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North Shore institutetouts 1,000th surgery

By Howard Koplowitz

Paddock, 31, of Lexington, S.C., was the 1,000th person to undergo brain surgery to treat Chiari malformation, a condition where excess brain tissue pushes against the cerebellum and spinal cord, at North Shore University Hospital's Chiari Institute in Manhasset. Before the surgery, Paddock had headaches, which she described as feeling as if someone was repeatedly stabbing her head, was unable to feel her pinkies or ring fingers and had difficulty swallowing. She thought she had a brain tumor.In 2002, she had surgery to treat Chiari malformation in South Carolina, but her headaches and other problems, caused by the lack of flow of cerebrospinal fluid, returned shortly after the operation. She was told that the pain she was experiencing was all in her head. One neurologist even advised her to get pregnant and then her pain would subside, she said. Paddock was put on a myriad of drugs, she said, ranging from seizure Ðshe did not suffer from seizuresÐ to anti-anxiety medications. “Well, the problem was all in my head, just not psychologically,” Paddock quipped during the hospital's news conference Monday to announce the milestone. Refusing to believe what her doctors were telling her, Paddock discovered the Chiari Institute by searching the Internet. “I feel sorry for people who were brought up thinking that doctors are all-knowing,” she said, adding that her background as a former paramedic proved helpful in getting her a proper explanation for her symptoms.Her surgery at the Chiari Institute involved having a metal rod implanted around her skull using bolts and screws to provide more stability to her head and neck . It was performed earlier last month and she was released from the hospital just three days after the operation. She said she does not experience headaches anymore and plans to get work again as an EMT or go into patient care. An avid gardener, Paddock mentioned that she mowed her lawn for the first time yesterday since her surgery and added that being able to vacuum reaffirmed the success of her surgery. Paddock was unable to get the appropriate care for her condition in South Carolina partly because neurosurgeons there were not equipped with the technology that is used at the Chiari Institute, most notably color Doppler ultrasound monitoring, a technique that enables neurosurgeons to measure cerebrospinal fluid which ensures greater success of the operation. The Chiari Institute, under the direction of Dr. Thomas Milhorat, is the only such clinic of its kind in the nation. Dr. Paolo Bolognese, the institute's associate director, said that there are only 10 doctors who perform more than 20 Chiari malformation cases per year outside the institute, which has performed 1,000 surgeries. That workload is what helps the Chiari Institute better diagnose patients, Bolognese said. He mentioned that 58 percent of the institute's patients have already had an operation to treat Chiari malformation. “We take pride in being a place that is called upon to fix operations,” Milhorat said.”Doctors Milhorat and Bolognese are a rarity and North Shore is lucky to have them,” Paddock said.”We want to be able to do things that others strive to do but can't,” said Michael J. Dowling, president and CEO of North Shore-LIJ. “This is a great example of the way we can do it.” Reach reporter Howard Koplowitz by e-mail at news@timesledger.com or by phone at 718-229-0300, Ext. 173