Gratitude Stories - Isabel
Isabel Allaire, 24, arrived at the emergency department trembling with excruciating pain, a loss of balance, and migraine. But by the time her Rhode Island Hospital patient journey ended, this grateful patient says she was “feeling better than I have in 10 years … like nothing happened.”
But something did happen. A lot, in fact.
First and foremost, she met Ziya Gokaslan, MD, the internationally renowned neurosurgeon-in-chief at Rhode Island and The Miriam hospitals. Dr. Gokaslan performed the high-risk, lifesaving surgery that eliminated the chronic pain Isabel tolerated for nearly a decade.
‘Every year it was getting worse’
Isabel’s ordeal began with an injury she sustained during a high school volleyball game eight years earlier, which caused pain and numbness and led her to seek immediate medical attention. X-ray results at the time indicated she had a moderate case of thoracic scoliosis.
Unfortunately, a much more serious condition was not discovered.
Following high school, Isabel went to the Fashion Institute of Technology in New York City and then the New York Film Academy. After graduating, she launched a career in video production and shortly after started to freelance in photography and social media marketing. Through it all, Isabel’s pain persisted. “Every year, it was getting worse,” she remembers. “My back would hurt, I felt numbness, tingles.”
Eventually, the Rhode Island native returned to the Ocean State for the support of her family while she reimagined her career and tried to manage an escalating health situation.
The pain in Spain
Isabel and her family had a trip to Spain planned. Leading up to their departure, Isabel’s pain prompted her to go for another x-ray. The results indicated something needed further exploration and an MRI was recommended. But she was advised that it wasn’t severe enough to cancel her trip that was in the next few days. Unfortunately, her pain followed her to Spain, and between paella and historical sites, she struggled with dizzy spells and was forced to lie still every few hours.
As soon as she returned home, Isabel scheduled the MRI. When doctors couldn’t detect the cause of her pain and other symptoms, they recommended she make an appointment with Brown University Health Neurosurgery, which is led by Dr. Gokaslan.
A week before her scheduled appointment, her condition intensified with migraines, dizziness, fainting, numbness on the left side of her body, and shaking. She could not wait for the appointment in few days. She called her primary doctor who sent her to the emergency department at Rhode Island Hospital.
An alarming discovery
Once there, doctors recognized a compression of her brain stem and promptly ordered additional imaging. The results were extremely complex.
In addition to scoliosis, Isabel had three serious conditions: 1.) Basilar invagination, a rare condition when the top of the spine gets pushed into the base of the skull; 2.) Chiari malformation, a condition in which brain tissue extends into the spinal canal; and 3.) Syringomyelia, fluid-filled cysts or syrinx within the spinal cord.
All of these added up to life-threatening pressure on the brain stem that was preventing cerebrospinal fluid, essential to the central nervous system, from flowing freely.
Trust and optimism in the face of uncertainty
Despite the complicated diagnosis, Isabel was optimistic. The doctors explained that surgery would align her body and reconfigure her skull and spine, permanently. “I was excited that something was getting done and they diagnosed the problem,” she remembers. “I was hoping that it was fixable. Everyone was so confident.”
The next morning, after an overnight in the ED, Dr. Gokaslan met with Isabel and her parents to explain the procedure and answer their questions. They trusted him 100 percent.
Dr. Gokaslan and his team had prepared for the surgery, creating three-dimensional models of Isabel’s spine, reviewing specifics of the surgery, and developing alternate techniques if a procedure was to fail. The 5-6 hours of delicate surgery went according to plan.
Isabel was in a Halo vest, an external brace that prevents the neck and spine from moving, as Dr. Gokaslan inserted, precisely, metal plates and screws into her skull, removed the base of the skull, performed a laminectomy procedure to remove the bone in the upper part of the cervical spine, and then sewed a surgical patch in place to provide more room and help relieve the pressure, improve the passage of spinal fluids, and prevent any further damage.
World-class care in her own backyard
Within hours after surgery, Isabel was able to walk about the floor where she was recovering. Four days later, she went home for a few months-long recovery. Six months after surgery, at her follow-up appointment with Dr. Gokaslan, she told him, “I feel better than I have in 10 years. It’s like nothing happened.”
Until she needed it, Isabel acknowledged that she never realized the high-level of care that was available right in her home state. “I can’t believe I didn’t have to be airlifted out of state. People are flying (to Rhode Island) from other countries to come here for these great facilities.”
Reflecting on her medical experience, she says, “I’m feeling so lucky because right here, in the smallest state, Dr. Gokaslan was the one who could do it.”