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The Show Must Go On

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Moira Royston and Dr. Ali Baaj

Moira Royston had never felt a pain quite like this one. She and her show dog had just completed the first round of a competition, where she had had unexpected difficulty keeping up. When she left the ring, she experienced a terrible pain in her leg. “The only way I could relieve it was to lie down or bend forward and lay my hands on my knees,” she says. “I finished the day, but I couldn’t handle my dog in other shows.” The active 65-year-old, a college professor and horseback rider as well as a show dog enthusiast, knew something was very wrong.

A few days later Moira saw a doctor, who recommended an MRI, but her insurance company denied it. “They had me do physical therapy for a little under two months,” she reports, but during that time her condition worsened. “I had a toe that started to droop, so my physical therapist told me to go to an orthopedist.” Approved for an MRI this time, Moira got some bad news from the orthopedist: there would be no more running with her dogs, no more riding horses, and a steady regimen of pain meds.

“I went home, cleaned the pigeon coop, and cleaned the pond,” Moira says. “I was angry!” But she didn’t let her anger drive her decision-making. Moira, who has a PhD in molecular developmental biology and teaches genetics at St. Joseph’s College on Long Island, decided that more information would help, so she sought a second opinion. “I chatted with my best friend, whose clients are surgeons, and they said to go to Weill Cornell.”

Just a few days later Moira was at the Weill Cornell Medicine Center for Comprehensive Spine Care with Dr. Naomi Feuer, a neurologist. Dr. Feuer performed electromyography (EMG) tests of Moira's legs. “I started dragging my right foot," Moira recalls, "and she ended up telling me that my EMG was flat.” Dr. Feuer immediately referred her to Dr. Baaj.

The MRI had shown that Moira had spinal stenosis  a narrowing of the spinal canal that puts pressure on the nerves and can cause the kind of pain Moira had felt starting at the dog show. The EMG confirmed that there was no nerve activity in her legs, explaining the foot drag.

“I recommended she undergo surgery soon,” Dr. Baaj recalls. “The problem was not with her legs but with her spine; because of the stenosis the nerves couldn’t send signals to her legs. Depending on the location and intensity of the spinal pressure, it can cause pain, numbness, weakness, and in severe cases bowel and bladder problems. In Moira’s case, it was on the L3-L5 levels, so multiple nerves were involved.”

For a less active patient, a life on pain medication might suffice, but not for Moira. She was adamant that she needed to return to her active lifestyle.

“Dr. Baaj was a nice guy — he didn’t talk down to me,” she says. “But doing what I do, he said I would have to have surgery. I already knew that, because I’d gone horseback riding. I can ride, but when I got off the horse and went up the stairs, I’d have to look down to see where my foot was!”

“I said to her, if you did not want to remain active, you’d be fine,” says Dr. Baaj. “In that situation, pain meds would do. But that’s not how she lives. Surgery could get her back to her active life. Though I really had to tell her — no more riding until after the surgery!”

The surgery, an L3-L5 laminectomy and fusion, was scheduled for the following week. A laminectomy reduces compression by removing the lamina, the part of the vertebra that covers the spinal canal and houses the spinal cord. A fusion was necessary as there was evidence of instability and significant degenerative disc and joint disease.

The procedure was performed on a Friday, bright and early, and it went off without a hitch. “They told me I was awake in recovery, which I don’t really remember,” says Moira. “I don’t remember much other than the nurses telling the porter that I had to be slid over. The nurses were so great!” Her recovery was quick: she was walking on Saturday, and on Monday — just three days after surgery — she went home.

“I’d never had surgery before,” Moira says. “But they told me what to do. By the time I got home, I was walking around Jones Beach and the boardwalk.” The first time she took a walk in August, she walked half a mile in an hour. Two weeks later, she started feeling things were getting better. “The only thing present was the pain from recovery,” Moira says. “But the pain I felt from the beginning, from the spinal stenosis, it was gone.”

By October she was doing five miles on the boardwalk. “At one point, an elderly man that I would see occasionally — he stopped me and said, ‘I’ve been watching you since you came in August! You could hardly move, and now look at you!’”

Two years after the surgery, Moira is feeling fine and back to tending to her dogs and their competitions. Professor that she is, she has her own guidance: “For anyone else going through this, I’d recommend you follow the directions the hospital staff tells you to do,” she says. “You have to go out and walk, and you have to be active. When I had the surgery, I lived in a three-story Victorian home. When my husband said he’d take care of everything, I said I’ll go to the second floor. I could climb the stairs.”

Now that her life is back to normal, she can plan for the future. “I’m looking forward to retiring soon and going full time with my dogs,” Moira says. “That, and just having the time to read!”

Learn more about Dr. Baaj