In Her Patients’ Shoes

Beth Karasin, APN-C, a nurse practitioner at Altair Health, has been caring for patients undergoing neurosurgical treatment for years. However, the tables turned when she found herself experiencing severe neck pain and personally in need of care.

“I’m used to being the caregiver, but I also became the patient when I began suffering from left side neck pain and headaches that were pretty unbearable,” Beth shares.

An MRI revealed Beth had cervical stenosis, which can cause the spinal canal to narrow and compress the nerves in the spine. Under the care of her colleague, Altair Health neurosurgeon and cervical neck specialist Jay Y. Chun, MD, PhD, she began a combination of physical therapy and oral steroids, which kept her active and in good shape for a few years.

“My symptoms were well controlled until about three years later,” Beth explains. “Just as my family and I were moving into a new home, the pain in my neck became severe, and I developed acute numbness, tingling and weakness in my left arm. Unfortunately, additional steroid treatment didn’t help, and I ended up in the emergency department.”

A new MRI of Beth’s cervical spine showed severely herniated discs and compressed nerves at the C5-C6 and C6-C7 levels of her spine.

“Having exhausted her options for conservative therapy, Beth was a prime candidate for a surgical procedure called Anterior Cervical Discectomy and Fusion (ACDF),” notes Dr. Chun, who is also director of the Atlantic Health Neuroscience Spine Center at Overlook Medical Center. “First, we removed the herniated discs in her cervical spine. We then filled those spaces with bone grafts to relieve nerve compression and secured them with a plate and screws to stabilize her spine.”

ACDF is one of the most common spine procedures in the U.S. More than 132,000 ACDF surgeries are performed each year.

Immediately following surgery, Beth’s pain and numbness began subsiding while her strength improved.

“If it’s any indication of how well the surgery went, Beth began asking me if she could come back to work at her two-week follow-up appointment,” Dr. Chun adds. “We gave her more time to heal and rest, but nine weeks after the procedure, she was back in action working, driving and keeping up with her three young kids.”

“The experience as a patient compared to a provider was really eye-opening for me,” Beth says. “I know the medical ins and outs of the procedure and have cared for many patients undergoing ACDF – but there’s something very different about living through the experience yourself. Now I tell my patients I truly know how they feel, and I can provide them even more personalized care.”

Beth is also sharing her experience and expertise to educate the nursing community. In March 2021, Beth and her colleague Monica Kleban, DNP, APN-C, a fellow nurse practitioner at Altair Health, authored a peer-reviewed article detailing nursing implications for patients undergoing ACDF, Beth’s case report and more. The piece, “Anterior Cervical Discectomy and Fusion: A Surgical Intervention for Treating Cervical Disc Disease,” was published in the AORN Journal, the award-winning journal of the Association of periOperative Registered Nurses.

This paper set the wheels in motion for a collaborative, ongoing publishing effort among the team of nurse practitioners at Altair Health. In addition to Beth and Monica, the publishing team includes Tara Hardinge, APN-C; Gina Rizzo, APN-C; Lauren Eskuchen, APN-C; Marissa Boyce, AGACNP-BC; and Johanna Watkinson, APN-C at Overlook Medical Center’s Neuro ICU. In six months, the group authored five peer-reviewed articles (two pending production) with perioperative insight on topics ranging from laparoscopic shunt placement to robotic brain and spine surgery. More pieces are now in the works.

“This has been a combination of us wanting to leverage the depth of our experience to help others in the field while staying at the forefront of best practices and innovative neurosurgical care,” explains Monica. “We examine dozens of the latest articles before landing on our topics and do an extensive amount of research as we draft our own pieces. At the end of the day, this collaboration among our team strengthens our ability to provide the very best care for our patients.”

Tara, who cared for Beth during and after her surgery, adds, “We’re not just co-workers. We’re family, and that extends to how we treat our patients as well. We have the privilege of caring for people who are often facing very serious medical issues, and we truly treat them like we would our own family members. With this bond – and our collective wealth of knowledge – we’re able to achieve some pretty incredible things.”