Gray Matter: A Neurosurgeon Discovers the Power of Prayer... One Patient at a Time by David Levy; Joel Kilpatrick

Author:David Levy; Joel Kilpatrick
Language: eng
Format: mobi
Tags: Non-Fiction, Religion, BIOGRAPHY & AUTOBIOGRAPHY / Medical, RELIGION / Christian Life / Prayer, Spirituality, MEDICAL / Surgery / Neurosurgery, Biography
ISBN: 9781414339757
Publisher: Tyndale House Publishers
Published: 2010-01-01T22:00:00+00:00

Chapter 8

Paralyzed

Sam was a thin man in his mid-forties, with straight black hair and a skeptical, serious personality. He was by most measures poor, having come from another country without a lot of advantages, but he was in the middle of a career change. He had returned to school to become a nursing assistant and had only a few more classes to take. He came to see me because he was having progressive difficulty walking and moving his arms. An MRI revealed the chilling truth: he had an intramedullary arteriovenous malformation—an AVM, which is similar to an AVF—in his spinal cord—that is, a thatch of abnormal and oversize vessels connecting an artery to a vein in the spine. As soon as I saw it, I drew my breath sharply and knew we were in for rough sailing. It was as if his body had created a problem designed to defy treatment.

Because the spine is part of the nervous system, the same system as the brain, neurosurgeons often work in this area as well. Spinal cord AVMs are the riskiest problems we deal with. Sam’s problem had the additional disadvantage of being high up on the spinal cord, meaning that everything below his neck was at risk of being paralyzed if the surgery failed. To make matters worse—much worse—because the AVM had been forming for probably more than forty years, putting steady pressure on the vein, the wall of the vein had ballooned out and created a huge aneurysm in the middle of one of his vertebra. The aneurysm was one of the largest I had ever seen in the cervical spinal cord—two centimeters in diameter, so large that it had actually changed the shape of and enlarged the bony opening in his spinal canal. This naturally threatened the spinal cord itself, which was pressed against the bone by the aneurysm. The spinal cord was now compromised and was slowly being severed.

The spinal cord in a normal body is a rope of densely packed nerves about the width of your index finger, traveling down the neck and back. These nerves connect the brain with the body. Sam’s spinal cord was no longer a thick rope but a thin layer of nerves draped around the aneurysm like a nightgown. All signals from his brain to his body were traveling through this ribbonlike connection. Any wrong move, any swelling, could irreparably damage the layer of nerves and break the connection, leaving him immobilized for the rest of his life.

Cases this risky showed up only every couple of years, and I soon realized that this would be one of the riskiest cases I had ever treated. There was no way to tackle it in a stepwise fashion, treating one problem and then waiting to fix the other. I couldn’t close the AVM without closing the aneurysm, or vice versa. It was all or nothing. Both had to be treated simultaneously or not at all.

I explained all this to Sam. He understood that the spine

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