At one of my appointments with Dr. Coleman, my mother asked if he knew anyone who works on feet and ankles. He immediately referred me to a local foot and ankle reconstruction specialist, who took one look at my ankle and said I had a ruptured tendon.” She had been walking on a ruptured tendon for about 4 years, until the pain forced her into the wheelchair. Her foot was already beginning to deform to the left.

“It was because Dr. Coleman referred me to the foot and ankle specialist that I got my ankle straight and got out of the wheelchair,” Beverly says. Able to walk without ankle pain, and move without shoulder pain, she was able to exercise, and has lost around 150 pounds. And the wheelchair? “I use it for a desk chair!”

She calls herself “literally, a new woman”; and in fact, when Dr. Coleman saw her at a community event – where she was a featured speaker – he didn’t recognize her. “She was out of the wheelchair, moving around comfortably, and she just looked terrific,” he says.

Today, Beverly devotes her time to working on behalf of patients with RA. As part of the Patient Ambassador Program with The Snow Companies, Beverly produces a monthly webcast, providing information and encouraging conversations about how to live successfully with rheumatoid arthritis.

“No one knows what causes RA,” she explains, “although it’s known that it can be hereditary. In my family, my paternal grandmother was diagnosed in her 70s. I’m the first one to get it so young.”

She still has RA, but before her first visit to OSC, Beverly would never have dared imagine the life she’s living today. “Everything is working, and I feel really good. I’m so thankful to Dr. Coleman, not just for getting my shoulder straight, but because he helped me get my ankle fixed. He started it all. I owe him so much.”

Charlene R. Small – Spine Surgery

Physician Name(s) – Dr. Haynes and Dr. Carlson

My name is Charlene R. Small (retired teacher). I live in Mathews County, VA. My problem started in June 2012. It was like a “Charlie Horse” in my right leg, just below my knee. Dr. Haynes put me on muscle relaxers and then therapy. I had a MRI which showed a slight tear in one of the lower vertebrae. Things improved and I was released on August 20th.

Well on August 23rd, I reached to pick up something and I thought I would never get up. The next day, my husband and I went to SC to help our grandson celebrate his 6th birthday. When we returned home, I called and got an appointment with Dr. Carlson. The next week, I had the lumbar shot. I steadily got worse. I couldn’t get up and down without a pain level of 10+.

I returned to see Dr. Carlson on September 28th. Since I had tried everything, the result was surgery; and I said when! Surgery was on October 2nd. It was a good decision. (My lower vertebrae (3 & 4) were tied together for alignment and spaced with rods). The surgery went well and I came home on October 5th.

Being an active person, walkers, potty chair and shower chair were all new to me. I had never had surgery. I had Home Health Care (Personal Touch – wonderful) and returned to Dr. Carlson on October 12th for a check-up and to get my 17 staples out. He said I was doing well and to walk. I could get rid of the walker. I started walking. By the first of November, I was walked 1 1/3 miles a day. (Remember to wear your brace all of the time). I had not taken a pain pill since October 20th.

I returned to Dr. Carlson on November 16th. Things were looking good and I started Physical Therapy. I used the Sentara group in Mathews – excellent). I will complete therapy on January 7th. I return to see Dr. Carlson on January 4th. I believe I am steadily improving.

My advice to anyone is listen to the Doctor and talk to someone who had had your problem. I did and still listen to them.
Take baby steps, listen to your therapists and do your exercises. I returned to the YMCA on January 2nd, but took things slowly. Just because you feel good, one must not over-do! AND wear your bone stimulator.

The physicians and staff at Orthopaedic & Spine Center are truly dedicated people. They really want you to be healthy.

William Watkins III – Partial Knee Replacement

Physician: Dr. Haynes

It was a dark and stormy night. Deep in the throes of depression, I was contemplating the misery that had befallen me through the inexorable degeneration of my left knee by osteoarthritis. Boyd Haynes III, MD, at OSC in Newport News, had tried valiantly to avoid surgery, to no avail. When the fateful day arrived that I was told all non-surgical remedies had been exhausted, Dr. Haynes informed me that I was candidate for his new robotic partial-knee replacement procedure. Scheduling the surgery for June 26th, 2013, I looked forward to having my normal mobility restored. The storm clouds began to clear; there was hope.

Full of angst and trepidation, I agonized over what I feared would be a very unpleasant experience; fraught with all of the perils that one associates with major surgery. Dr. Haynes and his physician’s assistant, Jamie McNeely, went out of their way to explain the details, reassuring me that the risks would be minimal and the results beyond my expectation. On the day of surgery, both were there to greet me with their bright, smiling, optimistic faces, assuring me that I could expect outstanding results.

As I write this testimonial, it is ten weeks post-surgery. The promised results have been nothing short of spectacular, bordering on miraculous. It is the dawn of a new era for me, with blue skies and bright sunshine. I now have ninety percent functionality of my left knee in the performance of normal daily activities, with little or no pain. I expect 100% full functionality within another month or two of physical therapy.

For anyone who has suffered the quality of life degeneration that I have for the past five years, I can personally attest to the fact that full and complete restoration is achievable. I am so very grateful to Boyd Haynes III, MD, Jamie McNeely, PA and OSC for restoring my normal ambulatory mobility. Thank you all!

Susan Evans – Spine Surgery

Physician – Dr. Carlson
I am Susan Evans from Williamsburg, VA. I was 55 years old when I had my spinal decompression and fusion of discs L4 and L5, performed by surgeon Jeffrey Carlson. My recovery has been nothing short of stunning.

On March 31, 2011, I fell while out of town. Looking up from the carpet of the corporate conference room wondering how I got there was frightening. I had never fallen like that and had no idea why my left leg and foot suddenly were numb, and my foot no longer seemed to get the message it was time to perform walking-related tasks. The foot simply flopped when my leg moved forward and back, seeming to stick to the floor rather than move up and down like usual. Walking across a room was difficult; walking to the mailbox was impossible. Since my husband had seen Dr. Carlson a year before for a similar issue I called and made an appointment for myself. That was a Thursday afternoon. On Friday I saw Dr. Carlson. He diagnosed a congenital spinal defect that required surgical intervention to prevent permanent damage. I had mounting pressure on the nerves to my left leg. If not relieved the “drop foot” would become permanent. The following Monday morning I was wheeled into surgery.

After surgery Dr. Carlson told me the surgery was a success, but I may or may not experience full return of the strength and functionality to my left leg and foot. “Time would tell”, he said.

After a 3 week recovery I entered physical therapy to rebuild strength and function. Core work, they said, was the secret to rebuilding the strength in my leg. I trusted their plan and worked diligently at the exercises the physical therapists prescribed. For 8 weeks I went 2 to 3 days per week and walked 3+ miles a day. I was released from PT in July, 2011.

When I was released from PT I had regained approximately 90% of my strength and flexibility; and I had regained complete control over my left foot. Since then, I have continued to use the exercises they taught me in PT and others I learned while becoming a certified personal trainer to exceed my previous levels of strength, flexibility and endurance. Today I am a triathlete – I swim, I bike, and I run – with no physical impairment from my back surgery and only mild discomfort and stiffness at the surgical site, mostly on rainy days.

Of course everyone will not experience the same results that I have, but Dr. Carlson’s talent and my determination to recover set me on a path to a dramatic recovery and a lifetime of continued mobility.

Steven Jacobs

Physician: Dr Haynes
I want to thank you for your wonderful care again. Thanks to you and your diagnosis and treatment, I not only felt better, I could truly enjoy every moment of my trip, especially the parasailing that my wife talked me into. To prove it, I am enclosing a picture to prove it. Thank you once again. Steven Jacobs

Sidney T. Duncan (Scott)

Physician – Dr. Haynes

At age 55, I was diagnosed with arthritis in my knees. At age 63, I had a full knee replacement surgery. Through the years, I was given a prescription for Celebrex to ease the pain. It worked for years, but as I got older, the arthritis gradually became worse. The pain would be so intense that I would not put any weight on my knee. I waited so long, because I did not relish the thought of my leg being cut open and the pain of rehabilitation I would have to go through.

The pain became so intense I finally decided I could not live like this any longer. Dr. Haynes was recommended to me, he performed the surgery. The first week after my surgery, the pain was excruciating. It has now been a year since my surgery and I am so glad I had the surgery done.

When I look back on it, I wish I would have had the surgery long ago. I’m now free of pain; I can now walk like a normal person and my quality of life has changed 100% for the better. I can’t thank Dr. Haynes enough for helping me to be pain-free. I enjoy my life so much more and I’m able to exercise on a regular basis now. I received excellent care while in the hospital and while I went through the rehabilitation process.

Margaret E. Bailey – Ankle Fracture/Spine Surgery/Knee Surgery

Physician Name: Drs. Coleman, McFarland, and Snyder

My story: A few years ago after breaking my ankle and not knowing any orthopedic doctors, my friend recommended Orthopaedic & Spine Center. Dr. Coleman saw me immediately and gave me advice to reduce the chance of putting pins in. I followed his advice and with his great care I have not had any aches, pains, or problems with my ankle. When I developed back problems other government physicians gave me treatment options that would only be temporary, if they found the problem. I again called OSC where I met Dr. McFarland. He removed 4 bone spurs off my spine. He was honest and told me I would always have some pain, but it would be manageable (and it is). Then I had to have knee surgery which Dr. Snyder performed. I am 74 and active. Thank you all. If you have a problem, don’t hesitate to call – they are caring and they listen. I hope I won’t need their services again, but they will be the first call I make.

Luvenia Cappe – Endoscopic Carpal Tunnel Surgery

Physician: Dr. Haynes

After thirty-five years of employment on typewriters and computers, I was diagnosed with Carpal Tunnel Syndrome. The numbness was so severe, it woke me up to find some comfort. After an appointment with Dr. Haynes, he suggested surgery.

On September 5, 2013, Dr. Haynes performed surgery. The numbness was immediately relieved. I did not need pain medication. The surgery was a real success. Thanks to Dr. Haynes and his staff. Dr. Haynes is very knowledgeable of the procedure and I got immediate relief.

Lucille Harris – Spine Surgery

Physician – Dr. Jeffrey Carlson

I went to see Dr. Carlson for severe back pain which was affecting my ability to do daily tasks like cleaning, bending, standing up after sitting and driving. On the MRI, Dr. Carlson found that I had a cyst on my lower spine which was causing my pain. He explained to me that surgery would be the only thing that would relieve my pain. I told him that surgery was not an option, initially, and I asked him to let me try Physical Therapy.

I did PT for 6 weeks to no avail. I went back to see Dr. Carlson, my pain was getting worse and my ability to do things was diminishing. I was so scared of the thought of surgery at first. But in the time I was in PT and not improving, I came to terms that, in fact, surgery was my only option and I was going to have to do it. It was not an easy decision at my age (84).

I went into surgery and when I woke up, the pain was gone, just as Dr. Carlson had promised. I spend 3 days in the hospital and 23 days in Rehab at Saunders Nursing Home. I healed extremely fast, being that I had two metal rods now in my back and line of staples, too. During my recovery, I did have to wear a back brace all the time and use a Bone Growth stimulator unit to help me heal.

Dr. Carlson was amazed at how well I did in healing so quickly. Six weeks after surgery, I was back to living my life – feeling good – all thanks to Dr. Carlson!